Boels David, Victorri-Vigneau Caroline, Grall-Bronnec Marie, Touré Ali, Garnier Anais, Turcant Alain, Le Roux Gaël
Poison Control Center, Angers University Hospital, Angers, France.
UMR 1246 SPHERE, Methods for Patients-Centered Outcomes and Health Research, Nantes University Hospital, Nantes, France.
Basic Clin Pharmacol Toxicol. 2017 Oct;121(4):353-359. doi: 10.1111/bcpt.12779. Epub 2017 May 25.
Baclofen is often prescribed in high doses to fight cravings experienced by alcohol-dependent patients. Such an increase in the availability of baclofen is concerning. This study aimed to determine the change in number and profile of self-poisoning with baclofen over time, as baclofen has become increasingly popular, in order to describe the severity of self-poisoning with baclofen and to focus on co-existing alcohol use disorders, and psychiatric illnesses determine predictors of severity. This was a retrospective study of self-poisoning with baclofen as reported by the western France Poison Control Center (PCC), which represents a population of more than 12 million people from January 2008 to March 2014. One hundred and eleven cases of self-poisoning with baclofen were reported to the western France PCC (62 males and 49 females; average age 39 ± 12). Poisoning severities were as follows: 'null' (nine cases), 'minor' (37 cases), 'moderate' (19 cases) and 'high' (46 cases, including four deaths). The most frequently reported symptoms were neurological (45%) and cardiovascular (27%). The severity was significantly associated with psychiatric disorders (OR = 2.9; p = 0.03). Baclofen, prescribed in high doses, may lead to severe poisoning, particularly in patients with psychiatric illnesses. Authorities should put forward a new policy for prescribing the drug as a treatment for alcohol dependence.
巴氯芬通常以高剂量开给酒精依赖患者以对抗其成瘾渴望。巴氯芬可获得性的这种增加令人担忧。随着巴氯芬越来越受欢迎,本研究旨在确定随时间推移巴氯芬自我中毒的数量和特征变化,以描述巴氯芬自我中毒的严重程度,并关注同时存在的酒精使用障碍和精神疾病,确定严重程度的预测因素。这是一项对法国西部毒物控制中心(PCC)报告的巴氯芬自我中毒情况的回顾性研究,该中心覆盖了2008年1月至2014年3月期间超过1200万人口。法国西部PCC报告了111例巴氯芬自我中毒病例(62例男性和49例女性;平均年龄39±12岁)。中毒严重程度如下:“无”(9例)、“轻度”(37例)、“中度”(19例)和“重度”(46例,包括4例死亡)。最常报告的症状是神经系统症状(45%)和心血管系统症状(27%)。严重程度与精神障碍显著相关(OR=2.9;p=0.03)。高剂量开具的巴氯芬可能导致严重中毒,尤其是在患有精神疾病的患者中。当局应提出一项新的药物处方政策,将其作为治疗酒精依赖的药物。