[Sedating antihistamines - risk of severe intoxication]. / Sedativa antihistaminer ­ risk för allvarlig intoxikation.

Overdoses with the sedating antihistamines alimemazine, hydroxyzine, promethazine and propiomazine have received attention in recent years in Sweden. The Poisons Information Center has noted an increase in calls regarding intoxications, and the National Board of Forensic Medicine has concluded that these substances have directly contributed to a large number of poisoning deaths. When prescribing alimemazine, hydroxyzine, promethazine and propiomazine, their pharmacological properties, such as antihistaminergic and anticholinergic effects, and their anti-arrhythmic potential must be considered. Furthermore, it is important to also consider the risks of severe intoxication in case of overdose. The lowest possible amount should be prescribed. Special attention is required when prescribing alimemazine oral solution.

Association between prescribed antidepressants and other prescribed drugs differ by gender: a nationwide register-based study in Sweden.

BACKGROUND: People with depression are prescribed more drugs than people in general, partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective. AIM: Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender. METHODS: Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressants and other drugs, by gender. RESULTS: For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were also found for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones. CONCLUSIONS: Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between antidepressants and other types of drugs are more common among women than men.

Are men under-treated and women over-treated with antidepressants? Findings from a cross-sectional survey in Sweden.

Aims and method To examine gender differences in self-reported depression and prescribed antidepressants (ADs). The Hospital Anxiety and Depression Scale was used to assess depression, and information on prescribed ADs was obtained from the Swedish Prescribed Drug Register. Results Depression was reported by 11.7% of the participants (12.3% men and 11.2% women). ADs were prescribed for 7.6% of the participants (5.3% men, 9.8% women). Among men, 1.8% reported depression and used ADs, 10.5% reported depression but did not use ADs, and 3.6% used ADs but did not report depression. The corresponding figures for women were 2.6%, 8.6% and 7.2%. Clinical implications Men report depression to a greater extent than women but are prescribed ADs to a lesser extent, possibly a sign of under-treatment. Women are prescribed ADs without reporting depression more often than men, possibly a sign of over-treatment. Although the causes remain unclear, diagnostic and treatment guidelines should benefit from considering gender differences in these respects.

Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey / Hombres y mujeres comunican diferentes comportamientos y razones para el incumplimiento de la medicación: encuesta nacional sueca

Objectives: The aim of the present study was to analyse gender differences in self-reported nonadherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA. Methods: A questionnaire was mailed to a crosssectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA. Results: Use of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR=0.77 (95%CI 0.65:0.92)], changing the dosage [OR=0.64 (95%CI 0.52:0.79)] and that they had recovered [14.3%, (OR=0.71 (95%CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR=1.25 (95%CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR=1.89 (95%CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs. Conclusions: Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes (AU)

Objetivos: El objetivo del presente estudio fue analizar las diferencias de género en el incumplimiento auto-reportado a la medicación prescrita en la población general sueca. Intentamos estudiar el incumplimiento voluntario e involuntario, así como las razonas dadas para el incumplimiento. Métodos: Se envió por correo un cuestionario a una muestra nacional, transversal, aleatoria de personas de 18-84 años en Suecia (n=7985). La tasa de respuesta fue de 61,1% (n=4875). El cuestionario trataba sobre el uso de los medicamentos prescritos, comportamiento sobre incumplimiento y razones. Resultados: Se comunicó uso de medicamentos de prescripción en un 59,5% (n=2802) de los participantes, y el 66,4% (n=1860) de ellos no cumplía el régimen prescrito. No se encontraron diferencias generales en la comunicación de incumplimiento. Sin embargo, al analizar los diferentes tipos de comportamientos en incumplimiento y las razones del incumplimiento, aparecieron patrones diferentes por géneros. Los hombres comunicaban más frecuentemente olvidos [OR=0.77 (IC95% 0.65:0.92)], cambios de la dosis [OR=0.64 (IC95% 0.52:0.79)] y que ya estaban recuperados [14.3%, (OR=0.71 (IC95% 0.56:0.90)] como motivo. Por el contrario, más mujeres que hombres comunicaba comprar la medicación pero no tomarla [OR=1.25 (IC95% 1.02:1.54)] y la aparición de reacciones adversas [OR=1.89 (IC95% 1.37:2.59)] como motivo. Las diferencias de género se mantuvieron en la mayoría de los casos después de controlar los factores de confusión tales como edad, factores socioeconómicos, problemas de salud y actitudes hacia los medicamentos. Conclusión: Hombres y mujeres tienen patrones diferentes de comportamientos de incumplimiento y diferentes motivos para el incumplimiento. Por tanto, si se quiere mejorar el cumplimiento, se requiere un amplio conocimiento de las razones del incumplimiento, así como la comprensión del impacto del género en los resultados (AU)

Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey.

OBJECTIVE: The aim of the present study was to analyse gender differences in self-reported non-adherence (NA) to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA. METHODS: A questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985). The response rate was 61.1% (n=4875). The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA. RESULTS: Use of prescription drugs was reported by 59.5% (n=2802) of the participants, and 66.4% (n=1860) of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR=0.77 (95%CI 0.65:0.92)], changing the dosage [OR=0.64 (95%CI 0.52:0.79)] and that they had recovered [14.3%, (OR=0.71 (95%CI 0.56:0.90)] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR=1.25 (95%CI 1.02:1.54)] and reported the development of adverse drug reactions (ADRs) [OR=1.89 (95%CI 1.37:2.59)] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs. CONCLUSIONS: Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes.