Abstract：
BACKGROUND: Antiepileptic drugs may cause delirium, and the risk may vary with each drug. However, related studies have provided inconsistent results.
OBJECTIVE: The aim of this study was to investigate whether the use of antiepileptic drugs is a risk factor for delirium development.
METHODS: Using the Japanese Adverse Drug Event Report database, we analysed 573,316 reports pertaining to the period from 2004 to 2020. Reporting odds ratios and 95% confidence intervals of delirium associated with use of antiepileptic drugs were calculated after adjusting for potential confounders. Furthermore, for each antiepileptic drug, we performed an analysis stratified based on older age and benzodiazepine receptor agonist usage.
RESULTS: There were 27,439 reports of antiepileptic drug-related adverse events. Of these, 191 reports were associated with antiepileptic drugs and delirium (crude reporting odds ratio [cROR], 1.66; 95% confidence interval [CI], 1.43-1.93). The use of lacosamide (adjusted reporting odds ratio [aROR], 2.44; 95% CI, 1.24-4.80), lamotrigine (aROR, 1.54; 95% CI, 1.05-2.26), levetiracetam (aROR, 1.91; 95% CI, 1.35-2.71), and valproic acid (aROR, 1.49; 95% CI, 1.16-1.91) was related to a significantly higher reporting odds ratio for delirium, even after adjustment for possible confounding factors. However, when used in combination with benzodiazepine receptor agonists, none of the antiepileptic drugs were found to be associated with delirium.
CONCLUSIONS: Our study\'s findings suggest that antiepileptic drug usage may be associated with delirium development.
OBJECTIVE: The aim of this study was to investigate whether the use of antiepileptic drugs is a risk factor for delirium development.
METHODS: Using the Japanese Adverse Drug Event Report database, we analysed 573,316 reports pertaining to the period from 2004 to 2020. Reporting odds ratios and 95% confidence intervals of delirium associated with use of antiepileptic drugs were calculated after adjusting for potential confounders. Furthermore, for each antiepileptic drug, we performed an analysis stratified based on older age and benzodiazepine receptor agonist usage.
RESULTS: There were 27,439 reports of antiepileptic drug-related adverse events. Of these, 191 reports were associated with antiepileptic drugs and delirium (crude reporting odds ratio [cROR], 1.66; 95% confidence interval [CI], 1.43-1.93). The use of lacosamide (adjusted reporting odds ratio [aROR], 2.44; 95% CI, 1.24-4.80), lamotrigine (aROR, 1.54; 95% CI, 1.05-2.26), levetiracetam (aROR, 1.91; 95% CI, 1.35-2.71), and valproic acid (aROR, 1.49; 95% CI, 1.16-1.91) was related to a significantly higher reporting odds ratio for delirium, even after adjustment for possible confounding factors. However, when used in combination with benzodiazepine receptor agonists, none of the antiepileptic drugs were found to be associated with delirium.
CONCLUSIONS: Our study\'s findings suggest that antiepileptic drug usage may be associated with delirium development.
摘要：
背景：抗癫痫药物可能会引起谵妄，风险可能因每种药物而异。然而,相关研究提供了不一致的结果。
目的：本研究的目的是调查使用抗癫痫药物是否是谵妄的危险因素。
方法：使用日本不良药物事件报告数据库，我们分析了2004年至2020年期间的573,316份报告。在调整潜在的混杂因素后，计算与使用抗癫痫药物相关的谵妄的报告比值比和95%置信区间。此外，每种抗癫痫药，我们根据年龄和苯二氮卓受体激动剂的使用情况进行了分层分析.
结果：有27,439例抗癫痫药相关不良事件的报告。其中,191份报告与抗癫痫药物和谵妄相关(粗略的报告比值比[cROR]，1.66；95%置信区间[CI]，1.43-1.93)。拉科沙胺的使用(调整后的报告优势比[aROR]，2.44；95%CI，1.24-4.80），拉莫三嗪（AROR，1.54；95%CI，1.05-2.26），左乙拉西坦（AROR，1.91；95%CI，1.35-2.71），和丙戊酸（aROR，1.49；95%CI，1.16-1.91）与谵妄的报告比值比显著较高相关，即使在调整了可能的混杂因素之后。然而,与苯二氮卓受体激动剂联合使用时，没有发现抗癫痫药物与谵妄相关.
结论：我们的研究结果表明，抗癫痫药物的使用可能与谵妄的发生有关。
目的：本研究的目的是调查使用抗癫痫药物是否是谵妄的危险因素。
方法：使用日本不良药物事件报告数据库，我们分析了2004年至2020年期间的573,316份报告。在调整潜在的混杂因素后，计算与使用抗癫痫药物相关的谵妄的报告比值比和95%置信区间。此外，每种抗癫痫药，我们根据年龄和苯二氮卓受体激动剂的使用情况进行了分层分析.
结果：有27,439例抗癫痫药相关不良事件的报告。其中,191份报告与抗癫痫药物和谵妄相关(粗略的报告比值比[cROR]，1.66；95%置信区间[CI]，1.43-1.93)。拉科沙胺的使用(调整后的报告优势比[aROR]，2.44；95%CI，1.24-4.80），拉莫三嗪（AROR，1.54；95%CI，1.05-2.26），左乙拉西坦（AROR，1.91；95%CI，1.35-2.71），和丙戊酸（aROR，1.49；95%CI，1.16-1.91）与谵妄的报告比值比显著较高相关，即使在调整了可能的混杂因素之后。然而,与苯二氮卓受体激动剂联合使用时，没有发现抗癫痫药物与谵妄相关.
结论：我们的研究结果表明，抗癫痫药物的使用可能与谵妄的发生有关。
