Journal articles on the topic 'Psychotropic drugs – adverse effects'
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Goff, Donald C. "Adverse Effects of Psychotropic Drugs." Journal of Clinical Psychopharmacology 14, no. 1 (February 1994): 83. http://dx.doi.org/10.1097/00004714-199402000-00017.
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Balis, George U. "Adverse Effects of Psychotropic Drugs." Journal of Nervous and Mental Disease 182, no. 3 (March 1994): 191–92. http://dx.doi.org/10.1097/00005053-199403000-00020.
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MARDER, STEPHEN R. "Adverse Effects of Psychotropic Drugs." American Journal of Psychiatry 152, no. 1 (January 1995): 146—a—146. http://dx.doi.org/10.1176/ajp.152.1.146-a.
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Khalil, Rami Bou, and Sami Richa. "Thyroid Adverse Effects of Psychotropic Drugs." Clinical Neuropharmacology 34, no. 6 (2011): 248–55. http://dx.doi.org/10.1097/wnf.0b013e31823429a7.
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Gullickson, Terri, and Brigittine French. "Review of Adverse Effects of Psychotropic Drugs." Contemporary Psychology: A Journal of Reviews 40, no. 1 (January 1995): 75. http://dx.doi.org/10.1037/003381.
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Gupta, Ankit, and Rakesh K. Chadda. "Adverse psychiatric effects of non-psychotropic medications." BJPsych Advances 22, no. 5 (September 2016): 325–34. http://dx.doi.org/10.1192/apt.bp.115.015735.
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SummaryPatients presenting to psychiatrists frequently have comorbid medical conditions for which they are receiving treatment. A range of medications used for treatment of these conditions can have adverse effects resembling psychiatric symptoms. This article presents the results of our review of the literature on psychiatric adverse effects of various non-psychotropic medications, and discusses the mechanisms of such effects, their assessment and management. Among the commonly prescribed drugs found to have psychiatric adverse effects are corticosteroids, anti-Parkinsonian drugs, anti-epileptics, antiretrovirals, antibiotics, anticancer drugs, analgesics, drugs targeting endocrine and cardiovascular disorders, immunosuppressants, skeletal muscle relaxants and bronchodilators. Some adverse effects are predictable and dose dependent, whereas others are rare and idiosyncratic, and psychiatrists need to be aware of them for accurate diagnosis and appropriate treatment.
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Bhuvaneswar, Chaya G., Ross J. Baldessarini, Veronica L. Harsh, and Jonathan E. Alpert. "Adverse Endocrine and Metabolic Effects of Psychotropic Drugs." CNS Drugs 23, no. 12 (December 2009): 1003–21. http://dx.doi.org/10.2165/11530020-000000000-00000.
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Vívian Ferreira da Costa, Ana, Larissa De Carvalho Bezerra, and Juliane Dos Anjos de Paula. "Use of psychotropic drugs in the treatment of fibromyalgia: a systematic review." Journal of Human Growth and Development 31, no. 2 (August 3, 2021): 336–45. http://dx.doi.org/10.36311/jhgd.v31.12228.
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Introduction: The treatment of fibromyalgia is evolving, and more and more drugs are available on the market. Objective: To verify the response, tolerability, and adverse events of the use of psychotropic drugs in the treatment of fibromyalgia. Methods: A systematic review of articles on fibromyalgia and psychotropic medications were carried out, indexed in the MEDLINE database (PUBMED) with the MeSH terms: “fibromyalgia”, “psychotropic drugs,” and “treatment outcome”. Of the 89 studies identified, 23 met the eligibility criteria. Results: It has been seen that some classes of psychotropic medications have significantly improved patients' painful episodes, which have an important positive impact on quality of life. Thus, it was realized that the pharmacological treatment of psychiatric disorders associated with fibromyalgia improves the condition of the patient's acceptance of the disease. Most medications had a good impact on the patient's quality of life without major side effects. It is known that adverse events are proportional to the dose of psychotropics, so for each patient, it is necessary to individualize the conduct. Conclusion: Antidepressants were the best-tolerated drug class, but antipsychotics, anticonvulsants, and other more recent drugs such as agomelatine were part of the study of the main drugs used in clinical practice.
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Petukhova, A. A., A. A. Panov, Ya V. Malygin, and M. A. Kazanfarova. "Side effects of psychotropic drugs on eye." Russian Journal of Clinical Ophthalmology 21, no. 1 (2021): 29–33. http://dx.doi.org/10.32364/2311-7729-2021-21-1-29-33.
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Any antipsychotics provoke more or less ocular complications. Some of them are relatively harmless (i.e., dark eyelids, conjunctival and corneal pigmentation, mydriasis, nystagmus, dry eye etc.). These adverse effects are resolved spontaneously after treatment discontinuation, drug switching, or prescribing additional therapy. However, the intake of both typical and atypical neuroleptics, lithium salts, some anticonvulsants (e.g., topiramate) is associated with high risks of vision loss. Moreover, in some patients these medications may result in blindness. The use of psychotropic drugs (e.g., tricyclic antidepressants or serotonin reuptake inhibitors) in patients with higher risk of acute angle closure is of particular concern. The association between phenothiazines and anticonvulsants and retinopathy, chlorpromazine and cataract, anticonvulsants and poor color vision and reduced contrast sensitivity is also important. Psychiatrists and ophthalmologists should consider potential ocular side effects in patients receiving psychotropic drugs. Knowing management algorithm for these conditions is also important. The number of recent publications on this issue is limited. Therefore, articles older than 10 years are sometimes used. Keywords: eye, visual organ, adverse effects, psychotropic drugs, neuroleptics, tricyclic antidepressants, selective serotonin reuptake inhibitors, glaucoma, retinopathy, cataract. For citation: Petukhova A.A., Panov A.A., Malygin Ya.V., Kazanfarova M.A. Side effects of psychotropic drugs on eye. Russian Journal of Clinical Ophthalmology. 2021;21(1):29–33. DOI: 10.32364/2311-7729-2021-21-1-29-33.
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G, Siddesha, Justina M. Steefan, and A. Naveen. "Adverse Effects of Antipsychotic Drugs - A Review." International Journal of Research and Review 10, no. 9 (September 15, 2023): 153–56. http://dx.doi.org/10.52403/ijrr.20230916.
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Antipsychotic drugs which are also known as Neuroleptics are group of psychotropic drugs or psychopharmacological agents1 that are primarily used to manage psychoses including delusions, hallucinations, paranoia, or disordered thought. Besides their antipsychotic action, they had been reported to have some adverse effects which can be seen in Cardiovascular system, Metabolic system, Skeletal and Muscular system, Cognitive and Emotional side effects, and Sexual dysfunction. These adverse effects were mainly observed when they used for longer duration or taken in larger doses or with sudden change in their dose. Keywords: Antipsychotic drugs, Adverse events, Side effects, Extrapyramidal symptoms
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Seifert, Randall D. "Therapeutic Drug Monitoring: Psychotropic Drugs." Journal of Pharmacy Practice 2, no. 6 (December 1989): 403–15. http://dx.doi.org/10.1177/089719008900200609.
