Comparison of abuse, suspected suicidal intent, and fatalities related to the 7-day buprenorphine transdermal patch versus other opioid analgesics in the National Poison Data System

Coplan, Paul; Sessler, Nelson E.; Harikrishnan, Venkatesh; Perkel, Charles

doi:10.1080/00325481.2017.1269596

Cited by 20 publications

(10 citation statements)

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“…In these processes, the influx of calcium ions is very important, which is inhibited by gabapentin and pregabalin [94] -active in the treatment of many symptoms induced by central sensitisation [95]. Until recently, the development of new SSRIs was inhibited due to reports of an increased risk of suicide in adolescents [96,97]. It seems, however, that further development of this group of drugs is possible, not only in the treatment of depression.…”

Section: Discussionmentioning

confidence: 99%

“…W procesach tych istotną rolę odgrywa napływ jonów wapnia, hamowany przez gabapentynę i pregabalinę [94], które wykazują aktywność w leczeniu wielu objawów wywołanych ośrodkową sensytyzacją [95]. Do niedawna rozwój nowych leków przeciwdepresyjnych SSRI był zahamowany z powodu doniesień o podwyższonym ryzyku samobójstwa u młodzieży [96,97]. Wydaje się jednak, że możliwy jest dalszy rozwój tej grupy leków, nie tylko w leczeniu depresji.…”

Section: Podsumowanieunclassified

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Immunologia dla specjalistów medycyny paliatywnej. Rola receptorów Toll-like w wywoływaniu objawów choroby

Żylicz

2019

Palliat Med Pract

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The human body is protected against pathogens originating from the external and internal world through a system of innate and acquired immunity, which work together both in healthy and sick subjects. The Toll-like receptors are located on the surface of microglia cells and are involved in the development of neurogenic inflammation, which subsequently leads to the emergence of many diseases and symptoms such as depression, fatigue, chronic and neuropathic pain, cough, constipation and pruritus. The Toll-like receptor activation is inhibited, inter alia, by antidepressants. It is probable that in the near future newer drugs will be known, which will inhibit the development of neurogenic inflammation more efficiently, in order to ensure a more effective treatment of symptoms resistant to standard pharmacotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Podsumowanieunclassified

Immunologia dla specjalistów medycyny paliatywnej. Rola receptorów Toll-like w wywoływaniu objawów choroby

Żylicz

2019

Palliat Med Pract

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“…This patch proceeds slowly, and ~48 hours are needed to reach the maximum buprenorphine concentrations after the initial patch application. 23 Thus, the optimal time for placing the patch would be 2 days before surgery. In the present study, the patch was placed 2 days before the operation.…”

Section: Discussionmentioning

confidence: 99%

Perioperative analgesia with a buprenorphine transdermal patch for hallux valgus surgery: a prospective, randomized, controlled study

Wang

et al. 2018

JPR

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PurposeHallux valgus surgery often results in significant postoperative pain. Adequate control of pain is essential for patient satisfaction and improves the outcome of the procedure. This study aimed to investigate the perioperative analgesic effect of a buprenorphine transdermal patch in patients who underwent hallux valgus surgery.Patients and methodsA total of 90 patients were randomly divided into the following three groups based on the perioperative analgesic method: flurbiprofen axetil intravenous injection (Group F), oral celecoxib (Group C), and buprenorphine transdermal delivery system (BTDS) (Group BTDS). The pain status, degree of satisfaction, adverse effects, and administration of tramadol hydrochloride for uncontrolled pain were recorded on the night before surgery, postoperative day 1, postoperative day 2, and postoperative day 3.ResultsThe BTDS could effectively control perioperative pain for patients undergoing hallux valgus surgery. The analgesic effect of the BTDS was better than that of oral celecoxib. In addition, statistically significant differences were not observed in the visual analog scale (VAS) scores, adverse effects, and rescue analgesia between the patients who received the BTDS and the patients who received the flurbiprofen axetil intravenous injection. However, the degree of patient satisfaction of the BTDS group was significantly higher (P<0.05) than that of the other two groups.ConclusionThe BTDS (a preemptive analgesia regimen) could exert an analgesic effect during the perioperative period for patients who had received hallux valgus surgery, and this effect is beneficial for sustaining postoperative physiological and psychological states and promoting functional rehabilitation.

