Adverse drug reactions of antidepressants and antipsychotics: Experience, knowledge and attitudes among Norwegian psychiatrists

Castberg, Ingrid; Reimers, Arne; Sandvik, Päl Thonstad; Aamo, Trond; Spigset, Olav

doi:10.1080/08039480600636494

Cited by 10 publications

(9 citation statements)

References 18 publications

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“…[9] A knowledge, attitude and practice based study conducted in Norway found that ADRs can be prevented by collecting reliable information about their frequencies and possible risk factors. [10] In our study, which is based on active surveillance rather than spontaneous reporting, we found antipsychotics to be most commonly responsible; this could be partly related to the frequency and duration of their use in the hospital setting.…”

Section: Discussionmentioning

confidence: 85%

Adverse drug reaction monitoring in psychiatry out-patient department of an Indian teaching hospital

et al. 2011

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Objectives:Adverse drug reactions (ADRs) to psychotropic agents are common and can lead to noncompliance or even discontinuation of therapy. There is paucity of such data in the Indian context. We deemed it worthwhile to assess the suspected ADR profile of psychotropic drugs in an ambulatory setting in a public teaching hospital in Kolkata.Materials and Methods:A longitudinal observational study was conducted in the outpatient department (OPD) of the concerned psychiatry unit. Twenty consecutive patients per day, irrespective of their psychiatric diagnosis, were screened for suspected ADRs, 2 days in a week, over 15 months. Adverse event history, medication history and other relevant details were captured in a format as adopted in the Indian National Pharmacovigilance Programme. Causality was assessed by criteria of World Health Organization-Uppsala Monitoring Center (WHO-UPC).Results:We screened 2000 patients (68.69% males, median age 34.4 years), of whom 429 were suspected of having at least one ADR; 84 cases had insufficient evidence about causality (WHO-UMC causality status “unlikely”) and were excluded from further analysis. Thus, 17.25% (95% confidence interval: 15.59-18.91%) of our study population reported ADRs with at least “possible” causality. Of 352 events recorded, 327 (92.90%) were “probable” and the rest “possible”. None was labeled “certain” as rechallenge was not performed. Patients received a median of 3.2 psychotropic drugs each. Thirty-three different kinds of ADRs were noted, including tremor (19.60%), weight gain (15.34%) and constipation (14.49%). Among the incriminated drugs, antipsychotics represented the majority (57.10%), with olanzapine topping the list.Conclusions:This study offers a representative profile of ADRs to be expected in psychiatry out-patients in an Indian public hospital. Establishment of a psychotropic drug ADR database can be a worthy long-term goal in the Indian context.

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Section: Discussionmentioning

confidence: 85%

Adverse drug reaction monitoring in psychiatry out-patient department of an Indian teaching hospital

et al. 2011

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“…A knowledge, practice and attitude based study conducted in Norway found that ADRs can be prevented by collecting reliable information about their frequencies and possible risk factors. [15] Spontaneous reporting is the most common method used in pharmacovigilance and is the best one to generate signals on new or rare ADRs. Under reporting is a major drawback of this system due to lack of awareness both at the level of healthcare professionals and patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Adverse Drug Reactions of Atypical Antipsychotic Drugs in Psychiatry OPD

Piparva

Buch

Chandrani

2011

Indian Journal of Psychological Medicine

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Background:Novel atypical antipsychotics are superior to conventional antipsychotics as they significantly reduce both positive and negative symptoms of schizophrenia and have lower risk of extrapyramidal symptoms (EPS). However, these drugs have separate set of adverse drug reactions (ADRs). Therefore, this study was carried out to assess these ADRs, which can have impact on long-term compliance and achieving successful treatment.Materials and Methods:A prospective study of analysis of ADR of atypical antipsychotic drugs was carried out in the psychiatry outpatient department. Patients of psychotic disorder (any age, either sex), who were prescribed atypical antipsychotic drugs, were included. Those who were prescribed conventional antipsychotics or combinations of antipsychotics were excluded from the study. Apart from spontaneously reported ADRs, a questionnaire related to the likely ADR was used and patients’ responses were recorded in the case record form.Results:Totally 93 ADRs were recorded from 84 prescriptions. Majority of the ADRs (82 out of 93) were seen with risperidone and olanzepine, as they were the commonly prescribed drugs. Weight gain, dizziness, sleep disturbance and appetite disturbance accounted for nearly 78% of the total events. With risperidone (at 4–6 mg/day) and olanzepine (at 10–15 mg/day), gastrointestinal and sleep disturbance were observed in the initial (within 7 days to 2–3 months after treatment) course of treatment, while EPS, fatigue, seizure, increased frequency of micturition and dizziness were observed after long-term (3–9 months) use.Conclusion:The present study adds to the existing information on the prevalence of adverse effects of atypical antipsychotic drugs. Role of active surveillance in post-marketing phase is also emphasized.

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“…Castberg et al (2006) studied the understanding of Acute Drug Reactions (ADR) and noted that psychiatrists reported bothersome ADR's occurred 2.4 to 9.3 times and to practitioners more than residents. Knowledge about the association of receptor site blockade with a specific ADR, varied from 37% to 76% of respondents.…”

Section: Studies Of Sleep Loss In the Clinical Situationmentioning

confidence: 99%

Sleep loss in resident physicians: the cause of medical errors?

Kramer¹

2010

Front. Neur.

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This review begins with the history of the events starting with the death of Libby Zion that lead to the Bell Commission, that the studied her death and made recommendations for improvement that were codified into law in New York state as the 405 law that the ACGME essentially adopted in putting a cap on work hours and establishing the level of staff supervision that must be available to residents in clinical situations particularly the emergency room and acute care units. A summary is then provided of the findings of the laboratory effects of total sleep deprivation including acute total sleep loss and the consequent widespread physiologic alterations, and of the effects of selective and chronic sleep loss. Generally the sequence of responses to increasing sleep loss goes from mood changes to cognitive effects to performance deficits. In the laboratory situation, deficits resulting from sleep deprivation are clearly and definitively demonstrable. Sleep loss in the clinical situation is usually sleep deprivation superimposed on chronic sleep loss. An examination of questionnaire studies, the literature on reports of sleep loss, studies of the reduction of work hours on performance as well as observational and a few interventional studies have yielded contradictory and often equivocal results. The residents generally find they feel better working fewer hours but improvements in patient care are often not reported or do not occur. A change in the attitude of the resident toward his role and his patient has not been salutary. Decreasing sleep loss should have had a positive effect on patient care in reducing medical error, but this remains to be unequivocally demonstrated.

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Adverse drug reactions of antidepressants and antipsychotics: Experience, knowledge and attitudes among Norwegian psychiatrists

Cited by 10 publications

References 18 publications

Adverse drug reaction monitoring in psychiatry out-patient department of an Indian teaching hospital

Adverse drug reaction monitoring in psychiatry out-patient department of an Indian teaching hospital

Analysis of Adverse Drug Reactions of Atypical Antipsychotic Drugs in Psychiatry OPD

Sleep loss in resident physicians: the cause of medical errors?

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