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The therapeutic monitoring of patients who take antipsychotic drugs can be both challenging and rewarding. Antipsychotics have been in clinical use for over 30 years; yet, their complex pharmacology is not fully understood and parallels our infant knowledge of human brain chemistry. The art of successful therapeutic drug monitoring depends on the clinician's knowledge of basic pharmacology, an understanding of psychiatric disorders, and a sensitivity for careful patient observation. In addition, a thorough history, well thought out goals, and reasonable recovery expectations are essential. Antipsychotic drugs are never curative and should be used judiciously for indications where positive results outweigh the risks of adverse effects. This article will provide the reader with sound, practical knowledge of how to monitor these drugs in any clinical setting. © 1989 by W.B. Saunders Company.
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Elmaataoui, Z., H. Belhadga, and H. Kisra. "The metabolic syndrom and the prescription of psychotropic drugs in children and adolescents: three clinical cases." European Psychiatry 66, S1 (March 2023): S749. http://dx.doi.org/10.1192/j.eurpsy.2023.1577.
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IntroductionAntipsychotics have shown their interest in several pathologies of the child and the adolescent. However, in this vulnerable population, they are not without adverse effects. Depending on the type of molecule used, classical neuroleptics or second generation antipsychotics, but also within these own classes, the profile of tolerance and adverse effects differs. In this sense, children treated with psychotropic drugs have a higher risk of developing metabolic syndrome compared to children who do not take this treatment.ObjectivesThe aim of this work is to discuss the metabolic syndrome in children treated with psychotropic drugs and this through three clinical vignettes.Methodswe conducted our study through an analysis of three clinical casesResultsIt is about three children followed in the service of child psychiatry of the hospital Ar-razi of salé, aged respectively 11, 13 and 14 years, these children were put under psychotropic drugs for various mental disorders and developed during the evolution of metabolic side effects in particular a dyslipidemia, a diabetes of type 2 revealed by a diabetic ketoacidosis and a hyperprolactinemia.ConclusionsSystematic monitoring and preventive programs targeting weight gain and metabolic side effects should be an integral part of the overall management of adolescents on psychotropic medications.Disclosure of InterestNone Declared
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Gupta, Sumeet, Mukesh Kripalani, Udayan Khastgir, and Joe Reilly. "Management of the renal adverse effects of lithium." Advances in Psychiatric Treatment 19, no. 6 (November 2013): 457–66. http://dx.doi.org/10.1192/apt.bp.112.010306.
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SummaryLithium is one of the most effective psychotropic drugs we have, but it is underused because of its low therapeutic index, the need for regular blood tests and perceptions about its adverse effects, including renal problems. The last include urinary concentration deficits and diabetes insipidus, chronic kidney disease (including renal failure), nephrotic syndrome, hypercalcaemia, hyperparathyroidism and distal tubular acidosis. This article reviews these adverse effects with special emphasis on their management.
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Goodlet, Kellie J., Monika T. Zmarlicka, and Alyssa M. Peckham. "Drug–drug interactions and clinical considerations with co-administration of antiretrovirals and psychotropic drugs." CNS Spectrums 24, no. 03 (October 8, 2018): 287–312. http://dx.doi.org/10.1017/s109285291800113x.
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Psychotropic medications are frequently co-prescribed with antiretroviral therapy (ART), owing to a high prevalence of psychiatric illness within the population living with HIV, as well as a 7-fold increased risk of HIV infection among patients with psychiatric illness. While ART has been notoriously associated with a multitude of pharmacokinetic drug interactions involving the cytochrome P450 enzyme system, the magnitude and clinical impact of these interactions with psychotropics may range from negligible effects on plasma concentrations to life-threatening torsades de pointes or respiratory depression. This comprehensive review summarizes the currently available information regarding drug–drug interactions between antiretrovirals and pharmacologic agents utilized in the treatment of psychiatric disorders—antidepressants, stimulants, antipsychotics, anxiolytics, mood stabilizers, and treatments for opioid use disorder and alcohol use disorder—and provides recommendations for their management. Additionally, overlapping toxicities between antiretrovirals and the psychotropic classes are highlighted. Knowledge of the interaction and adverse effect potential of specific antiretrovirals and psychotropics will allow clinicians to make informed prescribing decisions to better promote the health and wellness of this high-risk population.
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ROCK, NICHOLAS L. "Possible Adverse Effects of Buspirone When Used with Other Psychotropic Drugs." Journal of Clinical Psychopharmacology 10, no. 5 (October 1990): 380. http://dx.doi.org/10.1097/00004714-199010000-00028.
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Alderman, Christopher P., and Michael J. Ryan. "Consumer Requests for Information regarding Psychotropic Drugs: Experience from a National Medicines Phone-In." Annals of Pharmacotherapy 31, no. 11 (November 1997): 1301–5. http://dx.doi.org/10.1177/106002809703101104.
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OBJECTIVE: To undertake a qualitative analysis of calls regarding psychotropic drugs that were received during a national medicines phone-in day. BACKGROUND: In July 1996, The Society of Hospital Pharmacists of Australia coordinated a national medications phone-in day, allowing consumers to seek information about medications from pharmacists and physicians using a toll-free telephone number. METHODS: Data collection forms were used to record the details of all calls answered during the phone-in day. Demographic data collected included the estimated age and gender of the caller. Other data collected included the drugs that were the subject of the inquiry and the category of questions. RESULTS: There were 42 096 attempted connections to the service, but because of limited telecommunications capacity, only 2245 callers were successfully connected. Psychotropic drugs were the primary subject of 367 calls, representing 16.4% of all inquiries for which data collection forms were completed. Antidepressants (56.1%) and benzodiazepines (24.8%) were the two most commonly encountered classes of psychotropic drugs. The greatest proportion of calls (57.2%) was related to adverse effects of medications. The nature of the inquiries regarding adverse drug effects was generally consistent with the adverse effects detailed in the scientific literature. CONCLUSIONS: The results of this 1-day, consumer-oriented drug information project suggest that there is a substantial need for this type of service. Patients treated with psychotropic medications should have access to unbiased, high-quality information about drug therapy.
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Mula, Marco. "Psychotropic Effects of Anticonvulsant Drugs in Patients with Epilepsy." Clinical Medicine Insights: Therapeutics 2 (January 2010): CMT.S3285. http://dx.doi.org/10.4137/cmt.s3285.
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Anticonvulsant drugs continue to be the mainstay of epilepsy treatment but benefits of seizure control need to be balanced with the psychotropic potential of this class of compounds. The present paper is aimed at discussing positive and negative effects of anticonvulsant drugs on mood in patients with epilepsy. In general terms, the use in monotherapy, adopting slow titration schedules and low doses when possible, can significantly reduce the occurrence of treatment emergent adverse events. The mental state of the patient need to be taken into account in order to really optimize the anticonvulsant drug treatment.
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Sepúlveda-Lizcano, Lizeth, Vivian Vanessa Arenas-Villamizar, Enna Beatriz Jaimes-Duarte, Henry García-Pacheco, Carlos Silva Paredes, Valmore Bermúdez, and Diego Rivera-Porras. "Metabolic Adverse Effects of Psychotropic Drug Therapy: A Systematic Review." European Journal of Investigation in Health, Psychology and Education 13, no. 8 (August 12, 2023): 1505–20. http://dx.doi.org/10.3390/ejihpe13080110.
