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[成人使用精神刺激药物呈上升趋势]

[Upward trend in the use of psychostimulants by adults].

作者信息

van der Koog L, van der Schans J, Tjioe M A, Bos J H J, Bijker B J, Hak E, Schuiling-Veninga C C M

机构信息

Rijkuniversiteit Groningen, Groningen Research Institute of Pharmacy, afd. Farmacotherapie, -Epidemiologie & -Economie, Groningen.

出版信息

Ned Tijdschr Geneeskd. 2017;161:D1660.

Abstract

OBJECTIVE

To gain insight into the trends in the use of psychostimulants among adults.

DESIGN

Retrospective database study.

METHODS

We selected data on adults (≥ 18 years) who had had a minimum of 2 prescriptions for a psychostimulant drug within 1 year from IADB.nl, a Netherlands database of filled prescriptions (59 public pharmacies, approximately 600,000 patients). We calculated both the number of new users and the total number of users of psychostimulants per year in the period 2004-2014. We also assessed which agent was the most commonly prescribed psychostimulant drug and who had initiated treatment.

RESULTS

The number of adults who were prescribed psychostimulants (methylphenidate, dexamphetamine and amphetamine) increased from 1.5 per 1000 adults in 2004 to 7.8 per 1000 adults in 2014. Users were mainly male (63.0%) and methylphenidate was the most frequently prescribed agent (85.7%). The number of new users of these agents increased from 0.5 to 1.5 per 1000 adults, and the greatest increase was observed among young adults (< 30 years). The increase in new users seems to have stabilized since 2012. Around 40% of new treatments were initiated by the GP.

CONCLUSION

The large increase in the number of adults who are prescribed psychostimulants seems mainly to be the result of an increase in the number of new users, especially among young adults. As psychostimulants are only approved for the treatment of ADHD in children from 6 years of age and in adolescents, short- and long-term effects and side effects of these drugs need to be better assessed in the adult population.

摘要

目的

深入了解成人使用精神振奋剂的趋势。

设计

回顾性数据库研究。

方法

我们从IADB.nl(荷兰一个已配药处方数据库,涵盖59家公立药房,约60万名患者)选取了在1年内至少有2次精神振奋剂药物处方的成人(≥18岁)数据。我们计算了2004 - 2014年期间每年精神振奋剂的新使用者数量和使用者总数。我们还评估了哪种药物是最常处方的精神振奋剂以及谁开始了治疗。

结果

开具精神振奋剂(哌醋甲酯、右旋苯丙胺和苯丙胺)的成人数量从2004年的每1000名成人1.5例增加到2014年的每1000名成人7.8例。使用者主要为男性(63.0%),哌醋甲酯是最常处方的药物(85.7%)。这些药物的新使用者数量从每1000名成人0.5例增加到1.5例,在年轻人(<30岁)中增幅最大。自2012年以来,新使用者的增加似乎已趋于稳定。约40%的新治疗由全科医生发起。

结论

开具精神振奋剂的成人数量大幅增加似乎主要是新使用者数量增加的结果,尤其是在年轻人中。由于精神振奋剂仅被批准用于治疗6岁及以上儿童和青少年的注意力缺陷多动障碍,因此需要在成人人群中更好地评估这些药物的短期和长期影响及副作用。

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