Clinical characteristics of patients with psychotropic drug overdose admitted to the emergency department

Ookura, Ryusuke; Mino, Koichi; Ogata, Masaaki

doi:10.3893/jjaam.19.901

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…In contrast, in our report in which sedative drugs other than opioid analgesics are the main causes of drug overdose, females were predominant. This has been also reported in other surveys from hospital‐based studies …”

Section: Discussionsupporting

confidence: 88%

Characteristics and trends of emergency patients with drug overdose in Osaka

Kubota¹,

Hasegawa

Taguchi³

et al. 2015

Acute Medicine & Surgery

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Aim: Drug overdose is an important issue in emergency medicine. However, studies covering overdose patients transported by ambulance have not been sufficiently carried out. We attempted to clarify problems of suspected drug overdose patients transported by ambulance.Methods: This is a prospective population-based cohort study. Data were collected by emergency medical service crews in Osaka City, Japan, between January 1998 and December 2010.Results: Drug overdose cases increased annually from 1,136 in 1998 to 1,822 in 2010 (P < 0.0001 for trend). In these cases, the dominant age range was between 16 and 40 years and the age distribution did not change over time. The age of non-overdose cases increased (P < 0.0001 for trend), with patients aged ≥66 years becoming most common in recent years, reflecting the aging of society. Males comprised most non-overdose patients, but the percentage of females increased annually (P < 0.0001 in trend). Females comprised approximately 70% in overdose cases annually throughout the study period. The duration from the emergency call to the arrival at the hospital for overdose patients has increased markedly in recent years. It also takes more time to obtain acceptance from hospitals to care for patients of suspected overdose. Conclusion:The characteristics of drug overdose patients are clearly different from those of non-overdose patients. Recent trends of drug overdose patients indicate the accelerated burden on emergency medical services system.

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Section: Discussionsupporting

confidence: 88%

Characteristics and trends of emergency patients with drug overdose in Osaka

Kubota¹,

Hasegawa

Taguchi³

et al. 2015

Acute Medicine & Surgery

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“…The recent increase in number of psychiatric clinics in urban areas in Japan has been associated with an increase in the number of patients seen in emergency departments after attempting suicide by taking an overdose of psychoactive substances (Takei, 2007;Cabinets Office, 2010). In nearly 80% of cases, it has been an overdose of a BZ hypnotic or anxiolytic (Okura et al, 2008). Although overdoses of these drugs are unlikely to lead to death, they may be used for self-harm or suicide attempts, or lead to aggressive behavior in impulsive individuals due to their disinhibiting effect (The Royal College of Psychiatrists, 1997).…”

Section: Introductionmentioning

confidence: 99%

Current Situation and Clinical Characteristics of Sedative-Related Disorder Patients in Japan: Comparison with Methamphetamine-Related Disorder Patients

