Incidence and predictors of adverse drug reactions caused by drug-drug interactions in psychiatric patients: An empirical study

Lucca, Jisha M; Ramesh, Madhan; Ram, Dushad; Kishor, M

doi:10.4103/1119-0388.172059

Cited by 13 publications

(17 citation statements)

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“…This finding is in agreement with Vijayakumar and Dhanaraju on the description of ADRs in a multi-specialty teaching hospital (2013) which expressed that more reports were observed [11]. In our study, ADRs are commonly seen with orally administered drugs and delayed reactions were found to be more Red blood cell disorders (1210): Hemorrhage (7) and Anemia (7) 14 (6.6) Vision disorders (0431): Conjunctivitis (2), Nystagmus (7), and Ptosis (3) 12 ( [12].…”

Section: Discussionmentioning

confidence: 50%

Assessment of Adverse Drug Reactions Occurring at Department of Neurology of a Tertiary Care Hospital in India

Grace

Saina

Maheswari

et al. 2018

Asian J Pharm Clin Res

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Objective: The purpose of this study was to assess the incidence and pattern of adverse drug reactions (ADRs) reported from the department of neurology of a tertiary care hospital in Karnataka, India.Methods: It is a hospital-based prospective, observational study, conducted among the inpatients of all age groups of either sex for a period of 6 months. ADRs were reported by the clinical pharmacists and physicians of this hospital. ADRs obtained were categorized based on its causality, severity, preventability, predictability, and outcomes. Binary logistic regression was carried out to identify the predictors of ADR and Kaplan–Meier analysis was performed for survival analysis.Results: A total of 250 patients were enrolled for the study in which 108 (43%) patients were presented with at least one ADR and a total of 212 ADRs were observed. The highest rate of ADRs was observed with antiepileptics 61 (29.5%). The most commonly reported that ADRs were skin reactions 23 (10.8%). Causality was assessed using three different scales which showed that most of the ADRs were probable. Severity, preventability, and predictability were assessed, of which 125 (59%) ADRs were moderate, 192 (90.6%) ADRs were probably preventable, and 156 (73.6%) ADRs were predictable, respectively. The outcomes showed that 150 (70.1%) patients recovered from the reactions. Predictors such as polypharmacy and duration of stay were found to be significant.Conclusion: The study concluded that the prevalence of ADRs in the department of neurology is high. Thus, early detection and management of ADRs are essential to avoid further complications of the reaction.

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Section: Discussionmentioning

confidence: 50%

Assessment of Adverse Drug Reactions Occurring at Department of Neurology of a Tertiary Care Hospital in India

Grace

Saina

Maheswari

et al. 2018

Asian J Pharm Clin Res

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“…33 In comparison, Ismail et al and Lucca et al had reported a relatively lower percentage (64.8%; 55.2%). 24,28 During the duration of our study however, we had discovered an exorbitant amount of pDDIs accounting up to 95%.…”

Section: Discussionmentioning

confidence: 86%

“…Like us, most of the studies involved with a similar objective used Micromedex as their standard. 24,28,34,38 . Sengul et al though, used Drugs.com as their standard for reference.…”

Section: Discussionmentioning

confidence: 99%

“…The greatest propensity to interact with other medications was exhibited by risperidone with 41 occurrences. 28 In this study, the authors aimed to assess commonly occurring pDDIs, the psychiatric diagnosis of patients in the study, manifestation of comorbidities, customary psychotropic use, prevalence of pDDIs and their classification based on severity/documentation/onset, adverse clinical outcomes of pDDIs, and common interacting drug combinations with their probable mechanism of interaction along with their clinical management. This observational study also determines the statistical association of parameters like age, gender, comorbidity, diagnosis, body system, onset, documentation, psychotropic and non-psychotropic drug use against different severities of pDDIs.…”

Section: Global and Indian Scenariomentioning

confidence: 99%

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Appraisal and discernment of prevalent drug-drug interactions in patients with psychiatric disorders

