Adverse reactions to antidepressants in consultation-liaison psychiatry inpatients.
In a practice-based, prospective study of 1,551 inpatients referred to a consultation-liaison psychiatry service and prescribed an antidepressant, an adverse drug reaction judged sufficient to warrant discontinuation of the drug was noted in 158 (10.2%). The factors associated were older age (P < 0.05); ICD-9 genitourinary disorder (mainly renal failure) (P < 0.01); DSM-IV "delirium, dementia, etc." (P < 0.05); length of stay (P < 0.001); number of visits (P < 0.001); and time spent on case (P < 0.05). Neither psychological functioning (GAF) nor physical functioning (Karnofsky ratings) were associated with a reaction, nor was multiple psychotropic drug prescription. Tricyclics were more likely than selective serotonin reuptake inhibitors/norepinephrine reuptake inhibitors to be associated with a reaction (P < 0.05). Consultation-liaison psychiatrists need to be well informed about pharmacodynamics and drug interactions in patients with physical/psychiatric comorbidity.
Smith
Graeme C
GC
Monash University Department of Psychological Medicine and Southern Health, Melbourne, Australia. graeme.smith@med.monash.edu.au
Clarke
David M
DM
Handrinos
Dennis
D
Trauer
Thomas
T
D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors
D000928:Antidepressive Agents