Dobravc Verbič Matej, Grabnar Iztok, Brvar Miran
Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
The Department of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia.
Pharmaceuticals (Basel). 2024 Jan 22;17(1):143. doi: 10.3390/ph17010143.
Psychotropic prescription drugs are commonly involved in intoxication events. The study's aim was to determine a comparative risk for intoxication in relation to prescribing rates for individual drugs. This was a nationwide observational study in Slovenian adults between 2015 and 2021. Intoxication events with psychotropic drugs were collected from the National Register of intoxications. Dispensing data, expressed in defined daily doses, were provided by the Health Insurance Institute of Slovenia. Intoxication/prescribing ratio values were calculated. The correlation between trends in prescribing and intoxication rates was assessed using the Pearson correlation coefficient. In total, 2640 intoxication cases with psychotropic prescription drugs were registered. Anxiolytics and antipsychotics were the predominant groups. Midazolam, chlormethiazole, clonazepam, sulpiride, and quetiapine demonstrated the highest risk of intoxication, while all antidepressants had a risk several times lower. The best trend correlation was found for the prescribing period of 2 years before the intoxication events. An increase of 1,000,000 defined daily doses prescribed resulted in an increase of fifty intoxication events for antipsychotics, twenty events for antiepileptics, and five events for antidepressants. Intoxication/prescribing ratio calculation allowed for a quantitative comparison of the risk for intoxication in relation to the prescribing rates for psychotropic drugs, providing additional understanding of their toxicoepidemiology.
精神类处方药常与中毒事件相关。该研究的目的是确定个体药物处方率与中毒风险的比较情况。这是一项针对2015年至2021年斯洛文尼亚成年人的全国性观察性研究。从国家中毒登记处收集精神类药物中毒事件。斯洛文尼亚健康保险研究所提供以限定日剂量表示的配药数据。计算中毒/处方比值。使用皮尔逊相关系数评估处方趋势与中毒率之间的相关性。总共登记了2640例精神类处方药中毒病例。抗焦虑药和抗精神病药是主要类别。咪达唑仑、氯美噻唑、氯硝西泮、舒必利和喹硫平显示出最高的中毒风险，而所有抗抑郁药的风险则低几倍。在中毒事件发生前2年的处方期内发现了最佳的趋势相关性。每增加100万限定日剂量的处方，抗精神病药的中毒事件增加50起，抗癫痫药增加20起，抗抑郁药增加5起。中毒/处方比值计算能够对精神类药物处方率与中毒风险进行定量比较，有助于进一步了解其毒理流行病学。
