Evidence map›Paper›PMID 40611599›Full record

ArticleBritish journal of clinical pharmacology2025

The problem of propranolol poisoning.

Hayley Williams, Pardeep Jagpal, Euan Sandilands, Emma Morrison, Laurence Gray, Harry Krishna Ruben Thanacoody, Elisha Beg, Sally Bradberry, Robin Ferner

Abstract read
In one paragraph

Article in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. The problem of propranolol poisoning.British journal of clinical pharmacology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hayley WilliamsNational Poisons Information Service, (Birmingham Unit), Birmingham, UK.
Pardeep JagpalNational Poisons Information Service, (Birmingham Unit), Birmingham, UK.ORCID https://orcid.org/0000-0002-6869-9482
Euan SandilandsNational Poisons Information Service, (Edinburgh Unit), Edinburgh, UK.
Emma MorrisonNational Poisons Information Service, (Edinburgh Unit), Edinburgh, UK.
Laurence GrayNational Poisons Information Service, (Cardiff Unit), Cardiff, UK.
Harry Krishna Ruben ThanacoodyNational Poisons Information Service, (Newcastle Unit), Newcastle, UK.
Elisha BegChurch Street Medical Practice, Oxfordshire Clinical Commissioning Group, Oxford, UK.
Sally BradberryNational Poisons Information Service, (Birmingham Unit), Birmingham, UK.
Robin FernerNational Poisons Information Service, (Birmingham Unit), Birmingham, UK.ORCID https://orcid.org/0000-0003-3769-1346

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPropranolol is licensed in the UK and elsewhere to relieve symptoms of anxiety. In overdose, propranolol poisoning can be serious, difficult to treat and potentially fatal. This paper describes cases of intentional propranolol overdose reported to the UK National Poisons Information Service in order to raise awareness of the risk of harm following propranolol overdose and support safer prescribing.

methodsThis study reviews enquiries to UK Poison Centres involving intentional overdoses of propranolol requiring hospital attendance and reported between 1 January 2022 and 31 December 2023.

resultsThere were 444 enquiries about 363 intentional propranolol overdoses in 359 different patients (248 [69%] women). Median age [interquartile range, IQR] was 32 [22-45] years (n = 355); 52 (14%) patients were <18 years old. The indication was known in 121 (33%) cases, and was anxiety in 111. In 43/61 cases where propranolol and an antidepressant were co-prescribed, patients took both in overdose. The outcome was confirmed in 159 (44%) exposures; 110 patients recovered completely, 13 had ongoing features, one had permanent sequelae, and 35 died.

conclusionsOverdose patients were often prescribed propranolol for anxiety, and many developed systemic toxicity. Despite intensive treatment, many patients still die from poisoning with propranolol alone or in combination with other agents. Given the dangers of propranolol in overdose, prescribers based in primary care settings should recognize that using propranolol to manage anxiety can be dangerous.

Indexed as

Adrenergic beta-AntagonistsAnti-Anxiety AgentsDrug OverdosePropranololAdolescentAdultAnxietyFemaleHumansMaleMiddle AgedPoison Control CentersUnited KingdomYoung AdultAdrenergic beta-AntagonistsAnti-Anxiety AgentsPropranololanxietyoverdoseprescribingprimary carepropranolol

Identifiers

PMID40611599
PMCPMC12569547

What OpenQuestion holds

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Registered trials

None linked

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.