Schifano Fabrizio, Chiappini Stefania
Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.
Front Pharmacol. 2018 Mar 21;9:239. doi: 10.3389/fphar.2018.00239. eCollection 2018.
Traditionally, studies on the non-medical use of pharmaceutical products have focused on controlled substances; e.g., opiates/opioids; and benzodiazepines. Although both bupropion and venlafaxine have been reported as being misused, only anecdotal reports have been made available so far. Hence, the European Monitoring Agency (EMA) Adverse Drug Reactions (ADRs), misuse/abuse/dependence and withdrawal, venlafaxine- and bupropion-related, database was here analyzed. All EMA spontaneous reports relating to venlafaxine (2005-2016) and bupropion (2003-2016) notifications were here analyzed, to provide a descriptive analysis by source, gender, age, and type of report. The UK-based, 2000-2016, Yellow Card Scheme pharmacovigilance database, bupropion and venlafaxine withdrawal reports were compared as well with those pertaining to fluoxetine and paroxetine. Out of 20,720 (bupropion) and 47,516 (venlafaxine) total number of ADRs, some 2,232 (10.8%), and 4,071 (8.5%) misuse/abuse/dependence ADRs were respectively associated with bupropion and venlafaxine. Conversely, bupropion withdrawal-related ADRs were here reported in 299/20,720 (1.44%) cases and in 914/47,516 (1.92%) cases for venlafaxine. Overall, all bupropion and venlafaxine misuse-/abuse-/dependence- and withdrawal-ADRs were related to a respective number of 264 and 447 patients. According to the Proportional Reporting Ratio (PRR) computation, in comparison with venlafaxine bupropion resulted to be more frequently misused/abused (PRR: 1.50), but less frequently associated with both dependence (PRR: 0.92) and withdrawal (PRR: 0.77) issues. Yellow Card Scheme data suggested that paroxetine and venlafaxine, in comparison with fluoxetine and bupropion, were associated with higher number of withdrawal-related reports. The dopaminergic, stimulant-like, bupropion activities may be associated with its possible recreational value. Present data may confirm that the occurrence of a withdrawal syndrome may be a significant issue for venlafaxine-treated patients.
传统上，关于药品非医疗用途的研究主要集中在管制药物上，例如阿片类药物/阿片样物质以及苯二氮卓类药物。尽管有报告称安非他酮和文拉法辛都存在滥用情况，但目前仅有一些轶事性报道。因此，本文分析了欧洲药品管理局（EMA）的药物不良反应（ADR）、误用/滥用/依赖及戒断相关的、与文拉法辛和安非他酮有关的数据库。分析了EMA所有与文拉法辛（2005 - 2016年）和安非他酮（2003 - 2016年）通知相关的自发报告，以便按来源、性别、年龄和报告类型进行描述性分析。还将英国2000 - 2016年黄卡计划药物警戒数据库中安非他酮和文拉法辛的戒断报告与氟西汀和帕罗西汀的相关报告进行了比较。在总共20,720例（安非他酮）和47,516例（文拉法辛）药物不良反应中，分别约有2,232例（10.8%）和4,071例（8.5%）误用/滥用/依赖类药物不良反应与安非他酮和文拉法辛有关。相反，与安非他酮戒断相关的药物不良反应在20,720例中有299例（1.44%）报告，在文拉法辛的47,516例中有914例（1.92%）报告。总体而言，所有安非他酮和文拉法辛的误用/滥用/依赖及戒断类药物不良反应分别涉及264例和447例患者。根据比例报告率（PRR）计算，与文拉法辛相比，安非他酮被误用/滥用的频率更高（PRR：1.50），但与依赖（PRR：0.92）和戒断（PRR：0.77）问题相关的频率较低。黄卡计划数据表明，与氟西汀和安非他酮相比，帕罗西汀和文拉法辛与更多的戒断相关报告有关。安非他酮的多巴胺能、类似兴奋剂的活性可能与其潜在的娱乐价值有关。目前的数据可能证实，戒断综合征的发生对于接受文拉法辛治疗的患者可能是一个重要问题。
