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15 Med. Sci. & L. 1 (1975)

handle is hein.journals/mdsclw15 and id is 1 raw text is: Editorial Almost every year an average of five children under fourteen years of age succeed in taking their own lives, either as a result of coal gas, hanging or drug overdoses. Possibly one in two will have already threatened suicide and a sizeable minority have friends, schoolmates or parents who have already been successful in suicidal attempts. During 1962 to 1968 thirty children killed themselves, all under fourteen but over twelve years old. More boys than girls killed themselves; the girls preferring death by drugs, whilst the boys hanged themselves. In the problem with regard to the boys one must exclude in many cases the sexual asphyxias. Because child suicide is so rare, one is reluctant to draw any conclusions from any study that has so far been done, but one must obviously take suicidal behaviour seriously, even in the young child around puberty, who might even merely threaten to kill himself or herself. The considerable medical, social and legal importance of drug interactions with alcohol makes it essential that patients are correctly advised of any possibility that might occur. The most important of such drug interactions are those with other drugs acting on the central nervous system, but the metabolism of drugs of other groups may occasionally be affected by the rapid consumption of alcohol, even when the total amount taken is not large. It is well recognized that alcohol is a central nervous system depressant and pati- ents receiving other central nervous system depressant drugs, such as barbiturates or analgesics, antihistamines, anticonvulsants, hypnotics and tranquillizers, should always be told that side effects, such as drowsiness, ataxia and impaired judgement, may occur and that these effects may be potentiated to the extent of causing coma when alcohol is taken. In particular it is very important to warn patients who drive or who operate dangerous machinery of this possibility. On the other hand, those who are treated with tricyclic antidepressants on taking alcohol may show both unusual and unex- pected behavioural disorders, particularly during the first few days of the antidepressant therapy. On the other hand, hypertensive episodes have been reported following the consumption of alcoholic drinks by patients treated with monoamine oxidase inhibitors, probably due to an interaction between the monoamine oxidase inhibitor and amines (for example, tyramine) present in wines such as Chianti, rather than to a direct drug alcohol interaction. The consumption of alcohol in doses sufficient to cause mild intoxication may delay the elimination of other drugs given at the same time and potentiate the interaction. This has been shown to occur with barbiturates and meprobamate. There have been some dramatic advances in the quality and actions of new and improved drugs. The medical practitioner now has a wide range of effective antibiotics with which he can treat and manage the common bacterial infections that he sees. The explosion of available psychotrophic drugs has made the treatment of emotional dis- orders, and in particular the psychoses and depressions, more effective, but still difficult. 'The pill' has created a revolution in planned control of pregnancy and corticosteroids have exerted their influence in many ways. The past generation has seen the growth of a more permissive society with all its

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