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(A:4) The average monthly cost of four benzodiazepines was compared with their average drugstore coupon off monthly cost and the of all benzodiazepines except those listed below: Dalkox, diazepam; diazepam mixed with diafentanil; and lamotrigine. For this purpose, each drug was selected by considering the cost to manufacturers of its main active metabolite.
(B) A multivariable multinomial logistic regression analysis was used to determine the adjusted odds ratios for suicide related to the use of each benzodiazepines. Multivariable logistic regression models provided adjusted odds ratios for the characteristics of each sample according to whether the used benzodiazepines or nonbenzodiazepines by prescription. This model included the main characteristics cost of duloxetine uk of patients and the benzodiazepines. For with only one benzodiazepine prescribed by a health care professional, the baseline characteristics associated with benzodiazepine use (that is, their age, sex, race, marital status, highest education, or self-reported number of past physician visits) were entered into the adjustment equation before variable regarding the use of benzodiazepines by physician prescription became significant.
At baseline, there were only a small majority of patients taking only one or another of the benzodiazepines on a non-prescription basis (data not shown). In order to obtain a more homogenous sample, we did not restrict the analysis to patients with use in the 5 day period prior to baseline and the daily dose of benzodiazepine prescribed by physician prescription. This analysis would have led to biased results regarding the relationship between benzodiazepine, age, and marital status with suicide.
Analyses were performed with SAS version 9.3 (SAS Institute Inc) and SUDAAN version 10.0 (Research Triangle Institute) to account for the complex sample design of study. Cox proportional hazards regression model was used in all multivariable analyses to predict suicide for each patient, stratified by age, sex, race, marital status, highest education, and number of past physician visits during the month before baseline. Model 1 adjusted for age, sex, and race, Model 2 adjusted for the most common psychiatric conditions and comorbid medical conditions, Model 3 for total comorbid conditions. Standard errors were estimated by using the variance spline function (Stata, Cary, NC). The statistical analysis was performed lowest price for duloxetine using Stata Statistical Software version 10.0 (StataCorp LP).
Prevalence and Relative Risk (RR) of Suicidality
The prevalence of all suicidal behavior was determined among the sample as follows. probability of suicide among the sample during past year was calculated as the number of observations divided by the number of persons in sample, multiplied by 100 (1 person = generic price for duloxetine 10 persons). The proportion of patients in each age and sex category who had ever made a suicidal attempt prior to presentation for a suicide attempt diagnosis was calculated as the ratio of probability a prior suicidal attempt before presentation for a suicide attempt diagnosis patients over 65 years of age compared to patients over 65 of age. Proportions were calculated by age group and sex.
Relative risks for suicide behaviors were calculated using age- and sex-stratified models. For each sex, the median in that category of risk associated with use a benzodiazepine Phenergan pills dosage versus all other benzodiazepines on a non-prescription basis was determined by multivariable logistic regression. Relative risks compared to other benzodiazepines were calculated by age and sex-stratified models. Risk of suicide was calculated as the proportion of participants using a specific medication relative to the proportion of patients not using a specific benzodiazepine.
As this is an exploratory analysis, its conclusions should not be overstated. However, this study does indicate that the use of benzodiazepines is most commonly utilized by elderly patients.
DISCUSSION
For every 1 million people aged 65 and over with a mental condition in the United States, there were 33.3 million prescriptions written for a benzodiazepine (1). Benzodiazepines are used to treat anxiety, hyperarousal, and panic disorders. Their use in adults and adolescent |
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