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 reactions (ADRs) has become increasingly important within modern psychopharmacology. AMSP (“Arzneimittelsicherheit in der Psychiatrie”; Drug Safety in Psychiatry) was founded in 1993 and is a drug safety monitoring program with special emphasis on severe and unusual ADRs during treatment with psychotropic drugs.

Methods Data derives from the AMSP database.>100 psychiatric hospitals in Germany, Switzerland and Austria have participated from 1993 up to now. Data on psychotropic drug use was gathered on two reference days per year along with mean duration of treatment. ADRs were determined using ASMP definitions and rating questionnaire. Causal relationship between observed symptoms and drugs given at that time were carefully assessed.

Results A total of 462,661 psychiatric inpatients were monitored from 1993 to 2016. Antipsychotics and antidepressants were the most commonly prescribed drug classes. Polypsychopharmacology 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 mean 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 drugs, is a useful tool in estimating the risk/benefit ratio of drug therapy within clinical settings.

Publication History

Article published online:
16 May 2022