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This review aimed to investigate the metabolic alterations associated with psychopharmacological treatment of neuropsychiatric disorders, which can significantly impact patients’ physical health and overall quality of life. The study utilized the PRISMA methodology and included cross-sectional, retrospective studies, and randomized clinical trials from reputable databases like SCOPUS, CLARIVATE, SCIENCE DIRECT, and PUBMED. Out of the 64 selected studies, various psychotropic drug classes were analyzed, including antidepressants, anticonvulsants, and antipsychotics. Among the antidepressants, such as amitriptyline, Imipramine, and clomipramine, weight gain, constipation, and cardiovascular effects were the most commonly reported metabolic adverse effects. SSRI antidepressants like Fluoxetine, Sertraline, Citalopram, Escitalopram, and Paroxetine exhibited a high prevalence of gastrointestinal and cardiac alterations. Regarding anticonvulsants, valproic acid and Fosphenytoin were associated with adverse reactions such as weight gain and disturbances in appetite and sleep patterns. As for antipsychotics, drugs like Clozapine, Olanzapine, and Risperidone were linked to weight gain, diabetes, and deterioration of the lipid profile. The findings of this review emphasize the importance of continuous monitoring for adverse effects, particularly considering that the metabolic changes caused by psychopharmacological medications may vary depending on the age of the patients. Future research should focus on conducting field studies to further expand knowledge on the metabolic effects of other commonly prescribed psychotropic drugs. Overall, the study highlights the significance of understanding and managing metabolic alterations induced by psychopharmacological treatment to enhance patient care and well-being.
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Baldwin, David, and Andrew Mayers. "Sexual side-effects of antidepressant and antipsychotic drugs." Advances in Psychiatric Treatment 9, no. 3 (May 2003): 202–10. http://dx.doi.org/10.1192/apt.9.3.202.
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Adequate sexual expression is essential to many human relationships and provides a sense of physical, psychological and social well-being. Epidemiological and clinical studies show that depression and schizophrenia are associated with impairment of sexual function and satisfaction, even in untreated patients. Most antidepressant and antipsychotic drugs have adverse sexual effects but it is difficult accurately to identify the incidence of treatment-emergent dysfunction, as disturbances can be reliably detected only from systematic enquiries made at baseline and during treatment. Growing awareness of the adverse effects of psychotropic drugs has led to attempts to use adjuvants or substitute treatments to resolve sexual dysfunction. More studies of the effects of antidepressant and antipsychotic drugs on sexual function are needed.
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Botero, Beatriz, Erick Frota Gomes Figueiredo, Jesus Eden Bezerra da Costa, Méllory Nétaly de Oliveira Magalhães, Pablo Henrique Freitas de Almeida, Salomão Rocha Martim, and Ytalo Thiago Praciano da Silva. "Efficacy and risks of the use of psychotropics drugs in children and adolescents with depression disorders: a literature review." Research, Society and Development 11, no. 14 (October 27, 2022): e304111436284. http://dx.doi.org/10.33448/rsd-v11i14.36284.
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The transition from childhood to adolescence is a period of life characterized by hormonal and physiological changes. In this phase, there are also several social interactions that change according to the environment, imposing responsibilities and a desire for new cycles. These demands make people vulnerable and insecure to certain feelings, generating mood disorders that can progress to major depression disorder. Objective: to evaluate the efficacy and risks of psychotropic drugs prescribed to children and adolescents with depression disorders. Method: This is a bibliographic review of scientific articles of the descriptive-quantitative type, searched online, on Google Scholar platforms, Virtual Health Library - VHL (Medline, IBECS, LILACS), Portal Periodicals CAPES and SciELO and prepared from 1987 to 2021. The search used the descriptors, antidepressants, psychotropic drugs, adverse effects, depressed children and adolescents, in Portuguese, English and Spanish. Result: the same psychotropic drug is used in several other mental disorders, such as bipolar disorder and anxiety. Drugs that demonstrated significant efficacy were Serotonin Reuptake Inhibitors (SSRIs) such as paroxetine, sertraline and fluoxetine. Final Considerations: the psychotropic drugs used to treat depression in children and adolescents, although they are effective in some cases, nevertheless cause several adverse effects. The use of these drugs should not be carried out indiscriminately so that their risks do not outweigh their benefits, and it is essential to assess the causes of childhood depression and the clinical follow-up of patients by a multidisciplinary team.
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Piedad, John, Hugh Rickards, Frank M. C. Besag, and Andrea E. Cavanna. "Beneficial and Adverse Psychotropic Effects of Antiepileptic Drugs in Patients with Epilepsy." CNS Drugs 26, no. 4 (April 2012): 319–35. http://dx.doi.org/10.2165/11599780-000000000-00000.
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Aktepe, Evrim. "Endocrine and Metabolic Adverse Effects of Psychotropic Drugs in Children and Adolescents." TAF Preventive Medicine Bulletin 10, no. 6 (2011): 741. http://dx.doi.org/10.5455/pmb.20110815113354.
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KANEKO, Koichi. "6．Adverse Effects on Brain Function of Psychotropic Drugs, Corticosteroids and Interferon." Rinsho yakuri/Japanese Journal of Clinical Pharmacology and Therapeutics 48, no. 2 (2017): 84–90. http://dx.doi.org/10.3999/jscpt.48.84.
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Biering, Páll, and Ingibjörg Hjaltadóttir. "The prevalence of psychiatric diagnoses and psychotropic medication in icelandic nursing homes from 2003 to 2018." Læknablaðið 107, no. 01 (January 4, 2021): 11–16. http://dx.doi.org/10.17992/lbl.2021.01.615.
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INTRODUCTION: Research shows a high prevalence of mental disorders and psychotropic medication among older people, especially in nursing homes. Knowledge of this concerning issue among Icelandic nursing homes residents is limited, despite its importance for mental health policymaking. Therefore, the aim of this study was to investigate the prevalence of psychiatric diagnoses and psychotropic medication in Icelandic nursing homes, the relationship between these factors and how they have evolved from 2003 to 2018. MATERIAL AND METHODS: The research data comes from interRAI MDS 2.0 assessments for nursing home residents in Iceland, for the period 2003-2018. The study uses the last assessment of each year (N=47,526). RESULTS: Approximately half of the residents were diagnosed with anxiety and/or depression; 49.4% in 2003 and 54.5% in 2018. The use of psychotropic drugs increased from 66.3% to 72.5%. Antidepressants were most commonly utilized, with an increase from 47.5% to 56.2%. The use of antipsychotics drugs has remained nearly unchanged, at around 26%. Inconsistency was found between psychotropic medication and psychiatric diagnoses; on average, 18.2% of the residents took psychotropic drugs without being diagnosed and 22.3% took antipsychotics in other cases than recommended. CONCLUSION: Age related changes influence the effect of psychotropic drugs and studies have not supported their positive long-term effects for older people who are also sensitive to associated adverse effects, especially in cases of polypharmacy. Therefore, it is important that psychotropic drugs use is based on accurate mental health assessment. To reduce psychotropic medication, other mental health interventions need to be developed.
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Stimmel, Glen L., and Mary A. Gutierrez. "Sexual Dysfunction and Psychotropic Medications." CNS Spectrums 11, S9 (2006): 24–30. http://dx.doi.org/10.1017/s1092852900026730.
