Prescription Drugs Associated with Reports of Violence Towards Others 英文参考文献.docVIP

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Prescription Drugs Associated with Reports of Violence Towards Others 英文参考文献.doc

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Prescription Drugs Associated with Reports of Violence Towards Others 英文参考文献

PrescriptionDrugsAssociatedwithReportsofViolence TowardsOthers ThomasJ.Moore1*,JosephGlenmullen2,CurtD.Furberg3 1Institute for Safe Medication Practices, Alexandria, Virginia, United States of America, 2Department of Psychiatry-Cambridge Hospital, Harvard Medical School, Cambridge,Massachusetts, UnitedStates ofAmerica, 3Division ofPublicHealth Sciences, WakeForest University SchoolofMedicine, Winston-Salem,North Carolina, UnitedStatesofAmerica Abstract Context:Violencetowardsothersisaseldom-studiedadversedrugeventandanatypicalonebecausetheriskofinjury extendstoothers. Objective:Toidentifytheprimarysuspectsinadversedrugeventreportsdescribingthoughtsoractsofviolencetowards others,andassessthestrengthoftheassociation. Methodology:FromtheFoodandDrugAdministration(FDA)AdverseEventReportingSystem(AERS)data,weextractedall seriousadverseeventreportsfordrugswith200ormorecasesreceivedfrom2004throughSeptember2009.Weidentified anycasereportindicatinghomicide,homicidalideation,physicalassault,physicalabuseorviolencerelatedsymptoms. MainOutcomeMeasures:Disproportionalityinreportingwasdefinedasa)5ormoreviolencecasereports,b)atleasttwice thenumberofreportsexpectedgiventhevolumeofoverallreportsforthatdrug,c)ax2statisticindicatingtheviolence caseswereunlikelytohaveoccurredbychance(p,0.01). Results: We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivitydisorder.Theevidenceofanassociationwasweakerandmixedforantipsychoticdrugsandabsentforallbut1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggestingthatanassociationwiththisadverseeventisunlikelyforthesedrugs. Conclusions: Acts of violence towards others are a genuine and serious adverse drug event associated with a relatively small group of drugs. Varenicline, which increases th