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Current Psychopharmacology

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ISSN (Print): 2211-5560
ISSN (Online): 2211-5579

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Research Article

Outpatient Psychotropic Drug Interactions in a Public Psychiatry Hospital in Bahrain: An Audit Study

Author(s): Yasin Tayem*, Saeed Aljaberi, Ali Alfehaid, Abdulaziz Almekhyal, Haitham Jahrami, Mazen Ali and Suhaib Hattab

Volume 11, Issue 1, 2022

Published on: 01 July, 2021

Article ID: e010721194415 Pages: 6

DOI: 10.2174/2211556010666210701164436

Price: $65

Abstract

Background: Psychotropic polypharmacy is particularly common, which puts psychiatric patients at high risk for developing drug-drug interactions.

Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting.

Methods: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the grades and correlates of interactions between psychotropic drugs.

Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001) and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05).

Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

Keywords: Drug-drug interactions, polypharmacy, psychotropic drugs, plasma level, schizophrenia, schizoaffective disorder.

Graphical Abstract

[1]
Carpenter M, Berry H, Pelletier AL. Clinically relevant drug-drug interactions in primary care. Am Fam Physician 2019; 99(9): 558-64.
[PMID: 31038898]
[2]
Niu J, Straubinger RM, Mager DE. Pharmacodynamic drug-drug interactions. Clin Pharmacol Ther 2019; 105(6): 1395-406.
[http://dx.doi.org/10.1002/cpt.1434] [PMID: 30912119]
[3]
Palleria C, Di Paolo A, Giofrè C, et al. Pharmacokinetic drug- drug interaction and their implication in clinical management. J Res Med Sci 2013; 18(7): 601-10.
[PMID: 24516494]
[4]
Juurlink DN, Mamdani M, Kopp A, Laupacis A, Redelmeier DA. Drug-drug interactions among elderly patients hospitalized for drug toxicity. JAMA 2003; 289(13): 1652-8.
[http://dx.doi.org/10.1001/jama.289.13.1652] [PMID: 12672733]
[5]
Rodrigues MC, Oliveira Cd. Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review. Rev Lat Am Enfermagem 2016; 24: e2800.
[http://dx.doi.org/10.1590/1518-8345.1316.2800] [PMID: 27598380]
[6]
Kratz T, Diefenbacher A. Psychopharmacological treatment in older people: avoiding drug interactions and polypharmacy. Dtsch Arztebl Int 2019; 116(29-30): 508-18.
[PMID: 31452508]
[7]
Preskorn SH, Lacey RL. Polypharmacy: when is it rational? J Psychiatr Pract 2007; 13(2): 97-105.
[http://dx.doi.org/10.1097/01.pra.0000265766.25495.3b] [PMID: 17414685]
[8]
Faiad Y, Khoury B, Daouk S, et al. Frequency of use of the International Classification of Diseases ICD-10 diagnostic categories for mental and behavioural disorders across world regions. Epidemiol Psychiatr Sci 2018; 27(6): 568-76.
[http://dx.doi.org/10.1017/S2045796017000683] [PMID: 29117869]
[9]
Pirnejad H, Amiri P, Niazkhani Z, et al. Preventing potential drug-drug interactions through alerting decision support systems: A clinical context based methodology. Int J Med Inform 2019; 127: 18-26.
[http://dx.doi.org/10.1016/j.ijmedinf.2019.04.006] [PMID: 31128828]
[10]
Bhattacharjee S, Goldstone L, Warholak T. Prevalence, patterns and predictors of psychotropic polypharmacy among elderly individuals with parkinson’s disease in long term care settings in the United States. J Parkinsons Dis 2016; 6(1): 247-55.
[http://dx.doi.org/10.3233/JPD-150646] [PMID: 26756742]
[11]
Dagli RJ, Sharma A. Polypharmacy: a global risk factor for elderly people. J Int Oral Health 2014; 6(6): i-ii.
[PMID: 25628499]
[12]
Lavan AH, Gallagher PF, O’Mahony D. Methods to reduce prescribing errors in elderly patients with multimorbidity. Clin Interv Aging 2016; 11: 857-66.
[PMID: 27382268]
[13]
Wyska E. Pharmacokinetic considerations for current state-of-the-art antidepressants. Expert Opin Drug Metab Toxicol 2019; 15(10): 831-47.
[http://dx.doi.org/10.1080/17425255.2019.1669560] [PMID: 31526279]
[14]
Kim HA, Shin JY, Kim MH, Park BJ. Prevalence and predictors of polypharmacy among Korean elderly. PLoS One 2014; 9(6): e98043.
[http://dx.doi.org/10.1371/journal.pone.0098043] [PMID: 24915073]
[15]
Harugeri A, Joseph J, Parthasarathi G, Ramesh M, Guido S. Prescribing patterns and predictors of high-level polypharmacy in the elderly population: A prospective surveillance study from two teaching hospitals in India. Am J Geriatr Pharmacother 2010; 8(3): 271-80.
[http://dx.doi.org/10.1016/j.amjopharm.2010.06.004] [PMID: 20624616]
[16]
Lin C-F, Wang C-Y, Bai CH. Polypharmacy, aging and potential drug-drug interactions in outpatients in Taiwan: a retrospective computerized screening study. Drugs Aging 2011; 28(3): 219-25.
[http://dx.doi.org/10.2165/11586870-000000000-00000] [PMID: 21250763]

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