著者
Kensuke Yoshimura Tasuku Hashimoto Yasunori Sato Aiko Sato Takashi Takeuchi Hiroyuki Watanabe Takeshi Terao Michiko Nakazato Masaomi Iyo
出版者
The Japanese Society of Clinical Neuropsychopharmacology
雑誌
Clinical Neuropsychopharmacology and Therapeutics (ISSN:18848826)
巻号頁・発行日
vol.9, pp.20-28, 2018-09-28 (Released:2018-09-28)
参考文献数
30
被引用文献数
4

Purpose: Pharmacological treatments with some anticonvulsants, including valproate, and lithium should be avoided where possible in childbearing-aged and pregnant women with epilepsy and bipolar disorder because they increase the risk of major congenital malformations. We surveilled real-world prescriptions of anticonvulsants and lithium in childbearing-aged female and male outpatients in Japan, using the first public National Insurance Claims Database of Japan.Methods: We performed a summary statistical analysis of the numbers of the most prescribed 11 anticonvulsants and lithium tablets in female and male outpatients aged 15-29 (younger childbearing age), 30-49 (older childbearing age), and >50 (non-childbearing age) years from April 2014 to March 2015. We determined the association between anticonvulsant or lithium use and sex at childbearing age, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated using logistic regression analysis.Results: Valproate (number of tablets = 273,135,937) was the most prescribed among the 12 investigated drugs, and 125,451,907 tablets were prescribed for women (younger, older, and non-childbearing ages, 19,296,528, 47,826,746, and 58,328,63, respectively), compared to 147,684,031 tablets for men (24,534,648, 57,229,981, and 65,919,402, respectively). Valproate prescription was only slightly lower in childbearing-aged women than in the same-aged men (i.e., 15-29 years of age, OR = 0.889 [95% CI, 0.888-0.890]; 30-49 years of age, OR = 0.944 [95% CI, 0.944-0.945]).Discussion: This study demonstrated valproate was highly prescribed for childbearing-aged women in Japan in 2014-2015. Physicians should prescribe valproate with considerable caution in girls and childbearing-aged women.