Barbiturate automatism—myth or malady?

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Abstract
Patients admitted to the Regional Poisoning Treatment Centre at the Royal Infirmary, Edinburgh, were assessed to identify cases of drug automatism and those who denied the act of self-poisoning. Only two out of 994 instances of poisoning could be attributed to barbiturate automatism. The case histories of these patients are reported. Twenty-nine patients on thirty-one admissions denied the act of self-poisoning and clinical data on this sample are reviewed. It is suggested that there is insufficient evidence for accepting barbiturate automatism as a clinical entity and that the failure of these patients to remember the ingestion of more than a therapeutic dose is the result of psychogenic defence mechanisms. It is concluded that the use of the term automatism contributes nothing to the management of patients poisoned with these drugs.

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