Frauger Elisabeth, Pradel Vincent, Natali François, Thirion Xavier, Reggio Patrick, Micallef Joëlle
CEIP de Marseille (PACA-Corse, Centre Associé), Federation de Pharmacologie et de Toxicologie, CHU Timone, Marseille, France.
Therapie. 2006 Jan-Feb;61(1):49-55. doi: 10.2515/therapie:2006014.
Recent observations suggest the existence of clonazepam abuse. In order to determine the importance of this practice and the characteristics of these consumers, a study has been carried out, based on data from the Provence-Alpes-Côte-d'Azur and Corsica health reimbursement system. Individuals from these regions affiliated to the French health reimbursement system, who have had a prescription of clonazepam reimbursed between January 1, 2001 and February 15, 2001, have been selected. The deliveries have been monitored over a 9 month-period. 9381 subjects have been selected. A sub-group of 1.5 per cent subjects with a deviant behaviour has been identified by factorial analysis and has been compared to the sub-group without deviant behaviour. The subjects with deviant behaviour are younger and mostly male. The dosage of clonazepam is higher (10.8 mg per day versus 2.1 mg per day) with a significantly higher proportion of benzodiazepine and high-dose buprenorphine. The number of deliveries is higher (19.4 versus 5.9) as well as the number of different physicians (4.5 versus 1.5) and pharmacies (5.9 versus 1.3). This study provides some arguments in favor of the potential of abuse and dependence of clonazepam and the necessity to reinforce its monitoring. This information requires to be relayed to health professionals.
近期观察表明存在氯硝西泮滥用现象。为确定这种行为的普遍性以及这些使用者的特征，基于普罗旺斯-阿尔卑斯-蓝色海岸大区和科西嘉岛医保报销系统的数据开展了一项研究。选取了2001年1月1日至2001年2月15日期间医保报销过氯硝西泮处方的、隶属于法国医保报销系统的这些地区的人员。对为期9个月的配药情况进行了监测。共选取了9381名受试者。通过因子分析确定了1.5%行为异常的受试者亚组，并与无异常行为的亚组进行了比较。行为异常的受试者更年轻，且大多为男性。氯硝西泮的剂量更高（每天10.8毫克对2.1毫克），苯二氮䓬类药物和高剂量丁丙诺啡的比例显著更高。配药次数更多（19.4次对5.9次），不同医生（4.5名对1.5名）和药房（5.9家对1.3家）的数量也更多。这项研究为氯硝西泮存在滥用和依赖的可能性以及加强监测的必要性提供了一些依据。这一信息需要传达给医疗专业人员。
