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Introduction and purpose: Drug poisoning is one of the more common reasons for patients being hospitalized in toxicology wards. The wide availability and ease of obtaining a wide variety of drugs and supplements are the cause of adverse reactions associated with their use. Increasing life expectancy and emerging chronic diseases also require the use of sometimes many drugs to control people's health. This can lead to poly-pragmasy, which is an undesirable condition and leads to poisoning. The purpose of our work is to demonstrate the most common causes of drug poisoning considering the criterion of division according to ICD-10. Brief description of the state of knowledge: Any preparation, drug, supplement can cause negative effects on the organism. This depends on the dose, improper use, or cross-reactions of the relevant substances. The study compiled statistics on the cause of hospitalization of drug-poisoned patients based on ICD-10. 5433 patients were included in the study. Conclusions: Our work shows that the most common causes of hospitalization due to drug poisoning are those caused by antiepileptic drugs, sedative-hypnotics and antiparkinsonism medications. The data compiled in this article agree with scientific reports from different countries compiling the most common reason for hospitalization related to drug poisoning.

INTRODUCTION: Sodium valproate is one of the most important antiepileptic drugs. It can be effective as a preventive treatment for migraine, it has also found use in the maintenance treatment of bipolar disorder and acute mania,it is sometimes used in the treatment of chronic neuropathic pain and fibromyalgia, in the treatment of schizophrenia borderline personality disorder and acquired brain injury, this drug is used off-label. Its overdose can be fatal. MATERIALS AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on sodium valproate treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE REPORT: A 57-year-old patient with a history of depressive disorders was admitted to the Clinical Department of Toxicology and Cardiology in Lublin for intentional intoxication with the drug Absenor (sodium valproate). The patient had taken 3 packages of Absenor 500 mg (300 tablets in total) for suicidal purposes. The determined concentration of valproic acid was 841 µg/ml, and the patient's condition was very severe. Despite the treatment administered-multiple attempts at gastric lavage, administration of activated charcoal, performance of hemodialysis procedures, administration of infusion of catecholamines, the patient died on the fifth day of hospitalization. CONCLUSION: An overdose of sodium valproate can be fatal. Keep this in mind when ordering this drug for patients with a positive history of suicide attempts.

INTRODUCTION: Despite medical developments, drug poisoning still occurs. Lithium is a drug that has been used for more than 60 years as a mood stabilizer in the treatment and prevention of bipolar disorder, mania and recurrent depression. Lithium is the most commonly prescribed mood stabilizer. It has a narrow therapeutic index. Its target concentration in acute mania should be 0.6-1.5 mEq/L and 0.6-0.8 mEq/L for maintenance therapy. Because of this, there is a risk of lithium intoxication. We would like to present to you the case of a patient with chronic lithium poisoning. MATERIALS AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on lithium treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE REPORT: The patient, 58, was referred for lithium poisoning and admitted to the Clinical Toxicology and Cardiology Department in Lublin for treatment. The patient had a previous diagnosis of bipolar affective disorder, hypertension and obesity. According to the history, the patient was admitted to the psychiatric ward due to deterioration of her mental state for a month. She was found to have a high lithium level -2.98 mmol/L and elevated renal function parameters-creatinine 2.13 mg/dl. During treatment with hemodialysis, these parameters returned to normal. CONCLUSION: It is important to remember that lithium has a narrow therapeutic range. Attention should be paid during lithium treatment to situations that increase the risk of adverse effects and the development of toxicity, and serum lithium concentrations should be monitored during treatment.

Introduction Despite developing strategies for treatment of people with schizophrenia, earlier mortality rate is still observed in this group of patients. One of the major causes remains suicides due to drug overdose. Main approach to the treatment of schizophrenia is pharmacotherapy that is based on antipsychotics. Yet, in order to sustain patients well being, medicaments from other groups may be introduced. Pharmacological treatment should be accompanied by psychotherapy to prevent suicidal attempts. Case report A 28 years old woman diagnosed with paranoid schizophrenia was brought by the ambulance and admitted to the Clinical Toxicology Department due to deliberate drug overdose. Her history indicated previous suicidal attempt. A patient took all her psychiatric medications that included 240 tablets of quetiapine (Ketrel a 200 mg), 100 tablets of zuclopenthixol (Clopixol a 25 mg), 100 tables of chlorprotixen, several tablets of escitalopram (Aciprex) and 12 tablets of bisoprolol (Bibloc a 5 mg) - in summary around 470 tablets. This suicidal attempt was probably the cause of abrupt drugs withdrawal after discharge from recent hospitalization in psychiatric department. Complications involved allo- and autodisorientation, enhancement of imperative auditory hallucinations and psychotic symptoms, respiratory failure and aspiration pneumonia. After admission, intensive symptomatic treatment was introduced in order to sustain living functions of the patients. Due to respiratory failure, she was in need of external mechanical ventilation. The end of hospitalization was followed by implementation of new drug (perazine) and transportation to Neuropsychiatric hospital for further diagnosis and treatment. Conclusion Process of pharmacotherapy in case of patients with schizophrenia should be continuously and precisely monitored by psychiatrists. Such control would minimize the chance of suicidal attempt. What is more, patient should not limit the therapy to drugs and psychiatric appointments, but also should attend to community health services.

Introduction Suicidal risk caused by drug overdose is a considerable factor influencing earlier mortality among people with schizophrenia. An adjustment of effective pharmacological treatment is essential to sustain the stability of the patient. Commonly, the treatment divides to two groups: first generation antipsychotics (FGA) and second-generation antipsychotics (SGA). Yet, due to significant risk of depression and possible side effects of the drugs, other medicaments should also be introduced. Case report A 38 years old woman that was repeatedly hospitalized at the local ward, brought by ambulance and admitted to the Clinical Toxicology Department. She was admitted to the department for 20th time in period between April 2013 and May 2019 due to deliberate drug overdoses. During last hospitalization laboratory tests indicated presence of valproic acid (121,41 μg/ml). Moreover, psychiatric consultation revealed that although she was balanced state, she was not critical about her behavior. Patient was diagnosed with schizophrenia and mild intellectual disability. Each time, the intoxication was followed by medications from group of antipsychotics and tranquilizers used in treatment of the illness. Additionally, she confirmed that some of intoxications had suicidal attempt. 60% of hospitalizations of the patient were followed by stay in Neuropsychiatric hospital for further observation and treatment. Conclusion The administration of proper dosage of antipsychotics should be precisely controlled by the psychiatrist that takes care of the patient. For patients with greater suicidal risk, SGA are more recommended than FGA. Moreover, drugs from other groups such as antidepressants should also be introduced. Undoubtedly, efficient pharmacological treatment should be supported by psychotherapy of the patient.