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Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 29-35

Incidence and predictors of adverse drug reactions caused by drug-drug interactions in psychiatric patients: An empirical study

1 Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, Mysore, Karnataka, India
2 Department of Psychiatry, JSS Hospital, Mysore, Karnataka, India

Correspondence Address:
Jisha M Lucca
Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, SS Nagara, Mysore - 570 015, Karnataka
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DOI: 10.4103/1119-0388.172059

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Introduction: Potential drug-drug interactions (pDDIs) are very frequent in psychiatric practice and result in poor tolerability or reduced efficacy, or both, which can negatively impact patient outcomes. Clinically significant drug-drug interactions (DDIs) are the ones that can result in changes in the therapeutic effect of one of the two drugs, that is, adverse drug reactions (ADRs). The aim of this study was to identify the incidence and pattern of ADRs occurring as results of DDIs in patients with mental illness. Materials and Methods: This empirical study reviewed all the patients with a psychiatric diagnosis as per the Tenth Revision of the International Classification of Diseases (ICD-10) and received at least two medications. DDIs were identified using drug interaction software/databases, standard textbooks, and references. Result: A total of 122 ADRs were identified from 97 patients. The majority [n = 98 (68.5%)] of the DDIs involved pharmacodynamic interactions. Risperidone (41 occurrences) exhibited the greatest propensity to interact with other medications, and the most commonly observed ADR was extrapyramidal symptoms (EPS) (n = 33). More than half of the ADRs were “possible” in their causal relationship. Conclusion: The incidence of ADRs caused by DDIs in this study was 12%. Pharmacodynamic interactions accounted for the majority (68.5%) of ADRs. ADRs are an important cause of the increased burden of disease and unnecessary health-care expenditure. Intense monitoring of psychiatric patients for any DDI, and early detection and prevention of the same may result in improved therapeutic outcomes and decreased unnecessary health-care expenditure.

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