Drug Interactions and Adverse Drug Reactions in Hospitalized Psychiatric PatientsA Critical Element in Providing Safe Medication Use

Jain, Tarun and Bhandari, Anil and Veerma , Ram and Parakh, Manish and Wal, Pranay and Naik, Anantha Nagappa (2011) Drug Interactions and Adverse Drug Reactions in Hospitalized Psychiatric PatientsA Critical Element in Providing Safe Medication Use. The German Journal of Psychiatry. pp. 26-34.

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Abstract

Background: Schizophrenia represents a major burden on ental health services globally, and there are nearby 15millioncases in India. The treatment of schizophrenia promises improvement only with long-term medication, but noncompliance,adverse reactionsandinteractions are a major hurdle in thepathway.Methods: A six-month prospective study was conducted at the MDM Hospital, Jodhpur. Schizophrenicpatients(n=205) aged 18-70 years and prescribed with antipsychotics were evaluated for drug interactions (DI) and adversedrug reactions(ADR). Extrapyramidal symptoms (EPS) were evaluated at baseline and endpoint; weight gain andlipid profile were evaluated at variable time points.Results: In the presentstudy, 463 interactions occurred; 70 were of majorseverity. Antipsychotics were involved in42% of the total interactions, amongst which haloperidol (21.5%), and olanzapine (10.3%) were involved in most,while aripiprazole (3.48%) was involved in least interactions. A total of 194ADRs including 19 severe (5, arrhythmia,4, tremor, and 10, EPS) were reported. Other frequently reported ADRs were insomnia, anxiety, drymouth and EPS. Weight gain in the aripiprazole vs. olanzapine group was 0.23 kg vs. 2.74 kg (p <0.001). Patientson olanzapine vs. aripiprazole experienced elevated total cholesterol (6.7 mg/dl vs. -11.2mg/dl), low densitylipoprotein (4.3 mg/dl vs. -13.2 mg/dl), and triglyceride levels (12.7 mg/dl vs. -22.13mg/dl).Conclusion: Reasons of non-compliance and inadequate clinical improvement in schizophrenia are long-term medication,ADRs and drug interactions. ADRs and interactions were least in aripiprazole prescriptions. Further long-termstudies are required (German J Psychiatry 2011; 14: 26-34).

Item Type: Article
Uncontrolled Keywords: antipsychotics, adverse drug reactions,interactions,metabolic syndrome
Subjects: Pharmacy > MCOPS Manipal > Pharmaceutics
Depositing User: KMC Manipal
Date Deposited: 12 Jan 2012 10:11
Last Modified: 07 Feb 2015 05:11
URI: http://eprints.manipal.edu/id/eprint/2445

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