Key result
Newly initiated central nervous system medications doubled the risk of unintentional poisoning during the first two weeks of treatment in older adults (OR 2.06).
Why the study?
Medications acting on the central nervous system are common causes of medication-related unintentional poisoning, but little is known about their short-term effects on unintentional poisoning.
Does new initiation of central nervous system medications increase the short-term risk of unintentional poisoning in older adults?
Observational (n=9,354)
Does new initiation of central nervous system medications increase the short-term risk of unintentional poisoning in older adults?
Effect estimate: OR 2.06 (95% CI 1.70-2.48)
The risk of unintentional poisoning doubles in the two weeks following new initiation of CNS drugs in older adults, highlighting the need for careful monitoring.
New CNS drug starts may warrant short-term monitoring in older adults; this observational link leaves open causality and needs prospective confirmation.
INTRODUCTION: Medications acting on the central nervous system (CNS) are common causes of medication-related unintentional poisoning. Little is known about the short-term effects of CNS medications on unintentional poisoning. OBJECTIVE: This study aims to determine the short-term association between newly prescribed CNS drugs and unintentional poisoning. METHODS: We conducted a register-based case-crossover study of 9354 patients (age ≥ 50 years) with first-time hospitalization for unintentional poisoning in Sweden between 1 July, 2006 and 30 September, 2018. Newly initiated CNS medication was identified based on dispensations from the Swedish Prescribed Drug Register during 28 days prior to the unintentional poisoning event and compared with dispensations during an equally long control period. Conditional logistic regression was used to estimate the odds ratio and 95% confidence intervals. RESULTS: After a newly initiated CNS treatment, we found an increased risk of unintentional poisoning during the following 2 weeks with an odds ratio (95%) being 2.52 (1.98-3.21) and 1.47 (1.08-2.00) for the first and second week, respectively. The risk was elevated in all sub-groups but to a different degree with odds ratio ranges of 1.73-2.47 by age, 1.91-2.21 by sex, 1.40-2.30 by Charlson Comorbidity Index, 2.00-2.07 by neuropsychiatric comorbidity, and 1.63-2.82 by number of other medications. CONCLUSIONS: The risk of unintentional poisoning doubles in 2 weeks following a new initiation of CNS drugs and the risk is increased across a range of population groups. Clinicians should carefully monitor signs of poisoning after such initiation among not only multimorbid older adults but also those with less comorbidity and polypharmacy.
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Zhao et al. (2022) conducted an observational in Unintentional poisoning (n=9,354). Central nervous system (CNS) medications vs. Control period (113-140 days prior to poisoning event) was evaluated on Unintentional poisoning within 2 weeks of newly initiated CNS medication (OR 2.06, 95% CI 1.70-2.48). Newly initiated central nervous system medications doubled the risk of unintentional poisoning during the first two weeks of treatment in older adults (OR 2.06).
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