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CASE REPORT
Not so patchy story of attempted suicide…leading to 24 hours of deep sleep and survival!
  1. Adam Joseph Trist1,
  2. Hardeep Sahota1,
  3. Lucy Williams2
  1. 1Faculty of Health Sciences, University of Bristol, Bristol, UK
  2. 2Great Western Hospitals NHS Foundation Trust, Swindon, UK
  1. Correspondence to Adam Joseph Trist, at13365{at}my.bristol.ac.uk

Summary

Here, we present a somewhat unusual suicide attempt where, despite an unbelievable overdose with transdermal fentanyl patches, the patient survived. The patient—a woman aged 70 years, who has suffered from chronic back pain despite starting transdermal fentanyl patches in 2007. The unconventional method of attempted suicide was based on online research into deaths from fentanyl patch toxicity. She had gradually accumulated 100 µg fentanyl patches from repeat prescriptions, applying 14 patches with fatal intent, alongside 2 45 mg mirtazapine tablets, and concurrent therapeutic doses of tramadol and morphine sulfate oral solution. However, after 24 hours, she awoke from a deep sleep to the sound of the telephone ringing, somewhat amazed her drastic efforts had failed. During admission to Great Western hospital, she was seen by liaison psychiatry and subsequently transferred to the care of the pain management team, to which she had already been referred.

https://doi.org/10.1136/bcr-2016-217231

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    Footnotes

    • Contributors AJT (medical student), HS (medical student) and LW (Associate Specialist, Pain team Great Western Hospital) have made substantial contributions to the conception of this case report, including acquisition and writing of the patient's medical history, and formulating a discussion including literature that relates to the case presented here. All authors have helped to plan and draft the work and revised it critically for important intellectual content, and have given approval of this final version to be published. All authors are in agreement to be accountable for all aspects of the work in ensuring any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. LW is responsible for acquisition of patient medical history. AJT contributed to regarding chronic pain, opioids and suicide attempts, previous related case reports and wider implications. HS contributed to regarding pharmacokinetics of fentanyl, age-related changes and potential for polymorphism-induced insensitivity.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.