Co-proxamol and suicide: preventing the continuing toll of overdose deaths

QJM : Monthly Journal of the Association of Physicians
Sue SimkinNavneet Kapur


Restricting means for suicide is a key element in suicide prevention strategies of all countries where these have been introduced. Preventing deaths from analgesic overdoses is highlighted in the National Suicide Prevention Strategy for England. The problem of self-poisoning with the prescription-only drug co-proxamol (dextropropoxyphene plus paracetamol) has received attention in several countries. We have conducted a review of the international literature related to possible strategies to tackle this problem. In England and Wales in 1997-1999, 18% of drug-related suicides involved co-proxamol; these constituted 5% of all suicides. Death usually results from the toxic effects of dextropropoxyphene on respiration or cardiac function. Death from co-proxamol overdose may occur rapidly, the lethal dose can be relatively low, and the effects are potentiated by alcohol and other CNS depressants. The majority of co-proxamol overdose deaths occur before hospital treatment can be received. The risk can extend to others in the household of the person for whom the drug is prescribed. While there is limited evidence that educational strategies have been effective in reducing deaths from co-proxamol poisoning, initiatives in Scandinavia, A...Continue Reading


Mar 12, 1977·British Medical Journal
Jul 16, 1977·British Medical Journal·R M Whittington
Aug 1, 1977·Southern Medical Journal·P HudsonA J McBay
Jun 1, 1976·British Journal of Preventive & Social Medicine·N Kreitman
Jan 1, 1992·International Journal of Legal Medicine·E Kaa, M Gregersen
Feb 1, 1989·Forensic Science International : Synergy·P Theilade
Jan 1, 1989·Zeitschrift für Rechtsmedizin. Journal of legal medicine·E Kaa, J B Dalgaard
Apr 28, 1986·The Medical Journal of Australia·C HardwickeA J Smith
Sep 1, 1988·Journal - Forensic Science Society·B TeigeA Bugge
Nov 1, 1987·Medical Toxicology and Adverse Drug Experience·A A Lawson, D B Northridge
May 1, 1987·Human Toxicology·E Segest
Dec 1, 1987·American Journal of Public Health·S B SoumeraiS Hawley
Aug 1, 1984·Human Toxicology·R M Whittington
Aug 1, 1984·Human Toxicology·A T Proudfoot
Dec 1, 1984·Acta Anaesthesiologica Scandinavica·P Sloth MadsenM Bredgaard Sørensen
Apr 17, 1982·British Medical Journal·R M Whittington
Aug 1, 1981·Clinical Toxicology·G SangsterA A Lawson
Dec 1, 1981·Journal of Clinical and Hospital Pharmacy·R M Whittington, A D Barclay
Apr 12, 1980·British Medical Journal·R J Young, A A Lawson
Sep 1, 1980·Southern Medical Journal·C V Wetli, L R Bednarczyk
Sep 6, 1980·British Medical Journal·G M ShenfieldJ W Paterson
Jan 21, 1995·BMJ : British Medical Journal·Keith HawtonH Weitzel
Jan 1, 1994·International Journal of Legal Medicine·J O ObafunwaA M al-Oqleh
Jan 1, 1993·Acta Psychiatrica Scandinavica. Supplementum·P Crome
Jun 29, 1996·Lancet·V Murlidhar, G Upmanyu
Jun 29, 1996·Lancet·S Haigh
Jul 1, 1996·The British Journal of Psychiatry : the Journal of Mental Science·A OhbergJ Lonngvist
Dec 1, 1996·The Australian and New Zealand Journal of Psychiatry·G M Dore
Jun 26, 1998·BMJ : British Medical Journal·G W Hanks, K Forbes
Jun 26, 1998·BMJ : British Medical Journal·S HoustonK C Kain
Dec 17, 1998·Forensic Science International : Synergy·U JonassonT Saldeen
Dec 17, 1998·Forensic Science International : Synergy·B JonassonT Saldeen
Jan 6, 2000·The British Journal of Psychiatry : the Journal of Mental Science·I Chalmers
Sep 6, 2000·British Journal of Clinical Pharmacology·P B SalbachI Walter-Sack
Jul 19, 2001·Psychological Medicine·T AmosK Kiernan
Dec 4, 2001·Forensic Science International : Synergy·A SteentoftE Kaa
May 14, 2003·BMJ : British Medical Journal·Keith HawtonJonathan Deeks
Aug 5, 2003·BMJ : British Medical Journal·D N Bateman, R Afshari


Aug 4, 2009·Fundamental & Clinical Pharmacology·Khalid A J Al KhajaReginald P Sequeira
Jun 2, 2016·PloS One·Nikita VancayseeleKees van Heeringen
Aug 12, 2006·Cyberpsychology & Behavior : the Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society·Fabrizio SchifanoAlex Baldacchino
May 3, 2019·PloS One·Nikita VancayseeleKees van Heeringen
Mar 8, 2019·International Journal of Environmental Research and Public Health·Louise BrådvikMats Berglund

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