Department of Psychiatry, Hôpitaux Robert Schuman, Luxembourg, Luxembourg.
Department of Public Health, Competence Centre in Methodology and Statistics, Luxembourg Institute of Health, Luxembourg.
Int J Methods Psychiatr Res. 2021 Dec;30(4):e1888. doi: 10.1002/mpr.1888. Epub 2021 Jul 31.
A clear definition of what we understand of high-dose misuse or of a 'markedly increased dose' (as stated by the DSM-5) is important and past definitions may be inadequate. The aim of this review is to describe the different definitions used and to test these definitions for their accuracy.
A narrative PubMed literature review was conducted based on articles published between 1 January 1990 and 31 December 2020 describing benzodiazepines (in MeSH Terms or MeSH Major Topic) and high-dose (or high-dosage). Specific definitions were applied to a population sample to show how definitions affect high-dose benzodiazepine prevalence.
Multiples of an equivalent-diazepam dose or of the World Health Organization 'defined daily dosage' were used more frequently than the overstep of the recommended maximum therapeutic dosage as a cut-off point.
High-dose use is rare but the prevalence in the general population varies among studies, mainly due to different definitions, making both clinical and epidemiological comparisons between studies difficult. Defining a high-dose user as a person who takes at least a higher dose than the maximum usual therapeutic dose over a defined period of time therefore appears to be clinically more consistent.
明确我们对高剂量滥用或“明显增加剂量”（DSM-5 所述）的理解非常重要，过去的定义可能不够充分。本综述的目的是描述使用的不同定义，并测试这些定义的准确性。
根据 1990 年 1 月 1 日至 2020 年 12 月 31 日期间发表的描述苯二氮䓬类药物（在 MeSH 术语或 MeSH 主要主题中）和高剂量（或高剂量）的文章，进行了叙述性 PubMed 文献综述。特定的定义被应用于人群样本，以展示定义如何影响高剂量苯二氮䓬类药物的流行率。
以等效地西泮剂量的倍数或世界卫生组织“规定的日剂量”作为截止点比超过推荐的最大治疗剂量更常被使用。
高剂量使用很少见，但在一般人群中的流行率在不同的研究中有所不同，主要是由于不同的定义，使得研究之间的临床和流行病学比较变得困难。因此，将高剂量使用者定义为在规定的时间内至少服用比最大常规治疗剂量更高剂量的人，在临床上似乎更一致。
