26 Current data from the AMSP Project on the risk of treatment with antidepressants and antipsychotics within the clinical setting

Introduction The monitoring of adverse drug effects has become increasingly important within modern psychopharmacology. The AMSP (‘Arzneimittelsicherheit in der Psychiatrie’), founded in 1993, is a drug safety monitoring program with special emphasis on severe and unusual adverse drug reactions during treatment with psychotropic drugs.

Methods Data were gathered from the AMSP data base. 54 psychiatric hospitals in Germany, Switzerland and Austria participated from 1993 to 2018. Data on psychotropic use were based on two reference days per year. Adverse drug reactions (ADRs) were determined using ASMP definitions and rating questionnaire. Causal relationship between observed symptoms and drugs given at that time were carefully assessed [1].

Results A total of 462,661 psychiatric inpatients were monitored from 1993 to 2016. Throughout this time, antipsychotics and antidepressants were the drug classes most commonly prescribed. Polypsychopharmacology has increased over the years: The average number of prescribed psychotropic drugs increased from 2.2 per patient in 1994 to 2.6 psychotropic drugs in 2017. The total number of all drugs prescribed also increased from 3.0 in 1993 to 4.4 drugs per patient in 2017. A total of 7293 severe ADRs were registered from 1993 to 2016, 50.2 % of which were caused by a combination of drugs. ADRs most commonly observed under combination treatment were urinary retention, hyponatremia, seizures, and delirium.

Conclusion Observation of naturalistic prescription and safety data of psychotropic drugs, especially in combination with other (non-)psychotropic, is a useful tool in estimating the risk/benefit ratio of drug therapy within clinical setting.

Publication History

Article published online:
30 April 2020

• References

• 1 Grohmann R. et al. Pharmacopsychiatry 37: 4-11, 2004;