{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:55:47Z","timestamp":1740174947443,"version":"3.37.3"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to enable quick differentiation of drug overdose patients from patients with disorders of consciousness.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We evaluated 222 patients transported to the Advanced Critical Care Center of Teikyo University Hospital due to disorders of consciousness. The patients were categorized into two groups: overdose group (<jats:italic>n<\/jats:italic>\u2009=\u2009128) and control group with other disorders of consciousness (<jats:italic>n<\/jats:italic>\u2009=\u200994). Logistic regression models were used to assess the association between disorders of consciousness due to drug overdose and psychotropic drugs prescribed before emergency transportation based on sex and age.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>According to multivariate logistic regression analysis, only female sex (odds ratio [OR] 4.54, 95% confidence interval [CI] 2.43\u20138.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) was associated with overall overdose. Results from the univariate logistic regression analysis showed that in the group of patients aged 40\u201350\u2009years, female sex (OR 4.36, 95% CI; 1.54\u201312.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.006) and the use of psychotropic drugs (OR 5.05, 95% CI; 1.75\u201314.6, <jats:italic>P<\/jats:italic>\u2009=\u20090.003), benzodiazepines (OR 4.64, 95% CI; 1.61\u201313.4, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), antidepressants (OR 11.4, 95% CI; 2.35\u201355.8, <jats:italic>P<\/jats:italic>\u2009=\u20090.003), and anticonvulsants (OR 4.46, 95% CI; 1.11\u201317.9, <jats:italic>P<\/jats:italic>\u2009=\u20090.035) were associated with overdose. According to multivariate logistic regression analysis, female sex (OR 4.44, 95% CI; 1.37\u201314.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.013) and antidepressants (OR 7.95, 95% CI; 1.21\u201352.1, <jats:italic>P<\/jats:italic>\u2009=\u20090.031) were associated with overdose patients aged 40\u201350\u2009years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>As a reference in distinguishing overdose in women in their 40s and 50s who present with impaired consciousness, attention may need to be paid to the type of psychotropic drug used, especially antidepressants.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40780-021-00217-8","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T02:22:52Z","timestamp":1633054972000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: an age-specific research"],"prefix":"10.1186","volume":"7","author":[{"given":"Kazuki","family":"Nagashima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Sumida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoichi","family":"Imanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuro","family":"Kuwabara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasufumi","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Yasuno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumio","family":"Itagaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-5514","authenticated-orcid":false,"given":"Machiko","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"issue":"6","key":"217_CR1","doi-asserted-by":"publisher","first-page":"e001857","DOI":"10.1136\/bmjopen-2012-001857","volume":"2","author":"Y Okumura","year":"2012","unstructured":"Okumura Y, Shimizu S, Ishikawa KB, Matsuda S, Fushimi K, Ito H. Comparison of emergency hospital admissions for drug poisoning and major diseases: a retrospective observational study using a nationwide administrative discharge database. BMJ Open. 2012b;2(6):e001857. https:\/\/doi.org\/10.1136\/bmjopen-2012-001857.","journal-title":"BMJ Open"},{"issue":"2","key":"217_CR2","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1007\/s00134-008-1250-1","volume":"35","author":"L Schwake","year":"2009","unstructured":"Schwake L, Wollenschl\u00e4ger