Beta Blocker Intoxications in Belgium: A Data Analysis with Focus on Propranolol

TL;DR

This study examines beta blocker poisonings in Belgium, finding that propranolol is overrepresented in overdoses, especially among women and those with mental health conditions.

Contribution

The study uniquely integrates prescription, poisoning, and adverse drug reaction data to analyze propranolol's toxicological profile.

Findings

Propranolol is disproportionately involved in self-harm overdoses compared to its prescription rates.

Poisonings often occur in women, younger individuals, and those with psychiatric or cardiovascular conditions.

Propranolol is frequently co-ingested with benzodiazepines and antidepressants, leading to complex intoxication patterns.

Abstract

Background: The issue of beta blocker poisoning has received little attention, despite the widespread use of these compounds in cardiac and neuropsychiatric care. Safety profiles differ, and some beta blockers appear in poisonings far beyond what their usage rates imply. This study characterizes beta blocker intoxication patterns in Belgium, focusing on propranolol, by integrating national prescription data, poisoning reports, and adverse drug reaction records. Methods: Belgian prescription data, poison centre reports, and European ADR databases were analysed to identify intoxication patterns and demographic or clinical characteristics associated with these events. Results: Poisoning data revealed propranolol as markedly overrepresented compared to prescription rates and was the primary beta blocker implicated in self-harm-related overdoses. These cases occurred mainly in women, younger individuals, and patients with psychiatric or cardiovascular comorbidities. Co-exposures with benzodiazepines, antidepressants, and other psychoactive agents were frequent, and propranolol was linked to more complex intoxication patterns than other beta blockers. Conclusions: Propranolol shows a distinct toxicological profile and is disproportionately involved in intoxications, especially in vulnerable groups and in combination with psychoactive drugs. These findings highlight the need for greater awareness, targeted prevention, and careful monitoring.

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