抗薬と自殺,自殺未遂,暴力による死亡のリスク
Elisabetta Patorno1, Rhonda L Bohn, Peter M Wahl
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA. epatorno@partners.org
JAMA
|April 15, 2010
まとめ
ガバペンチンやラモトリジンなどの抗薬は,自殺行為のリスクを増やす可能性があります. この研究では,個々の薬物のリスクを比較し,トピラマートと対照的にいくつかの薬物のリスクが高まっていることを発見しました.
科学分野:
- 医薬品監視 医薬品監視
- 臨床流行病学 臨床流行病学とは
- 神経科学は神経科学である.
背景:
- 米国食品医薬品局 (FDA) は,2008年に抗発作薬の警告ラベルを義務付け,自殺思考と行動リスクの増加を理由に.
- 以前のメタアナリシスは,個々の抗薬に関連するリスクを評価するのに不十分でした.
研究 の 目的:
- 個々の抗薬と関連した自殺行為や併用自殺行為,または暴力による死亡のリスクを評価する.
- これらのリスクを基準抗薬と比較するために.
主な方法:
- HealthCore Integrated Research Database (HIRD) を使用したコホート研究設計が採用されました.
- 2001年7月から2006年12月の間に抗震剤治療を開始した15歳以上の患者を分析した.
- コックス比例リスクモデルと propensity score-matched分析は,併発症とリスク要因をコントロールし,個々の抗剤をトピラマートとカルバマゼピンと比較した.
主要な成果:
- この研究では297,620件の治療エピソードを分析し,26件の自殺,801件の自殺未遂,41件の暴力による死亡を特定した.
- ガバペンチン (HR,1.42),ラモトリジン (HR,1.84),オックスカルバゼピン (HR,2.07),ティアガビン (HR,2.41),バルプロアート (HR,1.65) と対比して,ガバペンチン (HR,1.42),ラモトリジン (HR,1.84),オックスカルバゼピン (HR,2.07),ティアガビン (HR,2.41) と対比して,バルプロアート (HR,1.65) と比較して,自殺行為のリスクが増加することが観察されました.
- ガバペンチンは,カルバマゼピンと比較して,若年/高齢の患者,気分障害,または/発作を有する患者のリスクが増加したことを示しました.
結論:
- ガバペンチン,ラモトリジン,オックスカルバゼピン,ティアガビンは,自殺行為や暴力による死亡のリスクの増加と関連している可能性があります.
- これらの発見は,抗薬療法における個別化されたリスク評価の重要性を強調しています.
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