I, Stremmel W, Encke J. Adverse drug reactions and deliberate self-poisoning as cause of admission to the intensive care unit: a 1-year prospective observational cohort study. Intensive Care Med. 2009;35(2):266\u201374. https:\/\/doi.org\/10.1007\/s00134-008-1250-1.","journal-title":"Intensive Care Med"},{"issue":"8","key":"217_CR3","doi-asserted-by":"publisher","first-page":"e0161996","DOI":"10.1371\/journal.pone.0161996","volume":"11","author":"K Ichikura","year":"2016","unstructured":"Ichikura K, Okumura Y, Takeuchi T. Associations of adverse clinical course and ingested substances among patients with deliberate drug poisoning: a cohort study from an intensive care unit in Japan. PLoS One. 2016;11(8):e0161996. https:\/\/doi.org\/10.1371\/journal.pone.0161996.","journal-title":"PLoS One"},{"issue":"12","key":"217_CR4","doi-asserted-by":"publisher","first-page":"4550","DOI":"10.3390\/ijerph8124550","volume":"8","author":"M Sarchiapone","year":"2011","unstructured":"Sarchiapone M, Mandelli L, Iosue M, Andrisano C, Roy A. Controlling access to suicide means. Int J Environ Res Public Health. 2011;8(12):4550\u201362. https:\/\/doi.org\/10.3390\/ijerph8124550.","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"217_CR5","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.ajem.2010.11.031","volume":"30","author":"Y Xiang","year":"2012","unstructured":"Xiang Y, Zhao W, Xiang H, Smith GA. ED visits for drug\u2013related poisoning in the United States, 2007. Am J Emerg Med. 2012;30(2):293\u2013301. https:\/\/doi.org\/10.1016\/j.ajem.2010.11.031.","journal-title":"Am J Emerg Med"},{"issue":"4","key":"217_CR6","doi-asserted-by":"publisher","first-page":"340","DOI":"10.5649\/jjphcs1975.24.340","volume":"24","author":"K Hirata","year":"1998","unstructured":"Hirata K, Matsumoto Y, Tomioka J, Kurokawa A, Matsumoto M, Murata M. Acute drug poisoning at critical care departments in Japan. Japanese J Hospital Pharmacy. 1998;24(4):340\u20138. https:\/\/doi.org\/10.5649\/jjphcs1975.24.340.","journal-title":"Japanese J Hospital Pharmacy"},{"issue":"1","key":"217_CR7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1080\/15563650601185969","volume":"46","author":"KE Hovda","year":"2008","unstructured":"Hovda KE, Bjornaas MA, Skog K, Opdahl A, Drottning P, Ekeberg O, et al. Acute poisonings treated in hospitals in Oslo: a one\u2013year prospective study (I): pattern of poisoning. Clin Toxicol Phila. 2008;46(1):35\u201341. https:\/\/doi.org\/10.1080\/15563650601185969.","journal-title":"Clin Toxicol Phila"},{"issue":"8","key":"217_CR8","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.je.2016.08.010","volume":"27","author":"Y Okumura","year":"2017","unstructured":"Okumura Y, Sakata N, Takahashi K, Nishi D, Tachimori H. Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: an exploratory descriptive study using a nationwide claims database. J Epidemiol. 2017;27(8):373\u201380. https:\/\/doi.org\/10.1016\/j.je.2016.08.010.","journal-title":"J Epidemiol"},{"issue":"2","key":"217_CR9","doi-asserted-by":"publisher","first-page":"16r02037","DOI":"10.4088\/PCC.16r02037","volume":"19","author":"TJ Dodds","year":"2017","unstructured":"Dodds TJ. Prescribed benzodiazepines and suicide risk: a review of the literature. Prim Care Companion CNS Disord. 2017;19(2):16r02037.","journal-title":"Prim Care Companion CNS Disord"},{"key":"217_CR10","doi-asserted-by":"publisher","first-page":"17m11982","DOI":"10.4088\/JCP.17m11982","volume":"79","author":"TL Brown","year":"2018","unstructured":"Brown TL, Gutierrez PM, Grunwald GK, DiGuiseppi C, Valuck RJ, Anderson HD. Access to psychotropic medication via prescription is associated with choice of psychotropic medication as suicide method: A retrospective study of 27,876 suicide attempts. J Clin Psychiatry. 