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Potential Drug-Drug Interactions among Patients with Schizophrenia Spectrum Disorders : Prevalence, Association with Risk Factors, and Replicate Analysis in 2021
ID Bačar, Cvetka (Author), ID Nagode, Katja (Author), ID Pišlar, Mitja (Author), ID Mrhar, Aleš (Author), ID Grabnar, Iztok (Author), ID Vovk, Tomaž (Author)

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Abstract
Background and Objectives: Patients with schizophrenia are often exposed to polypharmacotherapy, which may lead to drug—drug interactions. The aim of the study was to investigate the prevalence of potential drug—drug interactions (pDDIs) in hospitalized patients with schizophrenia spectrum disorders and to identify factors associated with pDDIs and manifested symptoms and signs. Materials and Methods: This cross-sectional observational study included 311 inpatients admitted to a psychiatric hospital. The LexiComp drug interaction program was used to identify pDDIs in 2014. Factors associated with the prevalence of pDDIs and factors related to clinically observed symptoms and signs were assessed using multivariable regression. In addition, replicate analysis of pDDI was performed using 2021 program updates. Results: The prevalence of pDDIs was 88.7%. Our study showed that more than half of the patients received at least one drug combination that should be avoided. The most common pDDIs involved combinations of two antipsychotics or combinations of antipsychotics and benzodiazepines, which can lead to cardio-respiratory depression, sedation, arrhythmias, anticholinergic effects, and neuroleptic malignant syndrome. The number of prescribed drugs was a risk factor for pDDIs (OR 2.85; 95% CI 1.84–5.73). All groups of clinically observed symptoms and signs were associated with the number of drugs. In addition, symptoms and signs characteristic of the nervous system and psychiatric disorders were associated with antipsychotic dosage (IRR 1.33; 95% CI 1.12–1.58), which could contribute to the development of extrapyramidal syndrome, insomnia, anxiety, agitation, and bipolar mania. The 2021 version of the drug interaction program showed a shift in drug interactions toward a lower risk rating, implying less severe patient management and possibly less alert fatigue. Conclusions: Patients with schizophrenia spectrum disorders are at high risk of developing drug—drug interactions. Optimization of drug therapy, patient monitoring, and use of drug interaction programs could help to prevent pDDIs and subsequent adverse drug events.

Language:English
Keywords:potential drug—drug interactions, schizophrenia, antipsychotics, drug interaction program, symptoms and signs, risk factors
Work type:Article
Typology:1.01 - Original Scientific Article
Organization:FFA - Faculty of Pharmacy
Publication status:Published
Publication version:Version of Record
Year:2023
Number of pages:13 str.
Numbering:Vol. 59, iss. 2, art. 284
PID:20.500.12556/RUL-144168 This link opens in a new window
UDC:615.214:616.895.8
ISSN on article:1648-9144
DOI:10.3390/medicina59020284 This link opens in a new window
COBISS.SI-ID:140427011 This link opens in a new window
Publication date in RUL:02.02.2023
Views:792
Downloads:53
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Record is a part of a journal

Title:Medicina
Publisher:MDPI
ISSN:1648-9144
COBISS.SI-ID:6754623 This link opens in a new window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Language:Slovenian
Keywords:možne interakcije med zdravili, abdominalni stent-graft, program medsebojnega delovanja zdravil, simptomi in znaki, dejavniki tveganja

Projects

Funder:ARRS - Slovenian Research Agency
Project number:P1-0189-2018
Name:Farmacevtska tehnologija: od dostavnih sistemov učinkovin do terapijskih izidov zdravil pri otrocih in starostnikih

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