Abstract
The frequency of severe adverse drug reactions (ADRs) from psychotropic drugs was investigated in hospitalised psychiatric patients in relation to their age. Specifically, the incidence of ADRs in patients up to 60 years was compared to that of patients older than 60 years. Prescription rates of psychotropic drugs and reports of severe ADRs were collected in psychiatric hospitals in Switzerland between 2001 and 2010. The data stem from the drug surveillance programme AMSP. A total of 699 patients exhibited severe ADRs: 517 out of 28,282 patients up to 60 years (1.8%); 182 out of 11,446 elderly patients (1.6%, ns). Logistic regression analyses showed a significantly negative relationship between the incidence of ADRs and patients' age in general and in particular for weight gain, extrapyramidal motor system (EPMS) symptoms, increased liver enzymes and galactorrhoea. A significantly negative relationship was observed for age and the dosages of olanzapine, quetiapine, risperidone, valproic acid and lamotrigine. When comparing age groups, frequency of ADRs was lower in general for antipsychotic drugs and anticonvulsants, in particular for valproic acid in the elderly. Weight gain was found to be lower in the elderly for antipsychotic drugs, in particular for olanzapine. For the group of mood-stabilising anticonvulsants (carbamazepine, lamotrigine and valproic acid) the elderly exhibited a lower incidence of reported allergic skin reactions. The results suggest that for psychiatric inpatients the incidence of common severe ADRs (e.g., weight gain or EPMS symptoms) arising from psychotropic medication decreases with the age of patients.
Highlights
The overall consensus is that elderly psychiatric patients are more prone to develop adverse drug reactions (ADRs) than younger patients as a consequence of psychopharmacological medication [1]
QUESTION UNDER STUDY: The frequency of severe adverse drug reactions (ADRs) from psychotropic drugs was investigated in hospitalised psychiatric patients in relation to their age
Prescription rates of psychotropic drugs and reports of severe ADRs were collected in psychiatric hospitals in Switzerland between 2001 and 2010
Summary
The overall consensus is that elderly psychiatric patients are more prone to develop adverse drug reactions (ADRs) than younger patients as a consequence of psychopharmacological medication [1]. Persons with psychiatric disorders frequently suffer from somatic diseases and may receive polypharmacy more than younger patients They may tend to develop ADRs more frequently. The present study aimed to verify the hypothesis that the risk of ADRs increases with the age of patients For this purpose we used a large data sample from the international AMSP drug surveillance programme (Arzneimittelsicherheit in der Psychiatrie – drug safety in psychiatry) [9]. The programme records severe ADRs in patients from a large age range who are hospitalised in psychiatric settings It records the prescriptions of drugs and personal data such as age, sex and diagnosis. To the best of our knowledge, such an analysis had not previously been conducted
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