Matsumoto

Ozaki

Kobayashi³

et al. 2015

Act Nerv Super

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The purpose of the present study is to examine the current situation of sedative-related disorders (mainly benzodiazepines) in Japan and the clinical characteristics of Japanese patients with this disorder. Subjects were 671 drug-related disorder patients diagnosed according to the ICD-10 classification as "F1: mental and behavioural disorders due to psychoactive substance use," who abused psychoactive substances other than alcohol. Of all the psychiatric hospitals in Japan between September and October 2010, these drug-related disorder patients had consecutively consulted or were admitted to 153 psychiatric hospitals. The present study was conducted by means of a mail survey. Subjects' clinical information, including history of psychoactive substance use, means of access to the primary drug of abuse, other ICD-10 diagnoses including F1 subcategory and comorbid psychiatric disorders, and recent history of self-destructive behavior, were collected from the attending psychiatrists of each subject. The data thus gathered concerning sedative-related disorder patients were compared with those patients with methamphetamine-related disorder, which has been the most serious drug-related problem in Japan since the 1950s. Out of the 671 subjects, 119 patients mainly abusing sedatives (the SRD group) were identified, while 361 patients were identified as mainly abusing methamphetamine (the MRD group). The MRD group was the largest population (53.8% of the total subjects), followed by the SRD group (17.7%), the inhalant-related disorder group with 56 patients (8.3%), and so on. Compared with the MRD group, the SRD group was younger, contained more female patients, and had a lower incidence of history of involvement with anti-social societies and anti-social behavior. Patients of the SRD group were more likely to have started abusing drugs with the intention of reducing the unpleasant symptoms of insomnia (42.9%), anxiety (26.1%), and depression (16.0%), and to acquire the drugs they abused from medical institutions such as psychiatric or primary care clinics (82.1%), while patients of the MRD group were more likely to have started out of curiosity (35.1%) or in response to peer pressure (47.1%), and to acquire their drugs from a "pusher" (32.8%). Additionally, in the SRD group, the ICD-10 Neurology and Psychiatry,4-1-1 OgawaHigashi, Kodaira, Tokyo 187-8553, Japan; Tel: +81-42-341-2711; Fax: +81-42-346-1944; email: tmatsu@ncnp.go.jp [Translated with permission from Seishinshinkeigaku-zasshi (Psychiatria et Neurologia Japonica), vol. 113, 1184-1198, 2011] Received May 16, 2013 accepted September 15, 2014; Act Nerv Super 57(1), 12-28; ISSN-1802-9698 F1 subcategory diagnoses that were clinically most important were "dependence syndrome" (64.0%), "harmful use" (16.2%) and "acute intoxication" (16.2%), while the most important subcategory diagnosis in the MRD group was "psychotic disorder" (34.3%) and "residual disorder and late-onset psychotic disorder" (32.9%). Further, comorbid psychiatric disorders were more fr...

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“…It has been reported, however, that patients with prescription‐related disorders are more likely to choose prescription drug overdose as a means of suicide attempt . Moreover, it has been reported that 77.7% of overdose patients in emergency departments overdose on benzodiazepines, which is increasing in drug‐dependent patients in Japan . Accordingly, it is possible that prescription drug overdose is overlapping with drug dependence and suicide attempt.…”

Section: Discussionmentioning

confidence: 99%

“…16 Moreover, it has been reported that 77.7% of overdose patients in emergency departments overdose on benzodiazepines, which is increasing in drug-dependent patients in Japan. 17 Accordingly, it is possible that prescription drug overdose is overlapping with drug dependence and suicide attempt.…”

Section: Discussionmentioning

confidence: 99%

Clinical behavior of Japanese community pharmacists for preventing prescription drug overdose

Shimane

Matsumoto

Wada

2014

Psychiatry Clin Neurosci

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Aim Prescription drug abuse, including benzodiazepines, is a growing health problem in Japan. This study examined the community pharmacist's clinical behavior regarding patients who overdose on prescribed drugs, and explored the possibility of overdose prevention by community pharmacists. Methods We surveyed all registered community pharmacies with dispensing functions (n = 1867) in the Saitama Pharmaceutical Association. An anonymous self‐administered questionnaire was mailed to each pharmacy. Respondents were asked about clinical behavior such as medication counseling and referral to the prescriber if prescription drug overdose was identified. Results Among respondents, 26% of community pharmacists reported clinical experience of working with patients who overdosed on prescribed drugs in the previous year. Half of respondents evaluated their practice such as medication counseling and referral to the prescriber as ‘good’. On multivariate analysis, a ‘poor’ self‐evaluation of referral to the prescriber was significantly associated with the following perceptions: ‘insufficient confidence in communication with prescribers’ (odds ratio [OR], 2.7; 95% confidence interval [95%CI]: 1.4–5.3), and ‘to avoid trouble with prescribers’ (OR, 1.7; 95%CI: 1.0–2.7). Conclusion Japanese community pharmacists could prevent prescription drug abuse in their practice, but the pharmacists who have insufficient confidence in communication with prescribers and who are afraid of trouble with a prescriber, reported poor self‐evaluation for referral to the prescribers. All prescribers should understand the importance of referral by community pharmacists, to assist community pharmacists in playing a critical role in prevention of prescription drug abuse.

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Clinical characteristics of patients with psychotropic drug overdose admitted to the emergency department

Cited by 9 publications

References 9 publications

Characteristics and trends of emergency patients with drug overdose in Osaka

Characteristics and trends of emergency patients with drug overdose in Osaka

Current Situation and Clinical Characteristics of Sedative-Related Disorder Patients in Japan: Comparison with Methamphetamine-Related Disorder Patients

Clinical behavior of Japanese community pharmacists for preventing prescription drug overdose

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