2018;79:17m11982. https:\/\/doi.org\/10.4088\/JCP.17m11982.","journal-title":"J Clin Psychiatry"},{"issue":"3","key":"217_CR11","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1002\/ams2.403","volume":"6","author":"T Haoka","year":"2019","unstructured":"Haoka T, Sakata N, Okamoto H, Oshiro A, Shimizu T, Naito Y, et al. Intentional or unintentional drug poisoning in elderly people: retrospective observational study in a tertiary care hospital in Japan. Acute Med Surg. 2019;6(3):252\u20138. https:\/\/doi.org\/10.1002\/ams2.403.","journal-title":"Acute Med Surg"},{"unstructured":"Matsumoto T, Usami T, Funeta D, Murakami M, Tanibuchi Y. http:\/\/ncnp.go.jp\/nimh\/yakubutsu\/report\/pdf\/J_NMHS_2018.pdf. Accessed 13 Oct 2020.","key":"217_CR12"},{"key":"217_CR13","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1080\/15563650.2019.1674321","volume":"58","author":"JM Friedrich","year":"2020","unstructured":"Friedrich JM, Sun C, Geng X, Calello DP, Gillam M, Medeiros KL, et al. Child and adolescent benzodiazepine exposure and overdose in the United States: 16 years of poison center data. Clin Toxicol (Phila). 2020;58:725\u201331.","journal-title":"Clin Toxicol (Phila)"},{"issue":"12","key":"217_CR14","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1177\/0960327116630353","volume":"35","author":"A Piekarska-Wijatkowska","year":"2016","unstructured":"Piekarska-Wijatkowska A, Kobza-Sindlewska K, Rogaczewska A, Zajdel R, Krakowiak A. Intentional poisoning among elderly people-residents of a large urban agglomeration in Poland. Hum Exp Toxicol. 2016;35(12):1328\u201336. https:\/\/doi.org\/10.1177\/0960327116630353.","journal-title":"Hum Exp Toxicol"},{"issue":"3","key":"217_CR15","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1080\/14034940210167966","volume":"31","author":"A Carlsten","year":"2003","unstructured":"Carlsten A, Waern M, Holmgren P, Allebeck P. The role of benzodiazepines in elderly suicides. Scand J Public Health. 2003;31(3):224\u20138. https:\/\/doi.org\/10.1080\/14034940210167966.","journal-title":"Scand J Public Health"},{"issue":"3","key":"217_CR16","doi-asserted-by":"publisher","first-page":"234","DOI":"10.2298\/VSP141208025P","volume":"73","author":"NP Vukcevi\u0107","year":"2016","unstructured":"Vukcevi\u0107 NP, Ercegovi\u0107 GV, Segrt Z, Djordjevi\u0107 S, Stosi\u0107 JJ. Benzodiazepine poisoning in elderly. Vojnosanit Pregl. 2016;73(3):234\u20138. https:\/\/doi.org\/10.2298\/VSP141208025P.","journal-title":"Vojnosanit Pregl"},{"issue":"5","key":"217_CR17","doi-asserted-by":"publisher","first-page":"e0216317","DOI":"10.1371\/journal.pone.0216317.eCollection","volume":"14","author":"N Vancayseele","year":"2019","unstructured":"Vancayseele N, Rotsaert I, van Heeringen GPK. Medication used in intentional drug overdose in Flanders 2008\u20132013. PLoS One. 2019;14(5):e0216317. https:\/\/doi.org\/10.1371\/journal.pone.0216317.eCollection.","journal-title":"PLoS One"},{"issue":"5","key":"217_CR18","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1007\/s001270170053","volume":"36","author":"E Townsend","year":"2001","unstructured":"Townsend E, Hawton K, Harriss L, Bale E, Bond A. Substances used in deliberate self\u2013poisoning 1985\u20131997: trends and associations with age, gender, repetition and suicide intent. Soc Psychiatry Psychiatr Epidemiol. 2001;36(5):228\u201334. https:\/\/doi.org\/10.1007\/s001270170053.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"2","key":"217_CR19","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s00406-008-0839-2","volume":"259","author":"M Tournier","year":"2009","unstructured":"Tournier M, Grolleau A, Cougnard A, Molimard M, Verdoux H. Factors associated with choice of psychotropic drugs used for intentional drug overdose. Eur Arch Psychiatry Clin Neurosci. 