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AbstractPsychotropic drugs are often associated with sexual dysfunction. The frequency of antidepressant-associated sexual dysfunction is greatly underestimated in clinical trials that rely on patient self-report of these adverse events. Direct inquiry reveals that delayed orgasm/ejaculation occurs in ≥50% and anorgasmia in at least one third of patients given selective serotonin reuptake inhibitors. Antidepressant-induced sexual dysfunction can be successfully managed. A different antidepressant without significant sexual effects, such as bupropion or mirtazapine, can often be substituted. Other strategies involve drug holidays or adjunctive therapy with drugs such as sildenafil. Dopamine antagonist antipsychotic drugs are most commonly associated with decreased libido. The newer atypical antipsychotics, with less effect on dopamine, are less commonly associated with sexual dysfunction. Sexual dysfunction is commonly reported with seizure disorders, and many anticonvulsant drugs affect levels of sex hormones. Because sexual dysfunction can be related to many factors, care must be taken to establish the patient's baseline sexual functioning before the initiation of psychotropic drug therapy and to rule out other etiologies before drugs are implicated as causative.
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Florian, A., C. Florian, A. Ignat, C. Voinea, L. Popescu, G. Ganea, C. Gherghe, and L. Mateescu. "QT Prolongation: Psychotropic medication versus illicit drugs." European Psychiatry 65, S1 (June 2022): S446. http://dx.doi.org/10.1192/j.eurpsy.2022.1133.
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Introduction Countless substances used for their psychotropic effects may induce adverse cardiac effects, such as QT prolongation. This category of substances holds illicit drugs as well as medications, with their effects influenced by dosage, concomitant use and patient specific factors. The appraisal of cardiac consequences is essential as delayed repolarization may lead to the rare but potentially deadly polymorphic ventricular tachycardia. Objectives The goal of this presentation is to underscore the cardiac risks associated with both medication use and substance abuse in order to ensure the suitable psychopharmacological treatment, especially in particular situations of drug using patients. Methods The subject of the presentation is a 17-year-old female adolescent hospitalized in our clinic, with multiple substance abuse, as seen in qualitative multidrug test (cannabis, amphetamines, ecstasy, barbiturates, benzodiazepines), previously under complex treatment prescribed by an adult psychiatrist (3 atypical antipsychotics, 1 selective serotonin reuptake inhibitor, 1 anticonvulsant, 1 benzodiazepine). Specialty literature has been reviewed concerning the cardiac effects of both the abuse substances and the psychiatric medications. Results Multiple drugs involved may cause a myocardial repolarization delay, the patient having a QTc of 508 msec at the admission. Consequent to parenteral fluids and treatment managing, ECG revealed a decrease to 379 msec 7 days later in the stay. This finding could not be viewed solely as caused by drug use, psychiatric medication or individual factors, but rather as their aggregation. Conclusions Psychotropic substances use may lead to QT prolongation, which calls for close cardiac supervision whenever patient’s behaviour warrants or when pharmacologic intervention is required. Disclosure No significant relationships.
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Gurung, Aruna, Jugalkishore B. Jaju, Ganesh R. Pawar, Shrikant C. Dharmadhikari, and Rajvardhan R. Solunke. "Study of drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of tertiary care hospital." International Journal of Basic & Clinical Pharmacology 7, no. 2 (January 23, 2018): 259. http://dx.doi.org/10.18203/2319-2003.ijbcp20180095.
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Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice.
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Bishara, Delia, Chris Kalafatis, and David Taylor. "Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents." Therapeutic Advances in Psychopharmacology 10 (January 2020): 204512532093530. http://dx.doi.org/10.1177/2045125320935306.
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As yet, no agents have been approved for the treatment of COVID-19, although several experimental drugs are being used off licence. These may have serious adverse effects and potential drug interactions with psychotropic agents. We reviewed the common agents being used across the world for the treatment of COVID-19 and investigated their drug interaction potential with psychotropic agents using several drug interaction databases and resources. A preliminary search identified the following drugs as being used to treat COVID-19 symptoms: atazanavir (ATV), azithromycin (AZI), chloroquine (CLQ)/hydroxychloroquine (HCLQ), dipyridamole, famotidine (FAM), favipiravir, lopinavir/ritonavir (LPV/r), nitazoxanide, remdesivir, ribavirin and tocilizumab. Many serious adverse effects and potential drug interactions with psychotropic agents were identified. The most problematic agents were found to be ATV, AZI, CLQ, HCLQ, FAM and LPV/r in terms of both pharmacokinetic as well as serious pharmacodynamic drug interactions, including QTc prolongation and neutropenia. Significant caution should be exercised if using any of the medications being trialled for the treatment of COVID-19 until robust clinical trial data are available. An even higher threshold of vigilance should be maintained for patients with pre-existing conditions and older adults due to added toxicity and drug interactions, especially with psychotropic agents.
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Gustafsson, Maria, Per-Olof Sandman, Stig Karlsson, Yngve Gustafson, and Hugo Lövheim. "Association between behavioral and psychological symptoms and psychotropic drug use among old people with cognitive impairment living in geriatric care settings." International Psychogeriatrics 25, no. 9 (June 20, 2013): 1415–23. http://dx.doi.org/10.1017/s1041610213000859.
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ABSTRACTBackground:Behavioral and psychological symptoms are common among cognitively impaired individuals and psychotropic drugs are widely used for their treatment. The aim of this study was to describe the prevalence and associated factors of psychotropic and anti-dementia drug use among old people with cognitive impairment living in geriatric care settings.Methods:The study comprised 2,019 cognitively impaired people living in geriatric care units in the county of Västerbotten, Sweden. Data concerning psychotropic and anti-dementia drug use, function in activities of daily living, cognitive function, and prevalence of behavioral and psychological symptoms were collected, using the Multi-Dimensional Dementia Assessment Scale.Results:Of the study population, 1,442 individuals (71%) were prescribed at least one psychotropic drug (antidepressants (49%), anxiolytics, hypnotics, and sedatives (36%), antipsychotics (25%)). Furthermore, 363 individuals (18%) received anti-dementia drugs. Associations between various behavioral and psychological symptoms were found for all psychotropic drug classes and anti-dementia drugs. Verbally disruptive/attention-seeking behavior was associated with all psychotropic drugs. Use of antipsychotics was associated with several behavioral and psychological symptoms, including aggressive behavior.Conclusion:The associations between behavioral and psychological symptoms and psychotropic drug use found in this study indicate that these drugs are prescribed to treat behavioral and psychological symptoms among cognitively impaired individuals despite limited evidence of their efficacy. Given the significant risk of adverse effects among old people with cognitive impairment, it is important to ensure that any medication used is both appropriate and safe.
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Gupta, Sumeet, Udayan Khastgir, Ogba Onwuchekwa, and Ioana Varvari. "Monitoring the Adverse Effects of Psychotropic drugs – Need for An Evidence-Based Approach." GLOBAL PSYCHIATRY ARCHIVES 5, no. 1 (May 1, 2022): 51–63. http://dx.doi.org/10.52095/gpa.2022.4362.1034.
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Baumann, P. "The AMSP-project: Pharmacovigilance in psychiatry - Presentation, challenges and results." European Psychiatry 29, S3 (November 2014): 663. http://dx.doi.org/10.1016/j.eurpsy.2014.09.050.
