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The problem of propranolol poisoning.
Hayley Williams1, Pardeep Jagpal1, Euan Sandilands2
1National Poisons Information Service, (Birmingham Unit), Birmingham, UK.
British Journal of Clinical Pharmacology
|July 4, 2025
Summary
Intentional propranolol overdose is a serious risk, often linked to anxiety treatment. Many patients experience severe toxicity and fatalities, highlighting the need for safer prescribing practices.
Area of Science:
- Pharmacology
- Clinical Toxicology
- Public Health
Background:
- Propranolol is prescribed for anxiety symptoms.
- Propranolol overdose can lead to severe, life-threatening poisoning.
- This study aims to increase awareness of propranolol overdose risks.
Purpose of the Study:
- To describe intentional propranolol overdose cases reported to UK Poison Centres.
- To highlight the potential for serious harm and fatalities.
- To support safer prescribing of propranolol, especially for anxiety.
Main Methods:
- Review of enquiries to UK Poison Centres regarding intentional propranolol overdoses.
- Inclusion of cases requiring hospital attendance.
- Data collected between January 1, 2022, and December 31, 2023.
Main Results:
- 444 enquiries concerning 363 intentional overdoses in 359 patients.
- Anxiety was the indication in 111 cases; co-ingestion with antidepressants was common.
- Of 159 confirmed outcomes, 35 patients died, indicating significant mortality.
Conclusions:
- Propranolol overdose, frequently associated with anxiety treatment, results in systemic toxicity.
- Fatalities occur despite intensive care, emphasizing the drug's danger in overdose.
- Primary care prescribers must recognize the risks of using propranolol for anxiety management.
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