INTRODUCTION: Antipsychotics (APs), during treatment or overdose, may be associated with respiratory aspiration.
AREAS COVERED: A PubMed search on 30 September 2022, provided 3 cases of respiratory aspiration during clozapine therapy and 1 case during an AP overdose. VigiBase records of respiratory aspiration associated with APs from inception until 5 September 2021, were reviewed. VigiBase, the World Health Organization's global pharmacovigilance database, uses a statistical signal for associations called the information component (IC).
EXPERT OPINION: The ICs (and IC(025)) were 2.1 (and 2.0) for APs, 3.2 (and 3.0) for clozapine, 2.6 (and 2.4) for quetiapine, and 2.5 (and 2.2) for olanzapine.
Cases of respiratory aspiration associated with APs included: 137 overdose/suicide cases (64 fatal) and 609 cases during treatment (385 fatal) including 333 taking clozapine (238 fatal). In logistic regression models of fatal outcomes, the odds ratios, OR, and (95% confidence intervals, CI) of significant independent variables were: a) 2.3-2.6 for clozapine in 3 samples of AP treatment of varying size, b) 1.9 (CI 1.0 to 3.5) for geriatric age in 284 patients on clozapine treatment, and c) 1.8 (CI 1.1-3.2) for antidepressant co-medication in 276 patients on non-clozapine APs. Multiple AP pharmacological mechanisms may explain respiratory aspiration.
|ジャーナル名||Expert opinion on drug metabolism & toxicology|
|投稿者||De Las Cuevas, Carlos; Sanz, Emilio J; Villasante-Tezanos, Alejandro G; de Leon, Jose|
|組織名||Department of Internal Medicine, Dermatology and Psychiatry, School of Medicine,;University of La Laguna, Canary Islands, Spain.;Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San;Cristobal de La Laguna, Spain.;Department of Physical Medicine and Pharmacology, School of Medicine, Universidad;de La Laguna, Canary Islands, Spain.;Hospital Universitario de Canarias, Tenerife, Spain.;Department of Preventive Medicine and Population Health, University of Texas;Medical Branch, Galveston, TX, USA.;Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA.;Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apostol;Hospital, University of the Basque Country, Vitoria, Spain.|