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For the introduction of novel drugs on the market, a limited number of patients have participated in clinical studies about their efficacy, safety and tolerance. However, many adverse effects and their impact are only revealed after the drug has been described in real life conditions, in comorbid and comedicated patients, in off-label situations or in populations not studied previously. Isolated severe adverse reactions have to be announced spontaneously by the physician to the authorities, but pharmacovigilance projects have the advantage of a more systematic approach. More than 25-years-ago, the Arzneimittelsicherheit in der Psychiatry (AMSP) project on pharmacovigilance in psychiatry was introduced in Germany, and then in Switzerland and in Austria. In 55 psychiatric hospitals, severe adverse effects of psychotropic drugs are continuously assessed; twice in a year, drug prescriptions are recorded [1]. This project has a high educational value in the clinical institutions, and it allows creating an important data base with material for investigations in several fields: Interactions between psychotropic and other drugs and clinical risks, age effect on drug safety, case studies on very rare adverse effects, pharmacoepidemiology on drug prescription habits in different institutions. More than 180 papers related to pharmacovigilance were published reporting original data, and many of them were reviews, articles for continuing education purposes and case reports (2005–2014).Pharmacovigilance projects such as the AMSP project help to increase the knowledge about clinical properties of drugs and to improve their use in clinical practice [2,3].
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Eustace, Andrew, Elaine Murray, and Kelley Daly. "341 The Prevalence and Factors Associated with Anti-psychotic Prescribing on Admission to a Dementia Specific Nursing Home." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.223.
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Abstract Background The use of psychotropic medications and their adverse effects in frail adults has been debated extensively. However, it is unclear if antipsychotics are initiated in a nursing home or if the new resident arrives with the medication prescribed. The purpose of this study is to ascertain how many residents arrive already on antipsychotics and which factors, make them more likely to be on this medication. Methods All admission notes to the centre between 1st Jan 2018 and 31st Dec 2018 were reviewed. Inclusion criteria was any person admitted with a diagnosis of dementia. Exclusion criteria was anyone who had psychiatric diagnosis such as bipolar disorder or schizophrenia. We collected data on age, gender, referral pathway (hospital or community), MMSE, Barthel, Cohen Mansfield Agitation Inventory (CMAI) For comparisons of characteristics between the two groups (psychotropic drugs at admission: yes/no), the independent samples t-test (normally distributed data) or the Mann-Whitney U test (non-normally distributed data) was used for continuous variables and Fisher’s exact test was used for categorical variables. Results There was a statistically significant relationship between source of admission and whether or not the patient was receiving psychotropic drugs on admission (p=0.017). 88.0% of patients on psychotropic drugs on admission came from an acute hospital setting. In contrast, only 4.0% of patients receiving psychotropic drugs on admission came from home Patients on psychotropic drugs at admission had higher CMAI scores compared to patients not on psychotropic drugs. Patients on psychotropic drugs at admission were younger (mean(SD): 76.2(8.7) years) than patients not of psychotropic drugs (mean(SD): 82.9(8.3). Conclusion Prevalence of prescribing antipsychotics outside of nursing homes is high with many residents being admitted already on these medications. Efforts should be put in place on admission to nursing homes to reduce and stop antipsychotics which have been initiated in the community and hospital setting.
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Verdoux, H. "Safety of psychotropic medicines: contribution from observational evidence." Epidemiology and Psychiatric Sciences 27, no. 6 (May 30, 2018): 531–36. http://dx.doi.org/10.1017/s2045796018000276.
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The risks associated with psychotropic drugs use should be accurately documented at the population level in view of the growing number of persons exposed to these drugs. The strengths of observational studies regarding the identification of drug-related harms mirror the limitations of randomised controlled trials and vice-versa. Observational studies can be carried out in large samples of unselected participants treated in real-life conditions and who may be followed up over long periods. Serious adverse effects undetected during pre-marketing clinical trials may be observed only in post-marketing use, such as metabolic effects of second-generation antipsychotics. Observational studies play a key role in the identification of teratogenic risks, such as those induced by prenatal exposure to anticonvulsants. These studies are the main source of information to investigate the long-term effects of drugs, such as the possible increased risk of dementia in benzodiazepine users. They may also contribute to the accurate assessment at population level of risks overestimated by studies carried out in non-representative samples, such as the risk of congenital heart diseases in babies prenatally exposed to lithium. Owing to the lack of random allocation of drugs, confounding by indication or by disease severity are the major sources of biases in observational studies exploring drug safety. An adverse outcome may be wrongly imputed to drug exposure while it is a symptom/outcome of the disease motivating the decision to prescribe. Such a bias may occur in studies investigating the link between exposure to antidepressants and suicidality. As several methods have been developed to lessen the impact of such biases, pharmaco-epidemiological studies based upon stringent methodological designs should be regarded as a valid approach for assessing psychotropic drug safety.
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Kumari, Rani, Rachna Gupta, Manjeet Singh Bhatia, and Suresh Kumar Gupta. "Assessment of adverse drug reactions of psychopharmacological drugs in patients of psychiatric disorders." Journal of Pharmacovigilance and Drug Research 2, no. 2 (June 1, 2021): 27–32. http://dx.doi.org/10.53411/jpadr.2021.2.2.6.
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Introduction: Psychopharmacological drugs are used in the treatment of different types of psychotropic disorders. These drugs are associated with a variety of adverse drug reactions (ADRs). The ADRs due to psychopharmacological drugs are a significant cause of mortality and morbidity.
Objectives: The current study assessed the adverse drug reactions of psychopharmacological drugs in patients with psychiatric disorders.
Methods: This study was a retrospective study. All ADR forms related to psychopharmacological drugs that were reported to the pharmacovigilance center, UCMS, and GTB Hospital, between December 2019 to February 2020, were assessed to identify the incidence and nature of important ADRs. Causality assessment was done by WHO Uppsala Monitoring Centre Global Introspection Method. A total of 150 ADR forms were analyzed.
Results: Females (60.66 %) experienced more ADRs than males (39.33 %). ADRs were most commonly reported in the age group of 18-28 years followed by 29-39 years. Depression was the most common diagnosis in patients with psychiatric disorders. Dizziness was the most common ADR followed by headache and insomnia. Escitalopram (12.21 %) was the most commonly implicated drug causing ADRs followed by clonazepam (9.92 %). As per the WHO causality assessment method, 77 % of ADRs were possible and 23 % were probable.
Conclusions: Therefore, early detection and awareness of ADRs are important to enable health professionals to perform alterations in the prescribed drug treatment to prevent or reduce the adverse effects due to psychotropic drugs. This will improve patient care and safety as well as promote rational use of drugs.
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Freitas, Eliane Da Silva, Joaquim Alves Diniz, Natália Rodrigues Alves, Pedro Ivo Palacio Leite, Modesto Leite Rolim Neto, and Poliana Moreira Medeiros de Carvalho. "Benzodiazepines use in elderly patients attended at a Public Pharmacy in Pernambuco Brazil." Amadeus International Multidisciplinary Journal 4, no. 7 (October 27, 2019): 203–16. http://dx.doi.org/10.14295/aimj.v4i7.91.
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: The elderly people are the group that most use psychotropic drugs, due to psychiatric comorbidity and somatic conditions. In Brazil some benzodiazepines are part of the National List of Essential Medicines (RENAME) being distributed free of charge, facilitating the population access, which can lead to irrational use. Methods: Cross-sectional, descriptive research through a qualitative and quantitative study of benzodiazepine use in patients attended at the Cedro Basic Pharmacy in the city of Cedro-PE. The data collection was done with the application of a semi-structured questionnaire. The pattern of benzodiazepine use has been described through patient-reported symptomatology, therapeutic adherence, medical specialty, dose increase without medical consultation, and adverse effects reported during the drug use. Results: There was a predominance of females (58.33%). The most commonly used benzodiazepine was diazepam (66.67%). The purchase of benzodiazepine without a prescription was reported by 16.67% of the elderly interviewed and an increase in the drug dose without doctor consulting by 25% of the interviewees. Final considerations: The prescription of these drugs for the elderly, as well as the chronic use, should consider the physiological changes caused by aging and the adverse effects of these drugs in order to guarantee a safe treatment. Keywords : Aged; Psychotropic drugs; Drug utilization.
