Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK.
Crisis. 2011;32(2):81-7. doi: 10.1027/0227-5910/a000063.
In early 2005 the UK Committee on Safety of Medicines (CSM) announced gradual withdrawal of the analgesic co-proxamol because of its adverse benefit/safety ratio, especially its use for intentional and accidental fatal poisoning. Prescriptions of co-proxamol were reduced in the 3-year withdrawal phase (2005 to 2007) following the CSM announcement.
To assess the impact of the CSM announcement in January 2005 to withdraw co-proxamol on nonfatal self-poisoning with co-proxamol and other analgesics.
Interrupted time series analysis of general hospital presentations for nonfatal self-poisoning (five hospitals in three centers in England), comparing the 3-year withdrawal period 2005-2007 with 2000-2004.
A marked reduction in the number of episodes of nonfatal self-poisoning episodes involving co-proxamol was found following the CSM announcement (an estimated 62% over the period 2005 to 2007 compared to 2000 to 2004). There was no evidence of an increase in nonfatal self-poisoning episodes involving other analgesics (co-codamol, codeine, co-dydramol, dihydrocodeine, and tramadol) in relation to the CSM announcement over the same period, nor a change in the number of all episodes of self-poisoning.
Data were from three centers only.
The impact of the policy appears to have reduced nonfatal self-poisoning with co-proxamol without significant substitution with other analgesics. This finding is in keeping with that for suicide.
2005 年初，英国药物安全委员会（CSM）宣布逐步撤回镇痛药复方羟考酮，因其不良的获益/风险比，尤其是其被用于故意和意外致命中毒。在 CSM 发布公告后，复方羟考酮的处方在 3 年的撤药阶段（2005 年至 2007 年）减少。
评估 2005 年 1 月 CSM 宣布撤回复方羟考酮对非致命性自我中毒用复方羟考酮和其他镇痛药的影响。
采用中断时间序列分析，对英格兰三个中心的五家医院的非致命性自我中毒（5 家医院）进行分析，比较 2005-2007 年的 3 年撤药期与 2000-2004 年。
在 CSM 宣布之后，非致命性自我中毒的事件数量明显减少，涉及复方羟考酮（与 2000 年至 2004 年相比，2005 年至 2007 年期间估计减少了 62%）。在同一时期，没有证据表明与 CSM 公告相关的涉及其他镇痛药（复方可待因、可待因、复方双氢可待因、二氢可待因和曲马多）的非致命性自我中毒事件增加，也没有改变自我中毒的总事件数量。
数据仅来自三个中心。
该政策的影响似乎降低了非致命性自我中毒用复方羟考酮的发生，而没有明显替代其他镇痛药。这一发现与自杀一致。
