a Maryland Poison Center, Department of Pharmacy Practice and Science , University of Maryland School of Pharmacy , Baltimore , MD , USA.
Am J Drug Alcohol Abuse. 2019;45(4):421-426. doi: 10.1080/00952990.2019.1599382. Epub 2019 Apr 11.
: Venlafaxine use to achieve an amphetamine-like high has been described but data regarding the epidemiology and clinical effects are sparse. : Describe the prevalence and toxicity of venlafaxine abuse reported to US poison control centers. : This was a retrospective review of venlafaxine exposures reported to the National Poison Data System (NPDS) from 2000 to 2016. Inclusion criteria were: age 12 years and older, reason for exposure intentional-abuse, and either single-substance exposure or venlafaxine was the first substance. The primary outcome was prevalence of intentional-abuse of venlafaxine. Secondary outcomes characterized demographics, geographic distribution, toxicity, and outcomes. : Intentional-abuse accounted for 752 of 85,621 venlafaxine exposures. Overall prevalence was 87.8 intentional-abuse exposures/10,000 venlafaxine exposures reported to NPDS (range, 59.3-117.6/10,000). Prevalence decreased from 107/10,000 in 2000 to 59.3/10,000 in 2016. Median age was 23 years and 50% were female. Primary route was ingestion (90.8%) with 4.7% using venlafaxine via inhalation/intranasal insufflation, and 3.7% both routes. There were 227 venlafaxine-only exposures; 54.0% were treated/released from the emergency department, 20% were admitted for medical management, 9.0% to a psychiatric facility, and 17.0% managed at home. Known medical outcomes for single-substance exposures were: no effect (24.0%), minor (39.0%), moderate (33.0%), and major (4.0%); no deaths occurred. Most frequent clinical effects were tachycardia (33.9%), drowsiness (20.7%), and agitation (11.5%). : The prevalence of venlafaxine abuse reported to poison control centers has decreased. Medical outcomes are usually not serious. Clinicians should be aware that non-medical use is possible but infrequently reported to poison control centers.
文拉法辛类兴奋剂的使用已被描述为一种欣快感，但关于其流行病学和临床影响的数据却很少。本文描述了 2000 年至 2016 年向美国国家毒物数据系统（NPDS）报告的文拉法辛滥用的流行率和毒性。这是一项对 NPDS 报告的文拉法辛暴露情况进行的回顾性审查，纳入标准为：年龄 12 岁及以上，暴露原因是故意滥用，且为单一物质暴露或文拉法辛是第一种物质。主要结果是故意滥用文拉法辛的流行率。次要结果包括人口统计学特征、地理分布、毒性和结果。故意滥用占 NPDS 报告的 85621 例文拉法辛暴露事件的 752 例。总体流行率为 87.8 例/10000 例 NPDS 报告的文拉法辛暴露事件（范围为 59.3-117.6/10000）。流行率从 2000 年的 107/10000 下降到 2016 年的 59.3/10000。中位年龄为 23 岁，女性占 50%。主要途径为口服（90.8%），4.7%通过吸入/鼻内吸入文拉法辛，3.7%同时使用两种途径。有 227 例文拉法辛单药暴露；54.0%在急诊科接受治疗/释放，20%接受住院医疗管理，9.0%入住精神病院，17.0%在家管理。单一物质暴露的已知医疗结果为：无影响（24.0%）、轻微（39.0%）、中度（33.0%）和严重（4.0%）；无死亡发生。最常见的临床效应是心动过速（33.9%）、嗜睡（20.7%）和激越（11.5%）。向毒物控制中心报告的文拉法辛滥用的流行率已经下降。医疗结果通常不严重。临床医生应该意识到，非医疗用途是可能的，但很少向毒物控制中心报告。