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Ferreira, A. R., S. Martins, C. Dias, M. R. Simões, and L. Fernandes. "Psychotropic Use in Elderly with Cognitive Impairment Living in Nursing Homes." European Psychiatry 41, S1 (April 2017): S174. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2069.
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IntroductionElderly patients in nursing homes (NH) are often prescribed medications for many physical and mental health problems, with polypharmacy. There is a considerable number of studies documenting this extensive prescription of psychotropic medication, despite the raised concerns about their overuse/misuse, due to serious adverse effects, including increased rate of cognitive decline associated with antipsychotics.AimsTo characterize the prescription of psychotropics in elderly sample with cognitive impairment living in NH.MethodsElderly living in three Portuguese NH were included in this cross-sectional study. All residents were eligible, unless they were unwilling or unresponsive. Participants’ medication was obtained from medical records. Guidelines of ATC were used to categorize the drugs. Participants were assessed with MMSE and GDS.ResultsThe sample included 172 elderly, mostly women (90%), with average of 81(sd = 10) years and median lengths of stay of 3 years. Overall, 79.1% used ≥ 1 nervous system-acting drugs. Anxiolytics (54.7%), antidepressants (29.1%) and antipsychotics (23.3%) were the most frequent. The majority (58%) presented cognitive impairment (MMSE). Among those, 46.2% presented depression (GDS) and 79.6% took at least one drug for the CNS and 41.9% ≥ 3. Antipsychotics were received by 26.5%, while 57.1% used anxiolytics, 31.6% antidepressants and 16.3% anti-dementia drugs. No significant relation between GDS and antidepressants was found.ConclusionThis study confirms the high usage of CNS drugs in patients with cognitive impairment in NH. These rates were comparable with previous studies. Antidepressants appear to be under-used, which can be related to the under-recognition of depression. Also, potential harmful psychotropic drugs such as anxiolytics and antipsychotics are overused.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Bingefors, Kerstin, Dag Isacson, Lars Von Knorring, Björn Smedby, Lisa Ekselius, and Lawrence L. Kupper. "Antidepressant-treated Patients in Ambulatory Care." British Journal of Psychiatry 168, no. 3 (March 1996): 292–98. http://dx.doi.org/10.1192/bjp.168.3.292.
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BackgroundDespite the problems involved in treating depression and concomitant medical disease, there are virtually no longitudinal studies on drug utilisation among depressed patients.MethodUse of prescription drugs among all first-time users of antidepressants in a defined population five years before and six years after the index (first) treatment was compared to a referent group without antidepressant treatment. The generalised estimating equations (GEE) method was used for analysis.ResultsThe antidepressant-treated group used considerably more non-psychotropic drugs during the whole study period than the referent group. They also used more psychotropic drugs, a use which increased in connection with the initiation of antidepressant treatment and stayed high for a further five years.ConclusionsThe high use of prescription drugs indicated widespread somatic and psychiatric health problems during the whole study period. Antidepressant-treated patients are at risk for drug interactions and adverse effects, and would benefit from a closer collaboration between psychiatry and medicine.
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Blom, Johanna, Elena Barisone, Marina Bertolotti, Daniela Caprino, Monica Cellini, Carlo Clerici, Chiara Colliva, et al. "The Use of Psychotropic Medication in Pediatric Oncology for Acute Psychological and Psychiatric Problems: Balancing Risks and Benefits." Children 9, no. 12 (November 30, 2022): 1878. http://dx.doi.org/10.3390/children9121878.
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Severe acute behavioral and emotional problems represent one of the most serious treatment-related adverse effects for children and adolescents who have cancer. The critical and severe nature of these symptoms often makes necessary the use of psychotropic drugs. A working group composed of experts in multiple disciplines had the task of creating an agreement regarding a management plan for severe acute behavioral and emotional problems (SABEPs) in children and adolescents treated for cancer. To obtain global information on the use of psychotropic drugs in pediatric oncology, the working group first developed and mailed a 15-item questionnaire to many Italian pediatric oncology centers. Overall, an evident lack of knowledge and education regarding the use of psychotropic medications for the treatment of SABEPs was found. Thus, by referring to an adapted version of the Delphi method of consensus and standard methods for the elaboration of clinical questions (PICOs), the working group elaborated evidence-based recommendations for psychotropic drugs in the pediatric oncology setting. Furthermore, based on a thorough multivariate analysis of needs and difficulties, a comprehensive management flow was developed to optimize therapeutic interventions, which allows more accurate and efficient matching of the acute needs of patients while guiding treatment options.
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Kennedy, Craig H., and Kim A. Meyer. "The Use of Psychotropic Medication for People with Severe Disabilities and Challenging Behavior: Current Status and Future Directions." Journal of the Association for Persons with Severe Handicaps 23, no. 2 (June 1998): 83–97. http://dx.doi.org/10.2511/rpsd.23.2.83.
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People with severe disabilities who engage in challenging behavior are often prescribed psychotropic medication as a form of intervention. Although the goal of the medication is to reduce challenging behavior, limited empirical evidence is available to support the use of psychotropic intervention for people with severe disabilities. However, across a range of drug classes basic research suggests that many psychotropic medications selectively affect dimensions of behavior that could be of benefit in reducing challenging behavior. Currently, researchers cannot demonstrate whether most drugs prescribed to reduce challenging behavior are effective or predict when adverse side effects will emerge from their use. In this article we review the basic literature on behavioral pharmacology and integrate those findings with existing applied research to update JASH readers regarding the status of psychotropic medication. From this review, we present a set of suggestions that include: (a) improving research practices, (b) increasing the diversity of individuals involved in decision-making processes regarding medication use, and (c) developing consumer-friendly strategies for monitoring drug effects.
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Tataru, Alexandra, George Tătaru, Floris Petru Iliuță, Alexandra Maștaleru, Irina Mihaela Abdulan, Carmen Marinela Cumpăt, Ingrid Georgiana Mihoc, Cozmin Mihai, and Raluca Ioana Modoranu. "The interactions between psychotropic medication and drugs used in the treatment of cardiovascular diseases." Bulletin of Integrative Psychiatry 101, no. 2 (June 15, 2024): 67–76. http://dx.doi.org/10.36219/bpi.2024.2.07.
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The coexistence of psychiatric disorders and cardiovascular diseases represents a complex clinical challenge, often necessitating the concurrent use of medications from both therapeutic categories. While these medications are essential for managing their respective pathologies, their combined use can lead to interactions that may affect treatment outcomes and patient safety. Understanding the interactions between psychotropic drugs and those used in cardiovascular diseases is crucial for healthcare professionals to optimize therapeutic regimens and minimize potential adverse effects. This article aims to explore the various types of interactions between psychotropic and cardiovascular medications, analyze their underlying mechanisms, evaluate the clinical implications, and propose strategies to reduce risks and optimize treatment outcomes. By understanding these interactions, healthcare professionals can enhance clinical decision-making and provide safer and more effective pharmacotherapy for patients with complex medical needs.
