The clinical value of drug analyses in deliberate self-poisoning

1. In a prospective, unselective study of self-poisoned patients in 1978 and 1987 blood samples for drug analyses were drawn on admission in 265 and 400 cases, respectively. 2. The results from the drug analyses were compared with the clinical information obtained on admission. The main drug taken was identified on admission in 228 (86%) in 1978 and in 383 cases (96%) in 1987 (P less than 0.001). 3. The clinical impression was completely in accordance with the results from the drug analyses in 192 cases (72%) in 1978 and 232 cases (58%) cases in 1987 (P less than 0.001). The discrepancies mainly involved secondary drugs. 4. There was no significant difference in the clinical course of the poisonings in situations where the correct main drug was identified on admission and where the wrong main drug was suspected. 5. Knowledge of the correct drugs used when admitted would not have prevented complications or deaths. 6. We conclude that extensive pharmacological drug analyses play a limited role in the routine management of patients admitted for deliberate self-poisoning.