Bonnet Udo, McAnally Heath B
Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Germany, Academic Teaching Hospital of the University of Duisburg-Essen, Essen, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Hum Psychopharmacol. 2022 May;37(3):e2822. doi: 10.1002/hup.2822. Epub 2021 Oct 23.
Gabapentinoids (GPT) are reported to be increasingly misused by opioid- and polydrug-users, but the addictive potential of GPT outside of these populations remains understudied. Investigations comparing GPT abuse and dependence liability to that of other commonly prescribed Central Nervous System-acting medications are therefore warranted. We provide a comparison of GPT-abuse/dependence to that of other GABAmimetics within an elderly population.
DSM-IV-TR-based data (previously prospectively collected by SKID-I-interview) from a random sample of elderly patients admitted to a metropolitan German general hospital were reviewed. The prevalence and severity of GPT, benzodiazepine (BDZ), and z-hypnotic drug (ZD)-abuse and -dependence were compared, stratified also by mono-substance (no concurrent current or previous substance use) and de novo-substance (first)-abuse and -dependence states.
Among 400 patients (75 ± 6.4 years old; 63% females), neither current nor past abuse of BDZ, ZD or GPT, nor other illicit substances was observed. Dependence upon BDZ, ZD or GPT was observed among 55 (13.75%) individuals. The related lifetime/12-month prevalence-rates were: dependence condition (BDZ: 7%/2.45%; ZD: 4.25%/4.25%; GPT: 2.75/2.5%); mono-dependence condition (BDZ: 2.25%/0.75%; ZD: 1%/1%, GPT: 0%/0%); de novo-dependence condition (BDZ: 2.75%/1.75%; ZD: 1%/1%, GPT: 0.5%/0.5%). Opioid analgesic-dependence (N = 43/400) was significantly more frequently linked with BDZ than with GPT (p < 0.01) [Correction added on 29 December 2021, after first online publication: In the sentence 'Opioid analgesic-dependence…', the term 'and ZD' has been deleted]. For all three GABAmimetic classes, most mono- and de novo-dependence states were mild-to-moderate and lasted 2-6 years (median).
GABAmimetic-dependence was usually mixed with other substance-dependences. Every third to fourth instance of BDZ- or ZD-dependence was a mono-dependence condition, while a pure GPT-dependence was absent in this elderly (and illicit substance-naïve) population.
据报道，加巴喷丁类药物（GPT）被阿片类药物和多种药物使用者滥用的情况日益增多，但在这些人群之外，GPT的成瘾潜力仍未得到充分研究。因此，有必要对GPT的滥用和依赖倾向与其他常用的中枢神经系统作用药物进行比较研究。我们在老年人群中对GPT滥用/依赖与其他GABA模拟物进行了比较。
回顾了德国一家大城市综合医院收治的老年患者随机样本中基于《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）的数据（此前通过SKID-I访谈前瞻性收集）。比较了GPT、苯二氮䓬类药物（BDZ）和z-催眠药物（ZD）滥用和依赖的患病率及严重程度，并按单一物质（无当前或既往并发物质使用）和新物质（首次）滥用及依赖状态进行分层。
在400名患者（75±6.4岁；63%为女性）中，未观察到当前或既往对BDZ、ZD或GPT以及其他非法物质的滥用情况。55名（13.75%）个体存在对BDZ、ZD或GPT的依赖。相关的终生/12个月患病率分别为：依赖情况（BDZ：7%/2.45%；ZD：4.25%/4.25%；GPT：2.75%/2.5%）；单一依赖情况（BDZ：2.25%/0.75%；ZD：1%/1%，GPT：0%/0%）；新发依赖情况（BDZ：2.75%/1.75%；ZD：1%/1%，GPT：0.5%/0.5%）。阿片类镇痛药依赖（N = 43/400）与BDZ的关联显著高于与GPT的关联（p < 0.01）[2021年12月29日首次在线发表后添加的更正：在句子“阿片类镇痛药依赖……”中，术语“和ZD”已删除]。对于所有三类GABA模拟物，大多数单一和新发依赖状态为轻度至中度，持续2至6年（中位数）。
GABA模拟物依赖通常与其他物质依赖混合存在。每三到四起BDZ或ZD依赖病例中就有一例是单一依赖情况，而在这个老年（且未使用过非法物质）人群中不存在单纯的GPT依赖情况。