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Ford, Loretta T., and Jonathan D. Berg. "Analytical evidence to show letters impregnated with novel psychoactive substances are a means of getting drugs to inmates within the UK prison service." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 55, no. 6 (March 30, 2018): 673–78. http://dx.doi.org/10.1177/0004563218767462.
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Introduction Novel psychotropic substances also known as legal highs are a major concern in UK prisons, fuelling violence and putting a strain on resources for inmates requiring medical treatment for adverse effects. We provide a clinical toxicology service including routine screening for novel psychoactive substances. In 2015, we were approached by Her Majesty Prison Service search dog training team to advise on which novel psychoactive substances to target, and again in 2016 to further provide analytical support to test five letters which the dogs positively identified for novel psychotropic substances during routine searches of prison mail rooms. Here we provide the first analytical confirmation that letters sent to inmates are being used to smuggle novel psychotropic substances into UK prisons. Results Novel psychotropic substances were detected on all five letters and these included the stimulants ethylphenidate, methiopropamine and methoxiphenidaine, the sedative etizolam and the third generation synthetic cannabinoids 5F-AKB-48, AB-FUBINACA, MDMB-CHMICA. Other compounds detected include the class A drug cocaine, class B drug methylphenidate and the cutting agents lignocaine, benzocaine and procaine. Conclusion Novel psychotropic substances smuggled into UK prisons is a major safety and security concern. By analytically confirming letters sent to inmates do contain novel psychotropic substances, we have produced categorical evidence to support anecdotal suggestions that novel psychotropic substances are entering UK prisons in this manner.
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Halaris, Angelos. "Antidepressant Drug Therapy in the Elderly: Enhancing Safety and Compliance." International Journal of Psychiatry in Medicine 16, no. 1 (March 1987): 1–19. http://dx.doi.org/10.2190/uhl6-0x4w-frng-8pff.
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This review article addresses some of the complex issues surrounding antidepressant drug usage among elderly depressives. While primarily geared toward the psychiatrist in general practice, the article provides useful information for the nonpsychiatric physician who is frequently called upon to evaluate and treat affective disorders in the geriatric population. Since tricyclic antidepressants and lithium are the most commonly used psychotropic drugs in the treatment of depression, their side effects and adverse reactions are discussed specifically as these relate to the elderly. Suggestions are offered on how to improve safety and enhance compliance. Brief mention is made of the monoamine oxidase inhibitors and the second generation antidepressants. Dose ranges are recommended for use of these agents in geriatric patients. Finally, a section of the article reviews the most commonly encountered drug interactions between tricyclic and a variety of other psychotropic and nonpsychotropic drugs.
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Petrykiv, S., M. Arts, and L. De Jonge. "Drug–drug interactions and clinical considerations with co-administration of antiretrovirals and psychotropic drugs." European Psychiatry 65, S1 (June 2022): S454. http://dx.doi.org/10.1192/j.eurpsy.2022.1152.
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Introduction Psychotropic medications are frequently co-prescribed with antiretroviral therapy (ART). Hepatic metabolism both of AP and ART involves the cytochrome P450 enzyme system, potentially leading to a multitude of pharmacokinetic (PK) interactions and serious adverse side effects. The magnitude and clinical impact of PK-interactions can vary significantly. Objectives The scope of this review is to summarize the currently available data regarding drug-drug interactions (DDI) between AP and ART, and to provide recommendations for their management. Methods A formal search of Embase, Cochrane and Medline was performed, searching for human studies from inception till 2017 on PK-interactions between AP and ART and reporting clinical toxicity as outcomes. Authors also provide their expertise on magnitude and clinical relevance of DDI using PK interaction chart. Results Ten case reports including total of 13 patient were analyzed, comprising following AP: aripiprazole (N=2), risperidone (N=4), quetiapine (N=3) and lurasidone (N=1) in combination with various ART regiments. Significant PK-interactions were to occur in cases when aripiprazole was combined with ritonavir and/or cobicistat or efavirenz and/or darunavir; risperidone with indinavir of ritonavir; quetiapine with ritonavir and atazanavir/ritonavir; lurasidone with atazanavir. Adverse events occurred in combinations of aripiprazole with ritonavir/darunavir, risperidone with ritonavir or indinavir, quetiapine with atazanavir and lurasidone with atazanavir. Conclusions Psychotropics and antiretrovirals may be used safely, particularly when known DDIs are proactively managed. Clinicians should be aware of the pharmacokinetic and pharmacodynamic properties of these agents to best direct therapy and to provide optimal patient care Disclosure No significant relationships.
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Baumann, P. "JS01-01 - Pharmacokinetics of psychotropic drugs - keys for treatments’ improvements." European Psychiatry 26, S2 (March 2011): 1995. http://dx.doi.org/10.1016/s0924-9338(11)73698-7.
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Non-response, adverse effects and pharmacokinetic interactions with clinical consequences are frequent manifestations observed in psychiatric patients treated with psychotropic drugs. These risks are increased in patients belonging to the category of “special populations”: elderly patients, children and adolescents, patients with a genetic particularity of metabolism or suffering from somatic or psychic comorbidities. Increasingly, the use of generics has been shown to represent a source of unexpected treatment outcomes. Therapeutic drug monitoring (TDM) is not only recommended in these situations, but especially also in patients who are suspected to be non-compliant. In addition, the increasing knowledge of the metabolism of psychotropic drugs allows the use of phenotyping and/or genotyping techniques (e.g. cytochrome P-450, P-glycoprotein) in patients and to adapt their medication considering their pharmacogenetic status. Pharmacokinetic (TDM) and pharmacogenetic tests are therefore useful to solve problems in psychopharmacotherapy and thus improve efficacy and safety of the drugs. An earlier developed Consensus guideline on TDM (Baumann et al., 2004) has recently been updated (Hiemke et al., 2011).
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Lozzi, Flavia, Cosimo Di Raimondo, Caterina Lanna, Laura Diluvio, Sara Mazzilli, Virginia Garofalo, Emi Dika, et al. "Latest Evidence Regarding the Effects of Photosensitive Drugs on the Skin: Pathogenetic Mechanisms and Clinical Manifestations." Pharmaceutics 12, no. 11 (November 17, 2020): 1104. http://dx.doi.org/10.3390/pharmaceutics12111104.
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Photosensitivity induced by drugs is a widely experienced problem, concerning both molecule design and clinical practice. Indeed, photo-induced cutaneous eruptions represent one of the most common drug adverse events and are frequently an important issue to consider in the therapeutic management of patients. Phototoxicity and photoallergy are the two different pathogenic mechanisms involved in photosensitization. Related cutaneous manifestations are heterogeneous, depending on the culprit drug and subject susceptibility. Here we report an updated review of the literature with respect to pathogenic mechanisms of photosensitivity, clinical manifestations, patient management, and prediction and evaluation of drug-induced photosensitivity. We present and discuss principal groups of photosensitizing drugs (antimicrobials, nonsteroidal anti-inflammatory drugs, anti-hypertensives, anti-arrhythmics, cholesterol, and glycemia-lowering agents, psychotropic drugs, chemotherapeutics, etc.) and their main damage mechanisms according to recent evidence. The link between the drug and the cutaneous manifestation is not always clear; more investigations would be helpful to better predict drug photosensitizing potential, prevent and manage cutaneous adverse events and find the most appropriate alternative therapeutic strategy.
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Ampong, David Nana. "Landmarks of pharmacogenomics and some considerations for clinical practice." Therapeutic Advances in Psychopharmacology 9 (January 2019): 204512531989665. http://dx.doi.org/10.1177/2045125319896650.
