Current use of anticholinergic medications in a large naturalistic sample of psychiatric patients.
Adverse drug reactions (ADR)
Anticholinergic burden
Drug safety
Drug–drug interactions (DDI)
Pharmacodynamics
Pharmacovigilance
Psychiatry
Psychotropic drugs
Journal
Journal of neural transmission (Vienna, Austria : 1996)
ISSN: 1435-1463
Titre abrégé: J Neural Transm (Vienna)
Pays: Austria
ID NLM: 9702341
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
01
09
2020
accepted:
27
12
2020
pubmed:
14
1
2021
medline:
16
10
2021
entrez:
13
1
2021
Statut:
ppublish
Résumé
Due to the high number of psychotropic drugs with anticholinergic potential, patients taking psychotropic drugs are at high risk for anticholinergic adverse drug reactions (ADRs). The aim of this study was to analyze the prevalence and type of pharmacodynamic anticholinergic drug-drug interactions in psychiatric patients. The retrospective longitudinal analysis used data from a large pharmacovigilance study conducted in ten German psychiatric hospitals. Anticholinergic burden of drugs was defined as "strong" or "moderate" based on current literature. Number and type of anticholinergic drugs were assessed. In total, 27,396 patient cases (45.6% female) with a mean age of 47.3 ± 18.3 years were included. 17.4% (n = 4760) of patients were ≥ 64 years. 35.4% of the patients received between one and four anticholinergic drugs simultaneously. A combination of drugs with anticholinergic potential was detected in 1738 cases (6.3%). Most prescribed drugs were promethazine (n = 2996), olanzapine (n = 2561), biperiden (n = 1074), and doxepin (n = 963). Patients receiving anticholinergic combinations were younger (45.7 vs. 47.4 years, p < 0.01) and had a longer inpatient stay (median 18 vs. 26.5 days, p < 0.001). The prevalence of anticholinergic drug use in psychiatry is high. Further efforts need to focus on reducing the rate of anticholinergics and inappropriate medication especially in the elderly. Anticholinergic ADRs can be prevented by avoiding high-risk drug combinations. Replacing tricyclic antidepressants and first-generation antihistamines with drugs with lower anticholinergic potential and avoiding biperiden could reduce 59.3% of anticholinergic drug application.
Identifiants
pubmed: 33439364
doi: 10.1007/s00702-020-02298-5
pii: 10.1007/s00702-020-02298-5
doi:
Substances chimiques
Cholinergic Antagonists
0
Psychotropic Drugs
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
263-272Subventions
Organisme : Deutsches Zentrum für Luft- und Raumfahrt
ID : 01VSF16009
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