Neonicotinoids are a newer class of insecticides, which act on postsynaptic nicotinic acetylcholine esterase receptors. Its use is gradually increasing over recent years due to its better safety profile compared to other commonly used pesticides like organophosphates, organochlorides, carbamates, and pyrethroids. The better toxicological profile is attributed to more selectivity for insects compared to mammals and decreased penetration through the blood–brain barrier. Common symptoms of self-poisoning described are dizziness, hypertension, tachycardia, nausea, vomiting, eye irritation, dermatitis, and oral mucosal lesions. Mortality due to poisoning is less than 3%. Till date, there is no specific antidote for neonicotinoid poisoning and management of poisoning is symptomatic and supportive.
Jeyarathnam J. Acute pesticide poisoning: a major global health problem. World Heal Stat Q 1990;43(3):139–144.
Batra AK, Keoliya AN, Jadhav GU. Poisoning: an unnatural cause of morbidity and mortality in rural India. J Assoc Physicians India 2003;51:955–959.
Singh D, Jit I, Tyagi S. Changing trends in acute poisoning in Chandigarh zone: a 25-year autopsy experience from a tertiary care hospital in northern India. Am J Forensic Med Pathol 1999;20(2): 203–210. DOI: 10.1097/00000433-199906000-00019.
Phua DH, Lin CC, Wu ML, Deng JF, Yang CC. Neonicotinoid insecticides: an emerging cause of acute pesticide poisoning. Clin Toxicol 2009;47(4):336–341. DOI: 10.1080/15563650802644533.
Mohamed F, Gawarammana I, Robertson TA, Roberts MS, Palangasinghe C, Zawahir S, et al. Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide. PLoS One 2009;4(4):e5127. DOI: 10.1371/journal.pone.0005127.
Tomizawa M, Casida JE. Neonicotinoid insecticide toxicology: mechanisms of selective action. Annu Rev Pharmacol Toxicol 2005;45(1):247–268. DOI: 10.1146/annurev.pharmtox.45.120403.095930.
Wang X, Anadón A, Wu Q, Qiao F, Ares I, Martínez-Larrañaga MR, et al. Mechanism of neonicotinoid toxicity: impact on oxidative stress and metabolism. Annu Rev Pharmacol Toxicol 2018;58(1):471–507. DOI: 10.1146/annurev-pharmtox-010617-052429.
Forrester MB. Neonicotinoid insecticide exposures reported to six poison centers in Texas. Hum Exp Toxicol 2014;33(6):568–573. DOI: 10.1177/0960327114522500.
David D, George IA, Peter JV. Toxicology of the newer neonicotinoid insecticides: imidacloprid poisoning in a human. Clin Toxicol 2007;45(5):485–486. DOI: 10.1080/15563650701338229.
Lin PC, Lin HJ, Liao YY, Guo HR, Chen KT. Acute poisoning with neonicotinoid insecticides: a case report and literature review. Basic Clin Pharmacol Toxicol 2013;112(4):282–286. DOI: 10.1111/bcpt. 12027.
Karatas AD. Severe central nervous system depression in a patient with acute imidacloprid poisoning. Am J Emerg Med 2009;27(9):1171.e5–1171.e7. DOI: 10.1016/j.ajem.2009.01.006.
Kumar A, Verma A, Kumar A. Accidental human poisoning with a neonicotinoid insecticide, imidacloprid: a rare case report from rural India with a brief review of literature. Egypt J Forensic Sci 2013;3(4):123–126. DOI: 10.1016/j.ejfs.2013.05.002.
Iyyadurai R, George IA, Peter JV. Imidacloprid poisoning-newer insecticide and fatal toxicity. J Med Toxicol 2010;6(1):77–78. DOI: 10.1007/s13181-010-0041-6.
Yeh IJ, Lin TJ, Hwang DY. Acute multiple organ failure with imidacloprid and alcohol ingestion. Am J Emerg Med 2010;28(2): 255.e1–255.e3. DOI: 10.1016/j.ajem.2009.05.006.