2009;259(2):86\u201391. https:\/\/doi.org\/10.1007\/s00406-008-0839-2.","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"issue":"3","key":"217_CR20","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1017\/S0033291702006943","volume":"33","author":"JT Cavanagh","year":"2003","unstructured":"Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM. Psychological autopsy studies of suicide: a systematic review. Psychol Med. 2003;33(3):395\u2013405. https:\/\/doi.org\/10.1017\/S0033291702006943.","journal-title":"Psychol Med"},{"issue":"3","key":"217_CR21","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1001\/archpsyc.63.3.332","volume":"63","author":"TA Hammad","year":"2006","unstructured":"Hammad TA, Laughren T, Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63(3):332\u20139. https:\/\/doi.org\/10.1001\/archpsyc.63.3.332.","journal-title":"Arch Gen Psychiatry"},{"issue":"5","key":"217_CR22","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1176\/ajp.2006.163.5.813","volume":"163","author":"DN Juurlink","year":"2006","unstructured":"Juurlink DN, Mamdani MM, Kopp A, Redelmeier DA. The risk of suicide with selective serotonin reuptake inhibitors in the elderly. Am J Psychiatry. 2006;163(5):813\u201321. https:\/\/doi.org\/10.1176\/ajp.2006.163.5.813.","journal-title":"Am J Psychiatry"},{"issue":"5","key":"217_CR23","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1192\/bjp.bp.109.070219","volume":"196","author":"K Hawton","year":"2010","unstructured":"Hawton K, Bergen H, Simkin S, Cooper J, Waters K, Gunnell D, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non\u2013fatal overdose. Br J Psychiatry. 2010;196(5):354\u20138. https:\/\/doi.org\/10.1192\/bjp.bp.109.070219.","journal-title":"Br J Psychiatry"},{"issue":"16","key":"217_CR24","doi-asserted-by":"publisher","first-page":"3101","DOI":"10.1007\/s00213-015-3952-8","volume":"232","author":"Y Okumura","year":"2015","unstructured":"Okumura Y, Tachimori H, Matsumoto T, Nishi D. Exposure to psychotropic medications prior to overdose: a case\u2013control study. Psychopharmacology. 2015;232(16):3101\u20139. https:\/\/doi.org\/10.1007\/s00213-015-3952-8.","journal-title":"Psychopharmacology"},{"key":"217_CR25","doi-asserted-by":"publisher","first-page":"pyv081","DOI":"10.1093\/ijnp\/pyv081","volume":"19","author":"F Termorshuizen","year":"2016","unstructured":"Termorshuizen F, Palmen SJM, Heerdink ER. Suicide behavior before and after the start with antidepressants: A high persistent risk in the first month of treatment among the Young. Int J Neuropsychopharmacol. 2016;19:pyv081. https:\/\/doi.org\/10.1093\/ijnp\/pyv081.","journal-title":"Int J Neuropsychopharmacol"},{"key":"217_CR26","first-page":"5103","volume":"8","author":"H Huang","year":"2015","unstructured":"Huang H, Zhao J, Jiang L, Xie Y, Xia Y, Lv R, et al. Paeoniflorin improves menopause depression in ovariectomized rats under chronic unpredictable mild stress. Int J Clin Exp Med. 2015;8:5103\u201311.","journal-title":"Int J Clin Exp Med"},{"key":"217_CR27","doi-asserted-by":"publisher","first-page":"863","DOI":"10.5649\/jjphcs.36.863","volume":"36","author":"M Nakajima","year":"2010","unstructured":"Nakajima M, Homma M, Igarashi T, Kambayashi Y, Ohara M, Nagasawa I, et al. Survey on benzodiazepine prescriptions. Jpn J Pharmaceutical Health Care Sci. 2010;36:863\u20137.","journal-title":"Jpn J Pharmaceutical Health Care Sci"}],"container-title":["Journal of Pharmaceutical Health Care and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-021-00217-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40780-021-00217-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-021-00217-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T02:33:47Z","timestamp":1633055627000},"score":1,"resource":{"primary":{"URL":"https:\/\/jphcs.biomedcentral.com\/articles\/10.1186\/s40780-021-00217-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,1]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["217"],"URL":"https:\/\/doi.org\/10.1186\/s40780-021-00217-8","relation":{},"ISSN":["2055-0294"],"issn-type":[{"type":"electronic","value":"2055-0294"}],"subject":[],"published":{"date-parts":[[2021,10,1]]},"assertion":[{"value":"24 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted after a review by the Teikyo University Ethical Review Board for Medical and Health Research Involving Human Subjects in accordance with the ethics guidelines for medical research on humans (approval number: 19\u2013049).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}