Jacob¹,

Thomas²,

Deore³

et al. 2021

Int J Basic Clin Pharmacol

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Background: Drug-drug interactions (DDIs) contribute majorly to hospital admissions, treatment failures, avoidable medical complications and subsequent healthcare costs. Thus, we employ a mechanistic approach to prospectively investigate the incidence of potential DDIs in the psychiatric patients in a clinical setting.Methods: In this prospective, observational, multi centred study conducted for a span of 6 months, psychiatric inpatients (≥18 years) prescribed with 2 or more medications daily for any medical illness were included. The secured prescriptions of the inpatients selected in accordance to the inclusion criteria were then assessed for DDIs using Micromedex(TM) as a standard.Results: Of the total 400 enrolled participants, 383 (95%) of them showed at least one pDDI regardless of the severity. An average of 7.33 interactions per patient was also deduced. A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. Most of the interactions were of major (56.52%) and moderate severity (39.07) followed by contraindicated (2.55) and minor (1.83). Cardiovascular system (41.77%) had the highest potential to be affected due to the pDDIs identified. Trihexyphenidyl, haloperidol, promethazine, amisulpride, risperidone, divalproex, trifluoperazine, olanzapine and clozapine where among the most commonly encountered drugs in these interactions.Conclusions: A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. A significant association of the pDDIs with variables such as age, gender, diagnosis and total number of drugs used was identified. More studies are required to explore the overall pattern of DDIs in psychiatric patients along with their levels and correlation with different risk factors. Careful monitoring and documentation are necessary to prevent further complications thereby improving the therapeutic outcome.

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“…Patients with such disorders are at particular risk for DDIs because of the practice of symptom-based prescribing, longer hospital stays and multiple prescribers, and medical, including psychiatric, comorbidity. DDIs contribute significantly to hospital admissions, treatment failures, avoidable medical complications, and subsequent healthcare costs (10,11).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of potential drug-drug interactions in psychiatric patients: a pilot study

Zhelyazkova-Savova

Todorova-Nenova

Gancheva

et al. 2018

Scripta Scientifica Medica

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INTRODUCTION: Drug-drug interactions (DDIs) are common but avoidable causes for adverse drug reactions. AIM: The present pilot study aimed to assess the prevalence of potential DDIs (pDDIs) among patients with psychiatric disorders by evaluation of patients' hospital records and their discharge medication lists. MATERIALS AND METHODS: A retrospective review of medication information was conducted for 47 male patients consecutively admitted for a period of one month to the acute unit of a university-based psychiatric clinic. Potential DDIs were checked with Medscape drug interaction checker and standard references on drug interactions, and were classified as major, moderate, or minor according to their severity. The statistical analysis included: Chi-square test, Student's t-test, and correlation analysis. RESULTS: For the duration of the hospitalization a total of 121 interacting drug pairs were detected, potentially capable of inducing DDIs (2.57 per patient). Out of all the patients 44 (94%) were exposed to at least one pDDI and 7 (15%) to at least one serious pDDI. The most common potential risk was the additive sedative effect, involving 58 drug pairs with an average rate of 1.23 per patient. QTc prolonging drug combinations were found in 11 (23%) patients, drug combinations with potential risk of hematologic toxicity in 10 (21%) patients and such with potential risk of hepatic/metabolic toxicity in 9 (19%). CYP-mediated pDDIs were identified in 8 (17%) patients. At hospital discharge fewer pDDIs per patient (1.13) were detected. CONCLUSION: A high prevalence of pDDIs among the psychiatric inpatients was recorded. Caution is warranted to limit the exposure of the patients to pDDIs.

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Incidence and predictors of adverse drug reactions caused by drug-drug interactions in psychiatric patients: An empirical study

Cited by 13 publications

References 0 publications

Assessment of Adverse Drug Reactions Occurring at Department of Neurology of a Tertiary Care Hospital in India

Assessment of Adverse Drug Reactions Occurring at Department of Neurology of a Tertiary Care Hospital in India

Appraisal and discernment of prevalent drug-drug interactions in patients with psychiatric disorders

Evaluation of potential drug-drug interactions in psychiatric patients: a pilot study

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