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Since the completion of the Human Genome Project 28 years ago, myriad genomics applications have risen in areas such as agriculture, livestock, infectious agents, forensics, bioenergy, ancestry, health, disease, and medicine. This was driven partly by the US government’s ability to use a unique program to facilitate genome sequencing to the point where the cost of sequencing a whole human genome is not prohibitive. However, application of this knowledge of the double helix twisted DNA at the bedside in psychiatric clinical practice has little to report, despite US Food and Drug Administration (FDA) approval of nearly 40 psychotropic drugs, as well as specific guidelines for their application. Patients with treatment-resistant mental illness, history of unresponsiveness to psychotropic medications, and history or family history of serious adverse effects to psychotropic drugs may qualify for pharmacogenomics (PGx) testing with insurance reimbursement, or a low, out-of-pocket, payment of not greater than US $300. Psychiatric mental health nurse practitioners and providers who utilize PGx will not only improve patient care outcomes, but also contribute to the acceleration of the potential diagnostic and preventive capabilities of PGx testing.
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Kocharyan, Garnik. "Hypoactive Sexual Desire and Other Sexual Dysfunctions Caused by Psychotropic Drugs and Anticonvulsants." Health of Man, no. 1 (March 31, 2023): 34–42. http://dx.doi.org/10.30841/2307-5090.1.2023.280049.
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Currently, there are a huge number of drugs. Every year their number increases and their number is in the tens of thousands, which makes it possible to speak of a “pharmaceutical explosion”. In addition to its main therapeutic effect, each of the drugs has side effects, which, in particular, may affect the sexual sphere. This article discusses the literature on the side effects of psychotropic drugs and anticonvulsants, which can lead to hypoactive sexual desire and other sexual dysfunctions. The side effects on sexual functions of tranquilizers, antipsychotics (traditional and newer), antidepressants of various groups (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, as well as newer antidepressants), mood stabilizers and anticonvulsants are considered. The degree of influence of neuroleptics and antidepressants on sexual function is discussed depending on the dose, duration of administration, belonging to one or another chemical class. It is noted that some drugs from these groups can have a stronger negative effect on sexual functions, others have a moderate or weak effect, and still others not only do not have such an effect, but even increase sexual desire and other sexual functions. Therefore, before starting to take one or another drug from these groups, one should evaluate the state of sexual functions and, in case of their violation, prescribe such drugs that have the same therapeutic effect, but when they are used, there is no risk of adverse effects on the sexual sphere. These drugs (for example, antidepressants) should be prescribed as a substitute even in cases where a drug with an antidepressant effect was previously taken, which led to sexual dysfunctions.
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Olczyk, Carla Joice Tomczak, and Eduardo Manoel Pereira. "Analysis of antimicrobial and psychotropic prescriptions in the central medication unit of the city of Guaramirim (Santa Catarina State - Brazil) / Análise de prescrições de antimicrobianos e psicotrópicos na unidade central de medicamentos da cidade de Guaramirim (Estado de Santa Catarina - Brasil)." Brazilian Journal of Development 8, no. 5 (May 20, 2022): 39527–42. http://dx.doi.org/10.34117/bjdv8n5-443.
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The doctor’s prescription defines the patient’s treatment. In order to use medicine within maximum efficacy and minimum toxicity parameters, the prescription must be properly filled and readable. Although specific laws are applied to guide prescription elaboration, errors persist, and depending on its nature, they may cause from lack of efficacy to adverse effects. The purpose of this study was to evaluate the quality of prescriptions for psychotropic and antimicrobial drugs dispensed by the central pharmacy of the city of Guaramirim, Santa Catarina state, from February 1 to April 30, 2019. A total of 3,780 prescriptions were analyzed, 3,388 of psychotropic drugs and 392 of antimicrobials. The most frequent errors found were omission of telephone number, and address of patients and physicians. Regarding the drugs prescribed, it was observed lack of information on dose, route, and quantity of the drugs, and also the frequent presence of non-standard abbreviations. Most prescriptions were readable, but despite typed prescriptions may solve illegibility issues, which did not reach homogeneously data omission, and it is essential that pharmacists position themselves so as not to dispense wrong prescriptions and that patients demand greater clarification of the prescription at the time of consultation.
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Prisco, V., T. Iannaccone, A. Capuano, M. Fabrazzo, and F. Catapano. "Drug safety warnings in psychiatry: Adverse drug reactions’ signaling from 2002 to 2014." European Psychiatry 41, S1 (April 2017): S758. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1420.
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Monitoring drug-related side effects in psychiatric patients is highly recommended. In fact, frequent exposure to long-term polipharmacotherapy, poor compliance to pharmachological treatment and co-morbidity with organic illnesses requiring the prescription of other drugs are causes of pharmacokinetic/pharmacodynamic interactions. These vulnerability factors result in a certain increase in ADRs (adverse drug reactions). This study performs an analysis of the Italian medicine agency (AIFA) data, in the section “signal analysis”, to attempt an assessment of the safety warnings among the different psychotropic drug classes, belonging to the ATC class: N03 (anti-epileptics), N05 (anti-psychotics), N06 (psycho-analectic drugs). Then we analyzed, in a descriptive way, the different association between the drug and the related ADR, evaluating the different safety profiles, in relation to experimental studies, supporting the importance of the signal. In the last years, among the new 25 ADRs, 10 were related to antidepressant drugs (8 SSRI, 1 mirtazapine, 1 agomelatine). In relation to anti-psychotic drugs, 6 new correlations were found between drug and ADR onset, mainly among atypical anti-spychotics. Other correlations (6 above all) were found among anti-epileptic drugs. Among benzodiazepines, a signal linked to rabdomylysis onset was found. It is also recommended an evaluation of safety profile in relation to zolpidem prescription. The results of our systematic review are a motivational input, considering the continuous increase of safety warnings, to attentively monitor drug's prescription. Spontaneous ADRs’ signaling is a classical system to provide the required attention in relation to a potential risk.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Creeley and Denton. "Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes." Brain Sciences 9, no. 9 (September 14, 2019): 235. http://dx.doi.org/10.3390/brainsci9090235.
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This paper reviews the findings from preclinical animal and human clinical research investigating maternal/fetal, neonatal, and child neurodevelopmental outcomes following prenatal exposure to psychotropic drugs. Evidence for the risks associated with prenatal exposure was examined, including teratogenicity, neurodevelopmental effects, neonatal toxicity, and long-term neurobehavioral consequences (i.e., behavioral teratogenicity). We conducted a comprehensive review of the recent results and conclusions of original research and reviews, respectively, which have investigated the short- and long-term impact of drugs commonly prescribed to pregnant women for psychological disorders, including mood, anxiety, and sleep disorders. Because mental illness in the mother is not a benign event, and may itself pose significant risks to both mother and child, simply discontinuing or avoiding medication use during pregnancy may not be possible. Therefore, prenatal exposure to psychotropic drugs is a major public health concern. Decisions regarding drug choice, dose, and duration should be made carefully, by balancing severity, chronicity, and co-morbidity of the mental illness, disorder, or condition against the potential risk for adverse outcomes due to drug exposure. Globally, maternal mental health problems are considered as a major public health challenge, which requires a stronger focus on mental health services that will benefit both mother and child. More preclinical and clinical research is needed in order to make well-informed decisions, understanding the risks associated with the use of psychotropic medications during pregnancy.