失眠药物与自杀死亡风险之间的关联
Jill E Lavigne1, Kwan Hur2, Jason B Gibbons3
1Wegmans School of Pharmacy, St John Fisher University, 3690 East Avenue, Rochester, New York, 14618, USA; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY, USA.
Sleep medicine
|October 6, 2023
概括
某些失眠药物可能会影响自杀风险. 三环抗抑郁药和镇静抗组胺药与佐尔皮德姆相比,与较低的自杀风险有关,而米尔塔扎平则显示出更高的风险. 需要进行进一步的试验.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 失眠是自杀的重要,可修改的危险因素.
- 治疗失眠的药物被广泛处方,但它们与自杀风险的关联尚未得到充分了解.
- 现有的研究缺乏对不同类别的失眠药物自杀风险的比较数据.
研究的目的:
- 为了比较与各种失眠药物相关的自杀风险.
- 为确定佐洛皮作为评估自杀风险的参考比较剂.
- 为临床实践提供有关失眠治疗方法比较安全性的信息.
主要方法:
- 利用电子医疗记录识别第一次失眠处方 (2005-2015).
- 访问死亡证明以确定死亡日期和原因.
- 采用考克斯的比例危险模型来分析处方后的自杀时间.
主要成果:
- 超过200万患者开始服用失眠药物,518人在12个月内因自杀而死亡.
- 三环抗抑郁药 (阿米特利普提林,多克西) 显示,自杀风险比索尔皮德姆 (HR 0.36) 低64%.
- 镇静抗组胺剂 (氧,二胺) 显示自杀风险降低了40% (HR 0.60),而米尔塔扎平显示自杀风险增加了62% (HR 1.62).
结论:
- 在失眠药物之间存在自杀风险的显著差异.
- 三环抗抑郁药和镇静性抗组胺药与佐尔皮相比,在自杀风险方面可能提供更安全的替代方案.
- 临床试验对于最终评估失眠药物在预防自杀方面的有效性至关重要.
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