Tramadol and seizures: A surveillance study in a managed care population

被引:91
作者
Gardner, JS
Blough, D
Drinkard, CR
Shatin, D
Anderson, G
Graham, D
Alderfer, R
机构
[1] Univ Washington, Dept Pharm, Seattle, WA 98195 USA
[2] Univ Washington, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA
[3] UnitedHlth Grp, Ctr Hlth Care Policy & Evaluat, Minnetonka, MN USA
[4] US FDA, Rockville, MD 20857 USA
[5] VAMC, Roanoke Salem Program, UVA Psychiat Med Residency, Salem, VA USA
来源
PHARMACOTHERAPY | 2000年 / 20卷 / 12期
关键词
D O I
10.1592/phco.20.19.1423.34854
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Study Objective. To investigate the occurrence of tramadol-associated seizures. Design. Retrospective cohort and case-control studies. Setting. UnitedHealth Group-affiliated independent practice model health plans, from different regions of the United States, contracting with large networks of physicians. Intervention. Analysis of administrative data from a large U.S. managed care population. Patients. A cohort of 9218 adult tramadol users and 37,232 concurrent nonusers. Measurements and Main Results. Fewer than 1% of users (80) had a presumed incident seizure claim after the first tramadol prescription. Risk of seizure claim was increased 2- to 6-fold among users adjusted for selected comorbidities and concomitant drugs. Risk was highest among those aged 25-54 years, those with more than four tramadol prescriptions, and those with history of alcohol abuse, stroke, or head injury. A case-control study among users was conducted to validate incident seizure outcomes from medical records. Only eight cases were confirmed, and all had cofactors associated with increased seizure risk. Conclusion. In a general population, risk of seizure may be associated with long-term therapy with tramadol or the presence of cofactors, or confined to a small sensitive population subset.
引用
收藏
页码:1423 / 1431
页数:9
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