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Pharmacopsychiatry 2020; 53(03): 133-137
DOI: 10.1055/a-1110-1010
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

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

Julia C. Stingl 
1   Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany
,
Katja S. Just 
1   Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany
,
Marlen Schurig
2   Research Department, Federal Institute for Drugs and Medical Devices, Bonn, Germany
,
Miriam Böhme
2   Research Department, Federal Institute for Drugs and Medical Devices, Bonn, Germany
,
Michael Steffens
2   Research Department, Federal Institute for Drugs and Medical Devices, Bonn, Germany
,
Matthias Schwab
3   Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
4   Department of Clinical Pharmacology, University of Tübingen, Tübingen, Germany
5   Department of Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany
,
Thomas Seufferlein
6   Internal Medicine Emergency Department, Ulm University Medical Centre, Ulm, Germany
,
Harald Dormann
7   Central Emergency Department, Hospital Fürth, Fürth, Germany
› Author Affiliations Funding This work was supported by the framework of the AMTS focus of the German Federal Ministry of Health (BMG), grant number ZMVI5–2514ATA004. The work done in the study center Stuttgart was funded by the Robert Bosch Stiftung Stuttgart. For the remaining authors, none were declared.
Further Information

Publication History

received 22 November 2019
revised 22 January 2020

accepted 26 January 2020

Publication Date:
27 February 2020 (online)

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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.

Key words

psychopharmacology - adverse drug reaction - emergency - older adults
 

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