{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:54:34Z","timestamp":1790787274562,"version":"4.1.0"},"reference-count":17,"publisher":"BMJ","issue":"7397","license":[{"start":{"date-parts":[[2003,5,10]],"date-time":"2003-05-10T00:00:00Z","timestamp":1052524800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2003,3,5]]},"published-print":{"date-parts":[[2003,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    To examine the incidence of suicides due to co-proxamol compared with tricyclic antidepressants and paracetamol, and to compare fatality rates for self poisonings with these drugs.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Analysis of routinely collected national and local data on suicides and self poisonings.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Records of suicides in England and Wales 1997-9; non-fatal self poisonings in Oxford District 1997-9.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Data sources:<\/jats:bold>\n                    Office for National Statistics and Oxford monitoring system for attempted suicide.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures:<\/jats:bold>\n                    Incidence of suicides with co-proxamol or tricyclic antidepressants or paracetamol. Ratios of fatal to non-fatal self poisonings.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Co-proxamol alone accounted for 5% of all suicides. Of 4162 drug related suicides, 18% (766) involved co-proxamol alone, 22% (927) tricyclic antidepressants alone, and 9% (368) paracetamol alone. A higher proportion of suicides in the 10-24 year age group were due to co-proxamol than in the other age groups. The odds of dying after overdose with co-proxamol was 2.3 times (95% confidence interval 2.1 to 2.5) that for tricyclic antidepressants and 28.1 times (24.9 to 32.9) that for paracetamol.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Self poisoning with co-proxamol is particularly dangerous and contributes substantially to drug related suicides. Restricting availability of co-proxamol could have an important role in suicide prevention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text position=\"float\">\n                      <jats:sec>\n                        <jats:title>What is already known on this topic<\/jats:title>\n                        <jats:p>Co-proxamol is dangerous in overdose<\/jats:p>\n                        <jats:p>Restricting availability of specific means of suicide can reduce deaths<\/jats:p>\n                      <\/jats:sec>\n                      <jats:sec>\n                        <jats:title>What this study adds<\/jats:title>\n                        <jats:p>Fatal overdoses due to co-proxamol are the second most frequent means of suicide with prescribed drugs in England and Wales<\/jats:p>\n                        <jats:p>The risk of death associated with co-proxamol overdose seems to be higher than for either tricyclic antidepressants or paracetamol<\/jats:p>\n                      <\/jats:sec>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1136\/bmj.326.7397.1006","type":"journal-article","created":{"date-parts":[[2003,5,8]],"date-time":"2003-05-08T18:45:44Z","timestamp":1052419544000},"page":"1006-1008","source":"Crossref","is-referenced-by-count":64,"title":["Co-proxamol and suicide: a study of national mortality statistics and local non-fatal self poisonings"],"prefix":"10.1136","volume":"326","author":[{"given":"Keith","family":"Hawton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Simkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Deeks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2003,5,10]]},"reference":[{"key":"2025122211074908000_326.7397.1006.1","unstructured":"Department of Health . 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