In the differential diagnosis of overdose in adults, common substances to consider include analgesics such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), sedative-hypnotics including benzodiazepines and barbiturates, opioids, antidepressants (particularly tricyclic antidepressants), antipsychotics, cardiovascular drugs like beta-blockers and calcium channel blockers, and substances of abuse such as alcohol and recreational drugs (e.g., cocaine, amphetamines) NICE CG89. Additionally, toxic alcohols (methanol, ethylene glycol), heavy metals, and household chemicals should be considered depending on the clinical context Olson et al. 1987. The clinical presentation often guides the suspicion of specific agents, but a broad consideration of these common substances is essential for accurate diagnosis and management Khan 2018.
Key substances to consider include:
- Paracetamol and NSAIDs
- Benzodiazepines and barbiturates
- Opioids
- Tricyclic antidepressants and other antidepressants
- Antipsychotics
- Cardiovascular drugs (beta-blockers, calcium channel blockers)
- Alcohol and recreational drugs (cocaine, amphetamines)
- Toxic alcohols and household chemicals
These substances are frequently implicated in overdose cases and should be systematically considered during assessment to guide appropriate investigations and treatment NICE CG89 Olson et al. 1987Khan 2018.
Key References
- CG89 - Child maltreatment: when to suspect maltreatment in under 18s
- CG120 - Coexisting severe mental illness (psychosis) and substance misuse: assessment and management in healthcare settings
- CG52 - Drug misuse in over 16s: opioid detoxification
- (Olson et al., 1987): Physical assessment and differential diagnosis of the poisoned patient.
- (Khan, 2018): Differential Diagnosis of Common Acute Toxicologic Versus Nontoxicologic Illness.