Gahr Maximilian, Connemann Bernhard J, Schönfeldt-Lecuona Carlos, Zeiss René
Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany.
Int J Mol Sci. 2017 Jan 5;18(1):101. doi: 10.3390/ijms18010101.
Pharmacological neuroenhancement (PNE) is a form of abuse and has not yet been addressed by methods of pharmacovigilance. In the present study, we tested if quantitative signal detection may be sensitive in regards to PNE. We evaluated the risk of drug abuse and dependence (DAAD) related to substances that are known to be used for PNE and divided this group into agents with (methylphenidate) and without a known abuse potential outside the field of PNE (atomoxetine, modafinil, acetylcholine esterase inhibitors, and memantine). Reporting odds ratios (RORs) were calculated using a case/non-case approach based on global and country-specific drug safety data from the Uppsala Monitoring Centre (UMC). Both control substances (diazepam and lorazepam) and methylphenidate were statistically associated with DAAD in all datasets (except methylphenidate in Italy). Modafinil was associated with DAAD in the total dataset (ROR, 2.7 (95% confidence interval (CI), 2.2-3.3)), Germany (ROR, 4.6 (95% CI, 1.8-11.5)), and the USA (ROR, 2.0 (95% CI, 1.6-2.5)). Atomoxetine was associated with DAAD in the total dataset (ROR, 1.3 (95% CI, 1.2-1.5)) and in the UK (ROR, 3.3 (95% CI, 1.8-6.1)). Apart from memantine, which was associated with DAAD in Germany (ROR, 1.8 (95% CI, 1.0-3.2)), no other antidementia drug was associated with DAAD. Quantitative signal detection is suitable to detect agents with a risk for DAAD. Its sensitivity regarding PNE is limited, although atomoxetine and modafinil, which do not have a known abuse potential outside PNE, and no antidementia drugs, whose use in PNE is presumably low, were associated with DAAD in our analysis.
药理学神经增强（PNE）是一种药物滥用形式，尚未通过药物警戒方法加以解决。在本研究中，我们测试了定量信号检测对PNE是否敏感。我们评估了与已知用于PNE的物质相关的药物滥用和依赖风险（DAAD），并将该组分为有（哌甲酯）和无PNE领域外已知滥用潜力（托莫西汀、莫达非尼、乙酰胆碱酯酶抑制剂和美金刚）的药物。报告比值比（ROR）使用基于乌普萨拉监测中心（UMC）全球和特定国家药物安全数据的病例/非病例方法计算。在所有数据集中，对照物质（地西泮和劳拉西泮）和哌甲酯均与DAAD存在统计学关联（意大利的哌甲酯除外）。莫达非尼在总数据集（ROR，2.7（95%置信区间（CI），2.2 - 3.3））、德国（ROR，4.6（95%CI，1.8 - 11.5））和美国（ROR，2.0（95%CI，1.6 - 2.5））与DAAD相关。托莫西汀在总数据集（ROR，1.3（95%CI，1.2 - 1.5））和英国（ROR，3.3（95%CI，1.8 - 6.1））与DAAD相关。除了在德国与DAAD相关的美金刚（ROR，1.8（95%CI，1.0 - 3.2））外，没有其他抗痴呆药物与DAAD相关。定量信号检测适用于检测有DAAD风险的药物。其对PNE的敏感性有限，尽管在我们的分析中，托莫西汀和莫达非尼在PNE领域外没有已知滥用潜力，且推测用于PNE的抗痴呆药物与DAAD相关。