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“…The tendency of patients with physical co-morbidities to overdose using non-psychotropics rather than psychotropics may relate to perceived lethality of nonpsychotropics, potentially greater lethality of non-psychotropics, or to prescribers being more primed to consider overdose potential when issuing and monitoring potentially cardiotoxic psychotropic drugs (Hawton et al, 2010) than medications used for physical health problems. Whilst acknowledging the poor predictive value of suicide risk classification scales (Steeg et al, 2018), our findings suggest that needsbased assessments of psychiatric patients with physical health problems should focus on addressing modifiable risk factors such as reviewing the need for more toxic medications, particularly opioids (Ilgen et al, 2016), considering safer transdermal routes for opioid administration (Coplan et al, 2017), and addressing inadequatelytreated pain (Yarborough et al, 2016). Guidelines on safe prescribing aim not to compromise on optimal pain management, but to reduce the potential for opioid addiction, diversion and fatalities (Volkow et al, 2019).…”

Section: Main Findingsmentioning

confidence: 96%

Access to means of lethal overdose among psychiatric patients with co-morbid physical health problems: Analysis of national suicide case series data from the United Kingdom

Pitman

Tham

Hunt

et al. 2019

Journal of Affective Disorders

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Background: Many physical health problems are associated with elevated suicide risk whilst also providing access to means of overdose. We aimed to investigate whether psychiatric patients with physical co-morbidities who die by suicide were more likely than those without co-morbidities to self-poison with non-psychotropic medications. Methods: We analysed data on 14,648 psychiatric patients who died by suicide in England & Wales during 2004-2015, as recorded by the National Confidential Inquiry into Suicide and Safety in Mental Health. Using logistic regression models adjusted for age, gender, ethnicity, and primary drug dependence/misuse we compared patients diagnosed with physical comorbidities versus those without to assess whether a greater proportion of the former had died by overdose, and medication prescribed to treat such disorders (e.g. opioids, insulin). Results: 24% (n=3525) were recorded as having physical co-morbidity. A greater proportion of these individuals died by self-poisoning than those without physical co-morbidity (37% vs. 20%, p<.001; adjusted OR 2.47; 95% CI 2.26-2.70), and they were more likely to have used medications for a physical health disorder in overdose (50% vs. 34%; adjusted OR 2.10; 95% CI 1.80-2.46), particularly opioids (30% vs. 22%; p<0.001), paracetamol/opioid compounds (11% vs. 7%, p<.001) and insulin (4% vs. 1%, p<.001). Limitations: Use of survey data may have resulted in under-reporting of physical health problems and/or overdose medications. Conclusions: Overdose, rather than hanging, is the leading cause of suicide among psychiatric patients with physical co-morbidities, particularly using non-psychotropic medications. There is potential for means restriction in preventing suicide among these patients.

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Comparison of abuse, suspected suicidal intent, and fatalities related to the 7-day buprenorphine transdermal patch versus other opioid analgesics in the National Poison Data System

Abstract: This post-marketing evaluation of BTDS indicates infrequent poison center calls for intentional abuse and suspected suicidal intent events, suggesting lower rates of these risks with BTDS compared to other ER/LA opioids.

Cited by 20 publications

References 49 publications

Immunologia dla specjalistów medycyny paliatywnej. Rola receptorów Toll-like w wywoływaniu objawów choroby

Immunologia dla specjalistów medycyny paliatywnej. Rola receptorów Toll-like w wywoływaniu objawów choroby

Perioperative analgesia with a buprenorphine transdermal patch for hallux valgus surgery: a prospective, randomized, controlled study

Access to means of lethal overdose among psychiatric patients with co-morbid physical health problems: Analysis of national suicide case series data from the United Kingdom

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