Prevalence of Psychotropic Drugs in Cases of Severe Adverse Drug Reactions Leading to Unplanned Emergency Visits in General Hospitals

Abstract

Introduction The prevalence of psychotropic drug use in our society is increasing especially in older adults, thereby provoking severe adverse drug reactions (ADR). To identify specific patient risk profiles associated with psychotropic drug use in the situation of polymedication. Methods Cases of ADRs in general emergency departments (ED) collected within the multi-center prospective observational study (ADRED) were analyzed (n=2215). We compared cases with use of psychotropic drugs and without concerning their clinical presentation at the ED. Results A third of patients (n=731, 33%) presenting to the ED with an ADR took at least 1 psychotropic drug. Patients with psychotropic drug use tended to be older, more often female, and took a higher number of drugs (all p<0.001). The frequency of falls was almost 3 times higher than compared to the non-psychotropic drug group (10.5 vs. 3.9%, p<0.001), and similar syncope was also more often seen in the psychotropic drug users (8.8 vs. 5.5%, p=0.004). The use of psychotropic drugs increased the risk for falls by a factor of 2.82 (OR, 95% CI (1.90–4.18)), when adjusting for gender, age, numbers of pre-existing diseases, and drugs, respectively. Discussion The association of psychotropic drug use with fall and syncope in combination with polymedication and older age leads to the suspicion that psychotropic drugs might be potentially harmful in specific risk populations such as older adults. It may lead us to thoroughly weigh the benefit against risk in a patient-oriented way, leading to an integrative personalized therapy approach.

The listed, delisted, and sustainability of therapeutic medicines for dementia patients: the study is specific to South Korea

“…The percentage of new users was 2.5% across hospitalisations for AD medication (Möllers et al 2020). Neuropsychiatric symptoms and adverse drug reactions were associated with a significantly increased prevalence of further psychotropic medication use (Stingl et al 2020). Hospital stays due to dementia and the need for care were predictors for the new use of psychotropic medication (Jordan et al 2019).…”

Dementia Management Act and Death Toll by Dementia Drug

“…The percentage of new users was 2.5% across hospitalizations for Alzheimer's medication 45 . Neuropsychiatric symptoms and adverse drug reactions were associated with signi cantly increased prevalence of further psychotropic medication use 46 , and hospital stays due to dementia and the need of care were predictors for new use of psychotropic medication 47 .…”

Death Toll by Dementia Drug

“…The percentage of new users was 2.5% across hospitalizations for Alzheimer's medication 44 . Neuropsychiatric symptoms and adverse drug reactions were associated with signi cantly increased prevalence of further psychotropic medication use 45 , and hospital stays due to dementia and the need of care were predictors for new use of psychotropic medication 46 . All studies from many countries have already con rmed that antipsychotic drugs should not be administered to dementia patients because of the risk of seizures and all-cause mortality 47,48 .…”