title: [Psychiatric polypharmacy: hazard through drug-drug-interaction and possibilities for prevention].
abstract: Psychiatric diseases and comorbidity have increased over the past years. Commonly used psychotropic drugs contain a high risk of drug interactions and adverse drug events (ADE). With a frequency of 10-12% psychotropic drugs are, among all pharmaceuticals, the most common cause of hospitalisation due to ADE. During a hospital stay the application of psychotropic drugs can also lead to adverse drug events--sometimes due to drug interactions. Currently, ADEs and drug interactions are the most frequent cause of death for in-patients (18% of all causes of death) with an overall mortality of 0.95%. As studies have shown, hospitals as well as insurers could save a considerable amount of resources by implementing a system with on-ward pharmacists, hereby reducing ADE and re-hospitalisation rates. In recent studies a large amount of current ADEs were rated as preventable. Patient impairment due to ADE is leading to an increase in liability cases with an expected 5% increase of compensation payments in 2011. To evaluate these ADE-related cases, a pharmaceutical assessment should be included in the expert trials, especially since a lack of awareness of medication errors is prevalent. When aiming towards a successful drug therapy, physicians must also consider that cheaper substances may often have an unfavourable drug interaction profile.
authors.affiliation: Aus der Klinik und Poliklinik für Psychiatrie und Psychotherapie, Dr. Horst Schmidt Klinik, Wiesbaden.
authors.forename: M
authors.initials: M
authors.lastname: Hahn
authors.forename: D F
authors.initials: DF
authors.lastname: Braus
mesh_terms: D000041:Absenteeism; D015897:Comorbidity; D017046:Cost Savings / Q000331:legislation & jurisprudence; D004185:Disability Evaluation; D004347:Drug Interactions; D057915:Drug Substitution / Q000191:economics; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000191:economics; D005104:Expert Testimony / Q000191:economics / Q000331:legislation & jurisprudence*; D005858:Germany; D006760:Hospitalization / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000331:legislation & jurisprudence; D016365:Liability, Legal / Q000191:economics; D008508:Medication Errors / Q000191:economics / Q000331:legislation & jurisprudence; D001523:Mental Disorders / Q000188:drug therapy* / Q000191:economics; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D012307:Risk Factors; D012943:Social Security / Q000191:economics / Q000331:legislation & jurisprudence
chemical_list: D011619:Psychotropic Drugs