Department of Pharmacy, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Department of Psychiatry, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Int J Clin Pharm. 2023 Oct;45(5):1260-1266. doi: 10.1007/s11096-023-01564-2. Epub 2023 Mar 28.
Antiepileptic drugs may cause delirium, and the risk may vary with each drug. However, related studies have provided inconsistent results.
The aim of this study was to investigate whether the use of antiepileptic drugs is a risk factor for delirium development.
Using the Japanese Adverse Drug Event Report database, we analysed 573,316 reports pertaining to the period from 2004 to 2020. Reporting odds ratios and 95% confidence intervals of delirium associated with use of antiepileptic drugs were calculated after adjusting for potential confounders. Furthermore, for each antiepileptic drug, we performed an analysis stratified based on older age and benzodiazepine receptor agonist usage.
There were 27,439 reports of antiepileptic drug-related adverse events. Of these, 191 reports were associated with antiepileptic drugs and delirium (crude reporting odds ratio [cROR], 1.66; 95% confidence interval [CI], 1.43-1.93). The use of lacosamide (adjusted reporting odds ratio [aROR], 2.44; 95% CI, 1.24-4.80), lamotrigine (aROR, 1.54; 95% CI, 1.05-2.26), levetiracetam (aROR, 1.91; 95% CI, 1.35-2.71), and valproic acid (aROR, 1.49; 95% CI, 1.16-1.91) was related to a significantly higher reporting odds ratio for delirium, even after adjustment for possible confounding factors. However, when used in combination with benzodiazepine receptor agonists, none of the antiepileptic drugs were found to be associated with delirium.
Our study's findings suggest that antiepileptic drug usage may be associated with delirium development.
抗癫痫药物可能会引起谵妄，且每种药物的风险可能不同。然而，相关研究的结果并不一致。
本研究旨在探讨抗癫痫药物的使用是否是谵妄发展的危险因素。
使用日本药品不良反应报告数据库，我们分析了 2004 年至 2020 年期间的 573316 例报告。在调整了潜在混杂因素后，计算了与抗癫痫药物使用相关的谵妄的报告比值比和 95%置信区间。此外，对于每种抗癫痫药物，我们根据年龄较大和苯二氮䓬受体激动剂的使用情况进行了分层分析。
共有 27439 例抗癫痫药物相关不良事件报告。其中，191 例报告与抗癫痫药物和谵妄相关（粗报告比值比[cROR]，1.66；95%置信区间[CI]，1.43-1.93）。使用拉科酰胺（调整报告比值比[aROR]，2.44；95%CI，1.24-4.80）、拉莫三嗪（aROR，1.54；95%CI，1.05-2.26）、左乙拉西坦（aROR，1.91；95%CI，1.35-2.71）和丙戊酸（aROR，1.49；95%CI，1.16-1.91）与谵妄的报告比值比显著升高相关，即使在调整了可能的混杂因素后也是如此。然而，当与苯二氮䓬受体激动剂联合使用时，没有一种抗癫痫药物与谵妄相关。
我们的研究结果表明，抗癫痫药物的使用可能与谵妄的发生有关。
