Acute poisonings among adolescents and young adults with anorexia nervosa
A. D. Woolf and J. M. Gren
Program in Clinical Pharmacology/Toxicology, Children's Hospital, Boston, MA.
The diagnosis and management of acute poisoning episodes in adolescents and
young adults with anorexia nervosa are complicated by their underlying
psychopathologic conditions. We investigated 23 consecutive cases of
poisoning in 21 patients with anorexia nervosa reported to the
Massachusetts Poison Center, Boston, during a 13-month period. All were
intentional self-poisonings. Agents involved most often were
psychotherapeutic drugs, cathartics, and/or analgesics. Potentially
life-threatening drugs were often implicated in the poisoning. Diagnosis
was complicated by purposefully deceptive information from patients and the
presence of unsuspected toxins. Treatment was complicated by long delays to
presentation for medical care and by underlying metabolic abnormalities.
Decontamination efforts were complicated by the patients' prior use of
emetics and cathartics. Seventeen patients required hospitalization; 4
patients suffered a complicated hospital course and a fifth patient died.
