| Title |
Concomitant use of opioid medications with triptans or serotonergic antidepressants in US office-based physician visits
|
|---|---|
| Published in |
Drug, Healthcare and Patient Safety, May 2018
|
| DOI | 10.2147/dhps.s151073 |
| Pubmed ID | |
| Authors |
Kyle C Molina, Kathleen A Fairman, David A Sclar |
| Abstract |
Opioids are not recommended for routine treatment of migraine because their benefits are outweighed by risks of medication overuse headache and abuse/dependence. A March 2016 US Food and Drug Administration (FDA) safety communication warned of the risk of serotonin syndrome from using opioids concomitantly with 5-hydroxytryptamine receptor agonists (triptans) or serotonergic antidepressants: selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Epidemiological information about co-prescribing of these medications is limited. The objective of this study was to estimate the nationwide prevalence of co-prescribing of an opioid with a serotonergic antidepressant and/or triptan in US office-based physician visits made by 1) all patients and 2) patients diagnosed with migraine. National Ambulatory Medical Care Survey (NAMCS) data were obtained for 2013 and 2014. Physician office visits that included the new or continued prescribing of ≥1 opioid medication with a triptan or an SSRI/SNRI were identified. Co-prescribed opioids were stratified by agent to determine the proportion of co-prescriptions with opioids posing a higher risk of serotonergic agonism (meperidine, tapentadol, and tramadol). Of an annualized mean 903.6 million office-based physician visits in 2013-2014, 17.7 million (2.0% of all US visits) resulted in the prescribing of ≥1 opioid medication with a triptan or an SSRI/SNRI. Opioid-SSRI/SNRI was co-prescribed in 16,044,721 visits, while opioid-triptan was co-prescribed in 1,622,827 visits. One-fifth of opioid co-prescribing was attributable to higher-risk opioids, predominantly tramadol (18.6% of opioid-SSRI/SNRI, 21.8% of opioid-triptan). Of 7,672,193 visits for patients diagnosed with migraine, 16.3% included opioid prescribing and 2.0% included co-prescribed opioid-triptan. During a period approximately 2 years prior to an FDA warning about the risk of serotonin syndrome from opioid-SSRI/SNRI or opioid-triptan co-prescribing, use of these combinations was common in the USA. Studies on prescribing patterns following the March 2016 warning, and on the risk of serotonin syndrome associated with these co-prescriptions, are needed. |
Mendeley readers
The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 22 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 5 | 23% |
| Researcher | 3 | 14% |
| Student > Ph. D. Student | 3 | 14% |
| Student > Bachelor | 2 | 9% |
| Other | 2 | 9% |
| Other | 2 | 9% |
| Unknown | 5 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 3 | 14% |
| Social Sciences | 2 | 9% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 9% |
| Nursing and Health Professions | 2 | 9% |
| Biochemistry, Genetics and Molecular Biology | 1 | 5% |
| Other | 5 | 23% |
| Unknown | 7 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 July 2018.
All research outputs
#4,858,306
of 25,461,852 outputs
Outputs from Drug, Healthcare and Patient Safety
#45
of 160 outputs
Outputs of similar age
#87,186
of 339,442 outputs
Outputs of similar age from Drug, Healthcare and Patient Safety
#2
of 4 outputs
Altmetric has tracked 25,461,852 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 160 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.5. This one has gotten more attention than average, scoring higher than 66% of its peers.
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We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.