"Superwarfarin" ingestion. A new problem in covert anticoagulant overdose.
For the attention of psychiatric consultants, brodifacoum, a new longer-acting, warfarin-like oral anticoagulant rodenticide, has been used for suicide attempts. The overdose potential with brodifacoum is serious since it is readily available without prescription, and bleeding complications last for weeks to months after a single ingestion. This article reports a case of ingestion and reviews four similar cases from medical literature. Also reviewed are details about mechanism of action, procedures for diagnosis, and treatment requirements. Also, characteristics of persons who ingest long-acting anticoagulants appear to differ from those who ingest short-acting anticoagulants reported from earlier literature.
Department of Psychiatry, University of Medicine and Dentistry, Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019.
M E
ME
Swigar
L P
LP
Clemow
P
P
Saidi
H C
HC
Kim
D015110:4-Hydroxycoumarins / Q000506:poisoning*; D000925:Anticoagulants; D005162:Factitious Disorders / Q000175:diagnosis* / Q000523:psychology; D006474:Hemorrhagic Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012378:Rodenticides; D013406:Suicide, Attempted / Q000523:psychology; D014812:Vitamin K / Q000037:antagonists & inhibitors
D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D012378:Rodenticides; D014812:Vitamin K; C013418:bromfenacoum