Abstract
Introduction The prevalence of psychotropic drug use in our society
is increasing especially in older adults, thereby provoking severe adverse
drug reactions (ADR). To identify specific patient risk profiles associated
with psychotropic drug use in the situation of polymedication.
Methods Cases of ADRs in general emergency departments (ED) collected
within the multi-center prospective observational study (ADRED) were
analyzed (n=2215). We compared cases with use of psychotropic drugs
and without concerning their clinical presentation at the ED.
Results A third of patients (n=731, 33%) presenting
to the ED with an ADR took at least 1 psychotropic drug. Patients with
psychotropic drug use tended to be older, more often female, and took a
higher number of drugs (all p<0.001). The frequency of falls was
almost 3 times higher than compared to the non-psychotropic drug group (10.5
vs. 3.9%, p<0.001), and similar syncope was also more often
seen in the psychotropic drug users (8.8 vs. 5.5%, p=0.004).
The use of psychotropic drugs increased the risk for falls by a factor of
2.82 (OR, 95% CI (1.90–4.18)), when adjusting for gender,
age, numbers of pre-existing diseases, and drugs, respectively.
Discussion The association of psychotropic drug use with fall and
syncope in combination with polymedication and older age leads to the
suspicion that psychotropic drugs might be potentially harmful in specific
risk populations such as older adults. It may lead us to thoroughly weigh
the benefit against risk in a patient-oriented way, leading to an
integrative personalized therapy approach.
Key words
psychopharmacology - adverse drug reaction - emergency - older adults
