Validation of four drug interaction programs for psychopharmacotherapy

Introduction: To predict whether a combination of drugs is associated with a potential risk, drug-drug interaction (DDI) software programs are available. This investigation evaluated four German-speaking interaction programs in terms of their quality and practicability for psychopharmacotherapy. Methods: Two web based programs (www.psiac.de, www.mediQ.ch) and two CD based programs (ifap index, arzneitelegramm/Wechselwirkungen) were validated. Critical and non-critical DDI pairs were entered into the four different programs and parameters like sensitivity and correctness of the provided information were evaluated. Results: Best sensitivity regarding the critical interaction pairs was shown for PsiacOnline (90%) and ifapIndex (85%). Correct recommendations were provided in ifap (91%), PsiacOnline (85%), MediQ (50%) and the Arzneitelegramm for only 25% of the examined DDI pairs, whereas helpfulness of the recommendations was found for PsiacOnline 83%, MediQ 40%, ifap 75% and Arzneitelegramm 25%. Discussion: Although the web based PsiacOnline showed advantages to some extent, all four software programs need to be improved, especially with regard to sensitivity. Valid interaction programs and TDM can improve the safety of drug combinations since pharmacokinetic DDIs must be considered.