Melbourne Medical School, University of Melbourne, Grattan Street, Parkville, 3010, Australia.
Department of Forensic Medicine, Drug Harm Prevention Unit, Monash University, 65 Kavanagh Street, Southbank, VIC, 3006, Australia.
Drug Alcohol Depend. 2018 Jun 1;187:95-99. doi: 10.1016/j.drugalcdep.2018.03.002. Epub 2018 Apr 7.
Quetiapine is misused due to its anxiolytic and hedonic effects and has been associated with deliberate self-harm. This study analyzed quetiapine-related calls to the Victorian Poisons Information Centre (VPIC), coronial data from Victorian Institute of Forensic Medicine (VIFM) and prescribed data from the Pharmaceutical Benefits Scheme (PBS) to determine current trends in overdose, misuse and mortality.
This was a retrospective review of multiple databases. Calls to VPIC and coronial data from the VIFM were reviewed from 2006 to 2016. PBS prescription data from 2000 to 2015 was obtained from the Australian Statistics on Medicines website.
VPIC data indicated a 6-fold increase in the number of quetiapine-related calls over the 11-year period of which most were overdose-related (77%). Overdose and misuse calls increased by 6-fold and 6.6-fold, respectively. Coronial data also indicated a rise in quetiapine-related harm; a 7.4-fold increase in quetiapine-related deaths was recorded for the same period. Similarly, Australian PBS data showed that quetiapine prescriptions increased 285-fold since 2000. There was a significant positive correlation between the increase in prescribing and overdose (r = 0.75, p < 0.001), and prescribing and mortality (r = 0.82, p < 0.01).
This study revealed an increasing trend of misuse, non-fatal and fatal overdoses in Victoria over the last decade. The increasing rates of prescriptions in Australia and thus increased quetiapine availability are likely to have contributed to increased poisoning and mortality. Further research is warranted to explore the reasons behind increased prescribing, including off-label use.
喹硫平具有抗焦虑和愉悦作用，因此被滥用于治疗，并且与故意自残行为有关。本研究分析了维多利亚毒物信息中心（VPIC）接到的与喹硫平相关的电话、维多利亚法医研究所（VIFM）的尸检数据和药品福利计划（PBS）的处方数据，以确定过量用药、滥用和死亡率的当前趋势。
这是一项对多个数据库的回顾性研究。对 VPIC 的来电和 VIFM 的尸检数据进行了 2006 年至 2016 年的回顾。从澳大利亚药品统计网站获取了 2000 年至 2015 年的 PBS 处方数据。
VPIC 数据表明，11 年间与喹硫平相关的来电数量增加了 6 倍，其中大多数与过量用药有关（77%）。过量用药和滥用来电分别增加了 6 倍和 6.6 倍。尸检数据也表明，与喹硫平相关的伤害有所增加；同期，与喹硫平相关的死亡人数增加了 7.4 倍。同样，澳大利亚 PBS 数据显示，自 2000 年以来，喹硫平的处方增加了 285 倍。处方增加与过量用药（r=0.75，p<0.001）和与死亡率（r=0.82，p<0.01）之间存在显著正相关。
本研究揭示了维多利亚州在过去十年中滥用、非致命和致命性过量用药呈上升趋势。澳大利亚处方量的增加以及喹硫平的可用性增加，可能导致中毒和死亡人数增加。需要进一步研究，以探讨处方增加的原因，包括标签外使用。
