Letter: Antidote to paracetamol

Antidote to paracetamol

Sir: As a doctor working in accident and emergency, paracetamol overdoses are the bread and butter of my weekends, along with drunks and sprained ankles. As Dr Geoffrey Brandon says (Letters, 7 October), the vast majority do not come to any lasting harm. This is often by luck alone.

Those who overdose feel perfectly well for 48 hours or so. After this time, it is too late to give the antidote effectively - the harm to the liver has been done, and may be irreversible if it is severe enough. We need an education programme to encourage "impulsive" overdosers to seek advice during this period, assuming that they have decided they do not want to die.

For reasons I can only guess at, inclusion of the oral antidote, methionine, will never catch on. A simpler measure would be to sell paracetamol only in packs of eight (the maximum safe daily dosage) rather than hundreds at a time. Of course, people could trail round several shops or pharmacies and pick up enough to harm themselves, but it might deter impulsive cases. of self-harm

As Dr Brandon says, they might "simply overdose on something else". Those intent on harming themselves will always find a way. But should this really deter us from attempting to tighten up paracetamol?

Dr ED WALKER

Sheffield