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

handle is hein.journals/mdsclw15 and id is 1 raw text is: 


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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