Clinical Pharmacist Driven Impact towards Intensive Monitoring and Reporting of Adverse Drug Events in Psychiatric Patients

Abstract

Background: Drugs are used for the well-being of an individual but apart from its effectiveness many adverse effects are observed. Antipsychotics are the mainstay of treatment for psychotic disorders. Most of the first generation and to a lesser degree second generation antipsychotic agents are associated with ADEs like extra pyramidal symptoms (EPS), sedation and anti-cholinergic side effects. Method: This study was conducted at a tertiary care hospital. Informed consent was obtained from patients care takers. Patients aged ≥18 years of either gender admitted to psychiatry department were included in the study. Patients on OPD basis, emergency, ICUs and special population were excluded. The main objective of the study was to estimate the incidence of ADEs and evaluate ADEs based on various parameters like demographics, drug class implicated, individual drug implicated, organ system affected, and analysis of ADEs (causality, severity and preventability). Result: A total of 58 patients were enrolled into the study. Out of them, 32 patients experienced 90 ADEs. The incidence rate was found to be 55.17%. Male (65.51%) preponderance was observed over females (34.48%). Benzodiazepine was reported to be one of the major drug class implicated in which Lorazepam accounted for 36.51% ADEs. CNS was one of the most prominent systems affected due to ADEs. Conclusion: The fact goes undenied, psychiatric patients are prone towards adverse events, the only good that could be done to these subjects is try avoiding and minimizing the events. This could be possible only by thorough monitoring of such cases. Our results showed incidence rate of 79.31%. This incidence rate could be minimized by the presence of a clinical Pharmacist for better treatment and creating awareness of the medicines to the patients.

Pharmacovigilance of Neuroleptics and Benzodiazepines in the Psychiatric Teaching Hospital of Benin Republic

“…The neurological ones (the most frequent) followed by appetite improvement. The frequency of neurological SEs is 61.58% against 79.10% in a study by Khoda et al [13] in India. Day sleeping occurred in 17.44% of the cases during the first three days of treatment and can be related to the sedative property of neuroleptics (action on H1 histaminic, α1 adrenergic and M1 muscarinic receptors) and to benzodiazepines (potentializing the depressive effect of the GABAergic transmission).…”

“…The size of the study population authorizes the recording of the most frequent side events. In contrary to other studies that followed only hospitalized patients [13,14] or ambulatory ones [15,16]. This study included both types of patients allowing a global view of the SEs' profile.…”

“…The occurrence of SEs calls for measures that could improve patients' quality of life. Doses have been reduced in 23% of the cases against 36% in India [13]. Possible strategies of an active monitoring, which could enable physicians to a possible prevention, early detection and a timely management of such adverse events should be developed in the psychiatry setting.…”

Critical analysis of drug related problems among inpatients in the psychiatry department of a tertiary care teaching hospital: A pharmacist led initiative

“…In a study done by Khoda DA et al, schizophrenia and bipolar affective disorder were highest in number. 14 The high frequency of ADS in the present study population can be because of the high frequency of alcoholics in the location where the study was conducted. Similarly, the most frequently prescribed class of drug was found to be atypical antipsychotics which constitute 35.7% of the total psychotropic drugs prescribed.…”