Promethazine overdose: is it a "Goodnight" after all?
OBJECTIVE
To evaluate and describe the perceived increase in number of promethazine overdoses presenting to Auckland Hospital Emergency Department since Goodnight became available in New Zealand.


METHODS
Emergency Department records were reviewed for 19.5 months from 19 December 1994 (when Goodnight became available on the New Zealand market) until 31 July 1996. The Emergency Department database for the preceding years dating back to 1 January 1984 was reviewed.


RESULTS
There were a total of 25 patients (18 female; 7 male) with 17 patients being between the ages of 15-25. The first cases presented in April 1995 and 15 cases (60%) presented during the 1996 period of the study. Fifteen patients (60%) ingested one or more full boxes of Goodnight. Twelve patients (48%) were admitted to intensive care, eight of whom were intubated. Fifteen patients were discharged from hospital in under 24 hours, but five (20%) stayed 2-3 days. Records dating back to 1 January 1984 revealed a total of 31 cases of promethazine overdose in just under 11 years, nine being accidental ingestion in children less than 5 years of age.


CONCLUSIONS
This review highlights the high morbidity and cost of having promethazine available as an unrestricted, pharmacy--only medication. It suggests that marketing laws should be reviewed and the availability of promethazine be curtailed.
Auckland Hospital.
J
J
Bergman
P
P
Wallman
D000293:Adolescent; D000328:Adult; D000329:Advertising; D004345:Drug Industry; D062787:Drug Overdose / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011398:Promethazine / Q000506:poisoning*
D006993:Hypnotics and Sedatives; D011398:Promethazine