ArticleJournal of psychopharmacology (Oxford, England)2021
Beyond the 'purple drank': Study of promethazine abuse according to the European Medicines Agency adverse drug reaction reports.
Article in Journal of psychopharmacology (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- The Benzydamine Experience: A Systematic Review of Benzydamine Abuse.Current neuropharmacology · 2021Pooled it
- Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants.Frontiers in psychiatry · 2021Pooled it
- Expecting medication misuse: a proactive approach to drug discovery to prevent fatal overdose.Future medicinal chemistry · 2025Review
- Binding studies of promethazine and its metabolites with human serum albumin by high-performance affinity chromatography and molecular docking in the presence of codeine.Analytical and bioanalytical chemistry · 2024Article
- Codeine and promethazine: Exploratory study on "lean" or "sizzurp" using national survey data and an online forum.PloS one · 2024Article
- Development and Validation of a High-Performance Liquid Chromatography-Tandem Mass Spectrometry Method to Determine Promethazine and Its Metabolites in Edible Tissues of Swine.Foods (Basel, Switzerland) · 2023Article
- Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System.Drug safety · 2023Article
- Knowledge and Use of Over-the-counter Drugs in Italy: An Exploratory Survey-based Study in the General Population.Current neuropharmacology · 2023Article
- Lean/Sizzurp Ingredients, Use, and Coping With Mental Health Symptoms.Substance abuse : research and treatment · 2023Article
- Misuse of Over the Counter and Prescription Only Medication by Adults Accessing Specialist Treatment Services in the UK: A Narrative Synthesis.Substance abuse : research and treatment · 2022Article
- Editorial: Prescribing psychotropics: Misuse, abuse, dependence, withdrawal and addiction, Volume II.Frontiers in psychiatry · 2022Article
- Promethazine-induced delirium with perceptual abnormalities: are we thinking broadly when assessing patients?BMJ case reports · 2021Article
- Article
- Editorial: Prescribing Psychotropics: Misuse, Abuse, Dependence, Withdrawal and Addiction.Frontiers in psychiatry · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPromethazine is a medicinal product, available on its own or in combination with other ingredients including dextromethorphan, paracetamol and/or expectorants. Anecdotal reports have however indicated that promethazine may have a misuse potential, especially in adolescents.
objectiveWe here aimed at studying how this phenomenon has been reported to the European Monitoring Agency Adverse Drug Reactions database.
methodsAfter a formal request to the European Monitoring Agency, the promethazine-specific dataset has been studied, performing a descriptive analysis of misuse/abuse/dependence-related adverse drug reaction reports. The study was approved by the University of Hertfordshire (LMS/PGR/UH/03234).
resultsThe analysis of promethazine data showed increasing levels of misuse/abuse/ dependence issues over time (2003-2019). Out of a total number of 1543 cases of adverse drug reactions, the abuse/misuse/dependence-related cases reported were 557, with 'drug abuse' (300/557: 53.8%) and 'intentional product misuse' (117/557: 21.0%). being the most represented adverse drug reactions. A high number of fatalities were described (310/557: 55.6%), mostly recorded as 'drug toxicity/drug abuse' cases, with opiates/opioids having been the most commonly reported concomitant drugs used.
conclusionAnecdotal promethazine misuse/abuse reports have been confirmed by European Monitoring Agency data. Promethazine misuse/abuse appears to be an alarming issue, being associated with drug-related fatalities. Thus, healthcare professionals should be warned about a possible misuse of promethazine and be vigilant, as in some countries medicinal products containing promethazine can be purchased over the counter. Since promethazine is often available in association with opioids, its abuse may be considered a public health issue, with huge implications for clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.