Rescue does not guarantee recovery: poisoning can leave lasting lung and brain damage
Paraquat has no antidote; in the cited study, more than four in ten poisoned patients died. It can inflame and scar the lungs and injure the kidneys and liver. After carbon monoxide poisoning, nearly half of patients given ordinary oxygen still had cognitive problems six weeks later; even with hyperbaric oxygen, the proportion was one-quarter.
What it takes
Free. Know this before a crisis.
What you may gain
A systematic review describes extremely high paraquat fatality because of its toxicity and the lack of effective treatment. Active uptake against a concentration gradient concentrates it in lung tissue, producing pneumonitis and pulmonary fibrosis, alongside kidney and liver injury. The review advises against gastric lavage; hemodialysis and hemoperfusion are unlikely to alter the clinical course, and evidence for steroids and immunosuppressants is weak. Fatality remained high across centers despite widely differing treatments. Ten tertiary hospitals in Bangladesh recorded 1,420 cases during 2013–2024; among 257 analyzable cases, fatality was 43.2%. Common findings were lower-limb swelling from acute kidney failure (71.2%), vomiting (65.8%) and abdominal pain (58.0%). A double-blind randomized carbon monoxide trial assigned 76 people per group, with patients and clinicians unaware of allocation. At six weeks, cognitive sequelae occurred in 19/76 (25.0%) after hyperbaric oxygen and 35/76 (46.1%) after normobaric oxygen, P=0.007; adjusted OR 0.45, 95% CI 0.22–0.92. A separate consecutive series of 73 cases found cognitive sequelae in 30% and white-matter hyperintensities in 12%. In China, registration and production licenses for aqueous paraquat were withdrawn and production stopped on July 1, 2014; domestic sales and use stopped on July 1, 2016. Domestic sales and use of soluble-gel formulations were prohibited from September 26, 2020. The regulatory notice explicitly cites recurring suicide incidents involving paraquat as a reason for tighter supervision.
Context & considerations
Grade B because these studies concern poisoned patients, not exclusively suicide-attempt survivors; the carbon monoxide trial included accidental poisonings. The percentages cannot be read directly as probabilities of harm after a suicide attempt. No method guarantees freedom from lasting harm. See carbon monoxide emergencies, accidental pesticide or medicine ingestion: do not induce vomiting; take the container to hospital, and avoiding stockpiles. This book does not compare methods' fatality rates or describe how to carry them out.
Research & references
Gawarammana IB, Buckley NA (2011). Medical management of paraquat ingestion. British Journal of Clinical Pharmacology, 72(5), 745-757. https://doi.org/10.1111/j.1365-2125.2011.04026.x ; Chowdhury FR et al. (2026). Clinical and Laboratory Profile of Paraquat Poisoning: A Toxicological Crisis in Bangladesh. American Journal of Tropical Medicine and Hygiene, 115, 176-182. https://doi.org/10.4269/ajtmh.25-0719 ; Weaver LK, Hopkins RO, Chan KJ, et al. (2002). Hyperbaric oxygen for acute carbon monoxide poisoning. New England Journal of Medicine, 347(14), 1057-1067. https://doi.org/10.1056/NEJMoa013121 ; Parkinson RB, Hopkins RO, Cleavinger HB, et al. (2002). White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology, 58(10), 1525-1532. https://doi.org/10.1212/wnl.58.10.1525 ; General Office, Ministry of Agriculture and Rural Affairs of China (2018). Notice on strengthening paraquat supervision, document Nongban Nong [2018] No. 17. https://www.gov.cn/zhengce/zhengceku/2018-12/31/content_5442594.htm