Gaist D, Hallas J, Sindrup S H, Gram L F
Department of Clinical Pharmacology, IMB, Odense University, Denmark.
Eur J Clin Pharmacol. 1996;50(3):161-5. doi: 10.1007/s002280050086.
Sumatriptan is highly efficacious in aborting acute attacks of migraine. Owing to recent reports of misuse of sumatriptan, we performed a study of its use in a Danish population.
Data were retrieved from a prescription database covering a period of 27 months after release of the drug. Consumption was described by the defined daily dose (DDD) unit and total individual consumption during the period was calculated. Those who received more than one prescription for sumatriptan were classified according to peak use of sumatriptan into high (> or = 60 DDD/31 days) (n = 45), intermediate (30-59 DDD/31 days) (n = 127) and low (< 30 DDD/31 days) (n = 1423) consumption groups. Individual usage of other medication was described.
We identified 2,878 users of sumatriptan, of whom 1,283 (45%) only redeemed one prescription. The use of sumatriptan was highly skewed. The 1% heaviest users accounted for 20% of the total consumption. The median total individual consumption of sumatriptan was 500 DDD, 192 DDD, and 24 DDD in the three groups of multiple redeemers, respectively. Pronounced differences in the total amounts of opioids and ergot alkaloids used were also found, with the high peak consumption group being the heaviest consumers of all drug categories, although half of them had only received large doses of sumatriptan. Fifty seven % of high peak users redeemed more than 29 DDD of sumatriptan within one month of initiation of treatment. The 45 high peak users had received the bulk of their medication, largely in tablet formulation, from 31 prescribers. The data points to rebound headache as a plausible underlying mechanism, but incorrect use of sumatriptan for migraine prophylaxis is also a possibility. Overuse of sumatriptan has serious economic consequences and its long-term health effects are not known.
舒马曲坦在终止偏头痛急性发作方面疗效显著。鉴于近期有关于舒马曲坦滥用的报道，我们对其在丹麦人群中的使用情况进行了一项研究。
数据取自一个处方数据库，涵盖该药物上市后27个月的时间段。用药量以限定日剂量（DDD）单位描述，并计算该时间段内的个人总用药量。接受过不止一张舒马曲坦处方的患者，根据舒马曲坦的峰值用量分为高用量组（≥60 DDD/31天）（n = 45）、中用量组（30 - 59 DDD/31天）（n = 127）和低用量组（< 30 DDD/31天）（n = 1423）。描述了其他药物的个人使用情况。
我们确定了2878名舒马曲坦使用者，其中1283人（45%）仅兑换了一张处方。舒马曲坦的使用情况严重不均衡。用量最大的1%的使用者占总用量的20%。三组多次取药者中舒马曲坦的个人总用药量中位数分别为500 DDD、192 DDD和24 DDD。在阿片类药物和麦角生物碱的总用量上也发现了显著差异，高用量峰值组是所有药物类别中用量最大的，尽管其中一半人仅接受了大剂量舒马曲坦。57%的高用量峰值使用者在开始治疗后的一个月内兑换了超过29 DDD的舒马曲坦。45名高用量峰值使用者的大部分药物，主要是片剂剂型，来自31名开处方者。数据表明反弹性头痛可能是一个潜在机制，但舒马曲坦用于偏头痛预防的不当使用也有可能。舒马曲坦的过度使用会带来严重的经济后果，其长期健康影响尚不清楚。
