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抗うつ薬と自殺未遂と自殺の相対的なリスク
S Kapur1, T Mieczkowski, J J Mann
1Laboratory of Neuropharmacology, Western Psychiatric Institute and Clinic, University of Pittsburgh, PA.
JAMA
|December 23, 1992
まとめ
三環抗うつ剤は,新しい抗うつ剤と比較して,過剰摂取による死亡率が高いと関連しています. デシプラミンヒドロクロライドが最も高いリスクを示し,患者の安全性に関するさらなる研究を正当化しました.
科学分野:
- 薬理学 薬理学とは
- 公衆衛生は公衆衛生である.
- 毒理学 毒理学 毒理学
背景:
- 薬物過剰摂取による自殺は,抗うつ薬が一般的に関与しているため,公衆衛生上の重要な懸念事項です.
- 以前のヨーロッパの研究では,抗うつ薬の過剰摂取による自殺率の変動が示されていたが,米国のデータは欠けていた.
研究 の 目的:
- 米国における抗うつ剤の過剰摂取による自殺と自殺未遂の比較リスクを推定する.
- 米国で販売されている主要な抗うつ剤の過剰摂取による死亡の相対的リスクを決定する.
主な方法:
- 薬物乱用と警告ネットワーク (DAWN) とアメリカ毒害管理センター協会 (AAPCC) のデータを活用した.
- 国家処方箋監査 (NPA) の情報を使用して,処方箋量の過剰摂取データを修正しました.
主要な成果:
- 異なる抗うつ剤の間で自殺未遂率の有意な違いは観察されなかった.
- 三循環型抗うつ剤 (TCA) は,より新しい非三循環型抗うつ剤と比較して,過剰摂取の死亡率が高いことを示しました.
- デシプラミンヒドロクロライドは,他のTCAと比較して,過剰摂取後に死亡する確率が高かった.
結論:
- TCAによる自殺リスクの上昇は,過剰摂取による死亡率の高さから生じる可能性があり,必ずしも自殺の試みが増えたわけではない.
- TCAはより大きな心毒性を持ち,過剰摂取による死亡率に寄与します.
- デシプラミン過剰摂取による高死亡率は,その背後にあるメカニズムを理解するためにさらなる調査を必要としています.
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