Analysis shows ‘worrisome’ increase in drug-related poisoning among children

Key takeaways:

• Study results show a 5% yearly increase in seizures from substances or medications in youth from 2009 to 2023.
• Diphenhydramine and bupropion ranked as among the most frequently reported substances in seizure cases.

Seizures caused by swallowing medications or illegal substances among youth have significantly risen over the past 15 years, data presented at the European Emergency Medicine Congress showed.

“Seizure is one of the most severe symptoms a poisoned patient can experience, and children are particularly vulnerable,” Connor T. McDonald, MD, from the University of Virginia School of Medicine, said in a press release. “Depending on variables such as where a seizure happens, how long it continues and the pre-existing health of the child, seizures can lead to long-term damage or even death.”

Healio previously reported that drug poisoning fatalities in children rose by 133.9% between 2011 and 2021. During that same time period, this group experienced a 9.9% increase in poison-related injuries.

McDonald and colleagues used National Poison Data System data on seizures that occurred in children and adolescents under the age of 20 years from Jan. 1, 2009, to Dec. 31, 2023.

They assessed single and multiple seizures, status epilepticus and changes in the most frequently reported substances.

The investigation showed 30,985 cases of seizure — 1,712 with status epilepticus — reported to poison centers during the study period.

McDonald and colleagues found that the number of seizure cases rose from 1,418 in 2009 to 2,749 in 2023, for an average annual increase of 5%.

The number of seizures doubled among those aged 6 to 12 years and 13 to 19 years during the 15-year period, for a 6% yearly increase.

Children under the age of 6 years experienced a 45% increase in seizures, corresponding to a 3% annual increase.

The researchers identified that diphenhydramine was a significant driver behind the findings. Seizures related to the antihistamine, typically used for hay fever and allergies, increased from 85 cases in 2009 to 404 cases in 2023.

Meanwhile, bupropion-related seizures increased from 162 cases in 2013 to 431 cases in 2023.

“Diphenhydramine can be purchased in the United States in bottles containing 500 or 600 tablets,” McDonald explained. “Bupropion is being more frequently prescribed to treat depression in adults and children. Other legal and illegal drugs can be bought online and shipped around the world. Therefore, these drugs are becoming more available in homes and within the reach of children.”

Tramadol and diphenhydramine comprised the first and second most frequently reported substances in seizure cases related to a single substance every year between 2009 and 2012.

Bupropion followed by diphenhydramine ranked as the most frequently reported substances in every year between 2013 and 2023.

McDonald and colleagues added that bupropion, diphenhydramine, synthetic cannabinoids and amphetamines serve as the most frequently reported substances in status epilepticus.

“The increase in drug poisoning among children is worrisome,” Barbra Backus, PhD, chair of the European Society for Emergency Medicine abstract selection committee, said in the release. “It is important that we keep looking for safer distribution and storage of medication. Blister packs and child-resistant pill bottles can help, but all drugs, whether they are over the counter, prescribed, or illegal should be kept out of reach or locked away where children cannot access them.”

References:

• Farah R, et al. Seizures in single substance pediatric exposures: Analysis from the United States National Poison Data System. Presented at: European Emergency Medicine Congress, Oct. 12-16, 2024; Copenhagen, Denmark.
• Press release: Seizures caused by children swallowing medications or illegal substances doubled over 15-year period. Available at: https://www.eusem.org/news/983-press-release-seizures-caused-by-children-swallowing-medications-or-illegal-substances-doubled-over-15-year-period. Published Oct. 15, 2024. Accessed Oct. 28, 2024.