Emerging Trends in Paediatric Toxicology: Psychotropic Drug Poisoning, High‑Risk Ingestions, and the Rising Burden of Adolescent Self‑Harm

Abstract

Paediatric toxicology has undergone a profound epidemiological shift over the past decade. While accidental ingestions in toddlers remain common, a rapid rise in psychotropic drug poisoning and intentional self-harm ingestion among adolescents has transformed clinical practice. Psychotropic exposures have increased from 18.5% to 31.2% in recent years, with self-harm ingestion emerging as one of the strongest predictors of severe poisoning. Toddlers remain vulnerable to “one pill killers” such as calcium channel blockers, beta blockers, opioids, sulfonylureas, and tricyclic antidepressants. High risk foreign body ingestions - including button batteries and high-powered magnets - continue to cause life threatening complications. Agricultural chemicals, environmental toxicants, heavy metals, endocrine disruptors, and air pollution represent additional emerging threats. This review synthesizes current trends, high risk exposures, predictors of severe poisoning, and evidence-based management strategies. It also highlights mental health drivers of adolescent toxicology, the role of toxicology databases (TOXBASE/NPIS), and future directions including AI assisted triage and global toxicology registries. The aim is to provide clinicians with a comprehensive, up to date overview of paediatric toxicology in 2026–2027, with emphasis on early recognition, risk stratification, and multidisciplinary management.

Keywords: Paediatric Toxicology; Psychotropic Poisoning; Adolescent Self‑Harm; Button Battery Ingestion; Environmental Toxicants; Herbicide Poisoning; Emergency Toxicology; One‑Pill Killers; NPIS; TOXBASE

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