How prevalent and severe is addiction on GABAmimetic drugs in an elderly German general hospital population? Focus on gabapentinoids, benzodiazepines, and z-hypnotic drugs

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Human Psychopharmacology: Clinical and Experimental Pub Date : 2021-10-23 DOI:10.1002/hup.2822

Udo Bonnet, Heath B. McAnally

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引用次数: 4

Abstract

Objective

Gabapentinoids (GPT) are reported to be increasingly misused by opioid- and polydrug-users, but the addictive potential of GPT outside of these populations remains understudied. Investigations comparing GPT abuse and dependence liability to that of other commonly prescribed Central Nervous System-acting medications are therefore warranted. We provide a comparison of GPT-abuse/dependence to that of other GABAmimetics within an elderly population.

Design

DSM-IV-TR-based data (previously prospectively collected by SKID-I-interview) from a random sample of elderly patients admitted to a metropolitan German general hospital were reviewed. The prevalence and severity of GPT, benzodiazepine (BDZ), and z-hypnotic drug (ZD)-abuse and -dependence were compared, stratified also by mono-substance (no concurrent current or previous substance use) and de novo-substance (first)-abuse and -dependence states.

Results

Among 400 patients (75 ± 6.4 years old; 63% females), neither current nor past abuse of BDZ, ZD or GPT, nor other illicit substances was observed. Dependence upon BDZ, ZD or GPT was observed among 55 (13.75%) individuals. The related lifetime/12-month prevalence-rates were: dependence condition (BDZ: 7%/2.45%; ZD: 4.25%/4.25%; GPT: 2.75/2.5%); mono-dependence condition (BDZ: 2.25%/0.75%; ZD: 1%/1%, GPT: 0%/0%); de novo-dependence condition (BDZ: 2.75%/1.75%; ZD: 1%/1%, GPT: 0.5%/0.5%). Opioid analgesic-dependence (N = 43/400) was significantly more frequently linked with BDZ than with GPT (p < 0.01) [Correction added on 29 December 2021, after first online publication: In the sentence ‘Opioid analgesic-dependence…’, the term ‘and ZD’ has been deleted]. For all three GABAmimetic classes, most mono- and de novo-dependence states were mild-to-moderate and lasted 2–6 years (median).

Conclusion

GABAmimetic-dependence was usually mixed with other substance-dependences. Every third to fourth instance of BDZ- or ZD-dependence was a mono-dependence condition, while a pure GPT-dependence was absent in this elderly (and illicit substance-naïve) population.

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在德国综合医院的老年人群中，GABAmimetic药物成瘾有多普遍和严重?关注加巴喷丁类药物，苯二氮卓类药物和z-催眠药物

据报道，越来越多的阿片类药物和多种药物使用者滥用加巴喷丁类药物(GPT)，但GPT在这些人群之外的成瘾潜力仍未得到充分研究。因此，将GPT滥用和依赖性与其他常用的中枢神经系统作用药物进行比较的调查是有必要的。我们在老年人群中比较了gpt滥用/依赖与其他GABAmimetics的情况。基于dsm - iv - tr的数据(先前通过skid -i访谈前瞻性收集)来自德国大都市综合医院的随机样本老年患者。比较GPT、苯二氮卓类药物(BDZ)和z-催眠药物(ZD)滥用和依赖的患病率和严重程度，并按单物质(没有同时使用或以前使用过物质)和新物质(首次)滥用和依赖状态进行分层。结果400例患者(75±6.4岁;(63%女性)，目前或过去均未观察到滥用BDZ、ZD或GPT或其他非法药物。55人(13.75%)对BDZ、ZD或GPT有依赖。相关终生/12个月患病率为:依赖状态(BDZ: 7%/2.45%;ZD: 4.25% / 4.25%;GPT: 2.75 / 2.5%);单依赖条件(BDZ: 2.25%/0.75%;Zd: 1%/1%， gpt: 0%/0%);新生依赖条件(BDZ: 2.75%/1.75%;Zd: 1%/1%， gpt: 0.5%/0.5%)。阿片类镇痛依赖(N = 43/400)与BDZ的相关性明显高于与GPT的相关性(p <0.01)[在首次在线发布后，于2021年12月29日进行了更正:在“阿片类镇痛依赖…”这句话中，“和ZD”一词已被删除]。对于所有三种GABAmimetic类别，大多数单一和新生依赖状态为轻度至中度，持续2-6年(中位数)。结论gabamitic依赖常与其他物质依赖混合存在。每三到四例BDZ或zd依赖是单一依赖条件，而在老年(非法substance-naïve)人群中没有纯粹的gpt依赖。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Human Psychopharmacology: Clinical and Experimental 医学-精神病学

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Human Psychopharmacology: Clinical and Experimental provides a forum for the evaluation of clinical and experimental research on both new and established psychotropic medicines. Experimental studies of other centrally active drugs, including herbal products, in clinical, social and psychological contexts, as well as clinical/scientific papers on drugs of abuse and drug dependency will also be considered. While the primary purpose of the Journal is to publish the results of clinical research, the results of animal studies relevant to human psychopharmacology are welcome. The following topics are of special interest to the editors and readers of the Journal: -All aspects of clinical psychopharmacology- Efficacy and safety studies of novel and standard psychotropic drugs- Studies of the adverse effects of psychotropic drugs- Effects of psychotropic drugs on normal physiological processes- Geriatric and paediatric psychopharmacology- Ethical and psychosocial aspects of drug use and misuse- Psychopharmacological aspects of sleep and chronobiology- Neuroimaging and psychoactive drugs- Phytopharmacology and psychoactive substances- Drug treatment of neurological disorders- Mechanisms of action of psychotropic drugs- Ethnopsychopharmacology- Pharmacogenetic aspects of mental illness and drug response- Psychometrics: psychopharmacological methods and experimental design