Factors associated with nonbenzodiazepine antiepileptic drug intoxication: Analysis of 9,809 registered cases of drug poisoning

Abstract

SUMMARYPurpose: Antiepileptic drug (AED) intoxications are common due in part to wide clinical application and availability. Because AEDs usually depress central nervous system function, overdosing may be potentially life-threatening or lead to a range of adverse outcomes. The aim of this study was to identify risk factors for nonbenzodiazepine AED (NBAED) intoxication. Methods: In this cross-sectional study, all consecutive adult and adolescent (>12 years old) poisoned patients who presented to the Loghman-Hakim Poison Hospital (LHPH) during a 6-month period were evaluated. Patients with NBAED intoxication were identified and compared to a control group of those other pharmaceutical intoxications. The risk factors for AED intoxication were identified using univariate analyses and multivariate modeling. Results: Among 9,809 cases of pharmaceutical agent overdose, there were 474 cases (4.8%) with NBAED intoxication. Mean age of the subjects was 24.5 ± 8.9 years. The most frequent NBAED was carbamazepine (n = 117), followed by phenobarbital (n = 77) and sodium valproate (n = 51). The most frequent motivation was intentional intoxication (95.3%). Multivariate analysis revealed that presence of medical disorders, a history of psychological events, and loneliness were associated with AED intoxication, whereas educational level had a protective effect. There was no association between previous history of parasuicide, sex, age, occupation status, and AED intoxication. Discussion: In conclusion, this study showed that the majority of AED intoxications are due to deliberate self poisoning. The presence of psychological events, medical disorders, and loneliness are risk factors for AED intoxication, whereas higher education level has a protective effect.

Epidemiological Study of Acute Poisoning for Antiepileptic Drugs: A 2-Year Retrospective Study in Cracow, Poland

“…In our study, the most commonly encountered drug was carbamazepine which generally corresponded with community prescribing patterns. It is also compatible with reports from Edinburgh [6], Iran (Tehran) [9], and São Paulo [5]. Another frequently used drug in our study was valproic acid.…”

“…The proportion of deliberate self-poisoning was 94.86% in our study. Suicide attempt was the most frequent circumstance observed in Brazil (Saõ Paulo) [5] and Iran (Tehran, 98.9%) [9], too.…”

“…In France (Paris emergency departments), the prevalence of poisoning with AEDs for the period 1992-1993 was 2.9% and for 2001-2002 was 0.9% [8]. In Iran (studies conducted in the referral center for all cases of poisoning occurring in Tehran), AED poisoning accounted for 4.8% of all the pharmaceutical intoxications [9].…”

The Evaluation of Patients Admitted to the Emergency Department with Non-Benzodiazepine Antiepileptic Drug Poisoning

“…Poisonings with drugs are more frequent in the young adult groups in our country as it is all over the world (3,9,(11)(12)(13). In a study from Iran, which included all age groups, it is reported that 43.2% of the patients who were poisoned with NBDAED were between the ages of 20-30 (8).…”

Loneliness in the elderly is associated with the use of psychotropic drugs

“…Another reason could be that, in some patients, loneliness is the cause or comorbidity of a psychological or somatic disease or that it even acts as a side effect of medication use (Hassanian-Moghaddam et al, 2010).…”