NSW Poisons Information Centre, The Children's Hospital at Westmead, Sydney, NSW
University of Sydney, Sydney, NSW.
Med J Aust. 2016 Mar 7;204(4):154. doi: 10.5694/mja15.00791.
To describe Australian trends in overdoses with medications used to treat attention deficit hyperactivity disorder (ADHD).
DESIGN, SETTING AND PARTICIPANTS: This was a retrospective observational study of intentional exposures to methylphenidate, dexamphetamine, modafinil and atomoxetine reported to the New South Wales Poisons Information Centre (NSWPIC) from 1 January 2004 to 31 December 2014. The NSWPIC takes calls from New South Wales, Tasmania and the Australian Capital Territory between 6 am and midnight each day, and, as part of a national after-hours roster, from all Australian states between midnight and 6 am on seven nights each fortnight. The target population included Australian residents aged 10-75 years.
Demographic characteristics of the patients, changes in numbers of exposures with time, co-ingestants, route of exposure, and disposition of patients.
During the 11-year study period, 1735 intentional exposures to the four medications were reported to NSWPIC. There was a 210% increase in intentional exposures to methylphenidate over this period, whereas the number of dexamphetamine exposures declined by 25%. Illicit use (defined as co-ingestion with alcohol or a street drug) increased by 429% across the study period. At least 93% of overdose patients required hospitalisation. Trends in exposures paralleled trends in the dispensing of these medications, as recorded in Pharmaceutical Benefits Scheme data.
NSWPIC data show a dramatic increase in intentional exposures to ADHD medications between 2004 and 2014, mainly to methylphenidate. Further, the data suggest that illicit use of these substances is increasing. The potential harm related to misuse of prescription stimulants and the close correlation between these exposures and the prescribing of these drugs causes concerns about their diversion, and highlights the importance of the quality use of medicines (ie, ensuring that they are used safely, appropriately and in an evidence-based manner, including considering non-medical or non-stimulant alternatives) and of risk assessment for misuse when prescribing ADHD drugs.
描述澳大利亚用于治疗注意缺陷多动障碍（ADHD）的药物过量趋势。
设计、设置和参与者：这是一项回顾性观察研究，对 2004 年 1 月 1 日至 2014 年 12 月 31 日期间向新南威尔士州毒物信息中心（NSWPIC）报告的有意暴露于哌醋甲酯、右旋苯丙胺、莫达非尼和阿托西汀的情况进行了研究。NSWPIC 每天上午 6 点至午夜接听新南威尔士州、塔斯马尼亚州和澳大利亚首都地区的电话，并且，作为全国夜间值班的一部分，每两周的 7 个晚上，从午夜到早上 6 点，接听所有澳大利亚州的电话。目标人群包括年龄在 10-75 岁之间的澳大利亚居民。
患者的人口统计学特征、随时间变化的暴露人数、共同摄入物、暴露途径以及患者的处理情况。
在 11 年的研究期间，NSWPIC 共报告了 1735 例有意暴露于这四种药物的情况。在此期间，哌醋甲酯的有意暴露增加了 210%，而右旋苯丙胺的暴露减少了 25%。非法使用（定义为与酒精或街头毒品一起摄入）在整个研究期间增加了 429%。至少有 93%的药物过量患者需要住院治疗。暴露趋势与这些药物的配药趋势相符，这与医药福利计划的数据相符。
NSWPIC 数据显示，2004 年至 2014 年间，有意暴露于 ADHD 药物的情况急剧增加，主要是哌醋甲酯。此外，数据表明这些物质的非法使用正在增加。处方兴奋剂的误用相关的潜在危害以及这些暴露与这些药物的开具之间的密切相关性，引起了人们对它们的转移的关注，并强调了优质药品使用（即确保安全、合理、基于证据地使用药品，包括考虑非药物或非兴奋剂替代物）和在开具 ADHD 药物时进行误用风险评估的重要性。
