Paracetamol is one of the most frequently used drugs in intentional overdoses. Countries that limit the quantity of paracetamol available in a single purchase generally report lower rates of paracetamol related morbidity and mortality.

To determine the socio-demographic characteristics of those who intentionally overdosed on paracetamol and associated psychiatric illness (identifying high-risk groups).

To improve mental health care delivery and propose a restriction of pack sizes of paracetamol in a single purchase.

This study was a retrospective, descriptive analysis study. Cases of parasuicide in the year 2008 were identified through our database and their case notes studied by completing questionnaires pertaining to details of the act.

Of the 437 cases of parasuicide, 195 cases overdosed on paracetamol (44.6%). Indians made up 41.0% of cases, followed by Malays (31.8%) and Chinese (20.5%). Of the Malays, 63.3% overdosed on paracetamol, compared with other means of parasuicide. 72.8% of those who overdosed with paracetamol were female, 54.4% were single and 69.7% purchased paracetamol over the counter. With increasing age, the incidence of paracetamol overdose declines, being highest (55.2%) in the age group 16-25. Of those who overdosed on paracetamol, 46.2% had a diagnosis of adjustment disorder, 26.2% of acute stress reaction and 21.0% of depression. 42.1% of them had a history of paracetamol overdose.

Paracetamol continues to be commonly used in parasuicides. Legislation restricting pack sizes of paracetamol in a single purchase is the most pragmatic means of reducing paracetamol related parasuicides and suicides.