title: Correlates of major medication side effects interfering with daily performance: results from a cross-sectional cohort study of older psychiatric patients.
abstract: BACKGROUND
  Polypharmacy is common among older persons who are also vulnerable to side effects. We aimed to characterize patients who on admission to a geriatric psychiatric hospital had major medication side effects interfering with daily performance.
  
  
  METHODS
  Cross-sectional cohort study of patients consecutively admitted to a geriatric psychiatric hospital from 2006, 06 December to 2008, 24 October. The UKU side effect rating scale was performed, and patients were divided into those with no/minor side effects versus those with major side effects. Blood levels of 56 psychotropic drugs and 27 safety laboratory tests were measured upon admission.
  
  
  RESULTS
  Of 206 patients included in the analysis, 70 (34%) had major side effects related to drug treatment. The most frequent side effects were asthenia (31%), reduced salivation (31%), concentration difficulties (28%), memory impairment (24%), and orthostatic dizziness (18%). The significant characteristics predicting major side effects were female gender (OR = 2.4, 95% confidence interval (CI) = 1.1-5.5), main diagnosis of affective disorder (OR = 4.3, 95% CI = 1.5-12.3), unreported use of psychotropic medications (OR = 2.0, 95% CI = 1.0-4.1), a higher number of reported psychotropic medications (OR = 1.7, 95% CI = 1.2-2.3), a higher number of reported medications for somatic disorders (OR = 1.2, 95% CI = 1.1-1.5), and a higher score on the Charlson comorbidity index (OR = 1.2, 95% CI = 1.0-1.4) (r 2 = 0.238, p < 0.001).
  
  
  CONCLUSIONS
  Clinicians should be especially aware of side effects related to drug treatment in geriatric psychiatric female patients with a high use of psychotropic and other medications and somatic comorbidity. Unreported use of psychotropic medications was also related to the risk for side effects, and clinicians should make an effort to ascertain all medications taken by geriatric psychiatric patients.
authors.affiliation: Department of Geriatric Psychiatry,Diakonhjemmet Hospital,Oslo,Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Tveito
authors.affiliation: Department of Psychiatry,The Zucker Hillside Hospital,North Shore - Long Island Jewish Health System,Glen Oaks,NY,USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Norwegian Centre for Addiction Research,University of Oslo,Oslo,Norway.
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
authors.affiliation: Norwegian Advisory Unit for Aging and Health,Vestfold Hospital Trust,Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
authors.affiliation: Department of Geriatric Psychiatry,Diakonhjemmet Hospital,Oslo,Norway.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Lorentzen
authors.affiliation: Center for Psychopharmacology,Diakonhjemmet Hospital,Oslo,Norway.
authors.forename: Helge
authors.initials: H
authors.lastname: Refsum
authors.affiliation: Center for Psychopharmacology,Diakonhjemmet Hospital,Oslo,Norway.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Høiseth
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003693:Delirium / Q000150:complications / Q000523:psychology; D003704:Dementia / Q000150:complications / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy*; D009664:Norway / Q000453:epidemiology; D019338:Polypharmacy; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs
keywords: drug use; elderly; geriatric psychiatry; side effects