The role of alcohol dependency in deaths among people with epilepsy recorded by the National Drug-Related Deaths Index (NDRDI) in Ireland, 2004–2013

Lynn, Ena; Lyons, Suzi; Langan, Yvonne; Craig, Sarah; Doherty, Colin

doi:10.1016/j.seizure.2016.11.014

Cited by 10 publications

(9 citation statements)

References 7 publications

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“…Other studies have reported the proportion or likelihood of alcohol involvement in death among persons with epilepsy. The National Drug-Related Deaths Index of Ireland is a surveillance system that records all causes of death in people who are dependent on alcohol or drugs, or die due to poisoning (21). Two percent of individuals in this register were known to have epilepsy and 81% of these had a history of alcohol dependence prior to death.…”

Section: Discussion Elevated Risk Of Alcohol-specific Deathmentioning

confidence: 99%

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

et al. 2021

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Objectives: The risk of dying by alcohol-specific causes in people with epilepsy has seldom been reported from population-based studies. We aimed to estimate the relative risk of alcohol-specific mortality in people with epilepsy, and the extent to which problematic alcohol use was previously identified in the patients' medical records.Method: We delineated cohort studies in two population-based datasets, the Clinical Practice Research Datalink (CPRD GOLD) in England (January 01, 2001–December 31, 2014) and the Secure Anonymised Information Linkage (SAIL) Databank in Wales (January 01, 2001–December 31, 2014), linked to hospitalization and mortality records. People with epilepsy were matched to up to 20 persons without epilepsy on gender, age (±2 years) and registered general practice. We identified alcohol-specific death from Office for National Statistics (ONS) records using specified ICD-10 codes. We further identified prescriptions, interventions and hospitalisations related to alcohol use.Results: In the CPRD GOLD, we identified 9,871 individuals in the incident epilepsy cohort and 185,800 in the comparison cohort and, in the SAIL Databank, these numbers were 5,569 and 110,021, respectively. We identified a five-fold increased risk of alcohol-specific mortality in people with epilepsy vs. those without the condition in our pooled estimate across the two datasets (deprivation-adjusted HR 4.85, 95%CI 3.46–6.79).Conclusions: People with epilepsy are at increased risk of dying by an alcohol-specific cause than those without the disorder. It is plausible that serious alcohol misuse could either contribute to the development of epilepsy or it could commence subsequent to epilepsy being diagnosed. Regardless of the direction of the association, it is important that the risk of dying as a consequence of alcohol misuse is accurately quantified in people affected by epilepsy. Systematically-applied, sensitive assessment of alcohol consumption by healthcare professionals, at opportunistic, clinical contacts, with rapid access to quality treatment services, should be mandatory and play a key role in reduction of health harms and mortality.

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Section: Discussion Elevated Risk Of Alcohol-specific Deathmentioning

confidence: 99%

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

et al. 2021

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“…According to a study by Lynn et al (48), between 2004 and 2013, 225 (2%) of registered cases had a documented history of epilepsy, of which 82 (36%) recorded epilepsy as the cause of death. Of these 82 deaths, the majority were male (60-73%) and for half of them the median age was 47 years or younger.…”

Section: Antiepileptic Drugsmentioning

confidence: 99%

A multidisciplinary approach to the management of liver disease and alcohol disorders in psychiatric settings (Review)

et al. 2021

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Society is burdened with the uncontrolled use of alcohol, an ongoing issue, with a substantial associated morbidity and a pressing economical reverberation. It is inevitable that a series of psychiatric patients who display alcohol disorders will be admitted to hospital while also suffering from health conditions, such as liver disease, due to the consumption of alcohol. Managing comorbid patients in a psychiatric facility is a delicate matter that requires a collaborative team. The aim of this systematic paper is to highlight the following: The possibility of treating alcohol use disorder (AUD) and alcohol withdrawal syndrome (AWS) overlapping alcohol liver disease (ALD) within a psychiatric institution, and the importance of a collaborative multidisciplinary team; correctly dosing psychoactive medication when metabolism is affected by ALD; deciding when is it necessary to seek a transfer to a general hospital. Prescribing medication in patients suffering from ALD is still a not a fully documented territory. Protein binding, metabolism, bioavailability, extraction ratios, excretion route, and half-life must be taken into consideration as well as frequently repeating liver panels. Studies suggest that short-acting benzodiazepines are preferred over their alternatives when treating AWS in ALD. All anticonvulsants can be used in patients with decompensated liver disease with caution, although newer generation antiepileptic agents should be first line. Propofol is favored to benzodiazepines or opioids in the case of decompensated cirrhosis. Patients with ALD are likely to be further compromised by the potential hepatocytotoxicity of some pharmacological agents. On that account, having an integrated perspective of the medical case while taking into consideration the underlying illness as well as possible drug interaction is crucial in treating AUD or AWS in a psychiatric institution.

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“…Substance abuse may increase the risk of poorly controlled epilepsy, as both alcohol and drug use may worsen seizures. Patients with epilepsy and alcohol dependence are at an increased risk of medication noncompliance, increasing the possibility of epilepsy‐related death …”

Section: Social Issuesmentioning

confidence: 99%

“…Patients with epilepsy and alcohol dependence are at an increased risk of medication noncompliance, increasing the possibility of epilepsy-related death. 32 Some transgender persons cannot or do not seek traditional health care for gender-affirming treatment, and a substantial percentage may purchase hormones from nonmedical sources, 33 such as websites or untrained providers. These products may not have the level of oversight and quality control of medical sources of hormones, and patients may be at risk for seizure exacerbation if using impure or adulterated products.…”

Section: Social Issuesmentioning

confidence: 99%

Caring for transgender patients with epilepsy

Johnson

Kaplan

2017

Epilepsia

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The role of alcohol dependency in deaths among people with epilepsy recorded by the National Drug-Related Deaths Index (NDRDI) in Ireland, 2004–2013

Abstract: The high percentage of individuals with a diagnosis of alcohol dependency that died as a result of epilepsy and who have no antiepileptic drugs in their system at the time of their death, highlights the need for preventative measures for this at-risk group.

Cited by 10 publications

References 7 publications

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

Alcohol-Specific Mortality in People With Epilepsy: Cohort Studies in Two Independent Population-Based Datasets

A multidisciplinary approach to the management of liver disease and alcohol disorders in psychiatric settings (Review)

Caring for transgender patients with epilepsy

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