Cutaneous adverse drug reactions to psychotropic drugs and their risk factors – a case-control study
DOKPE
- Greil, Waldemar Ludwig-Maximilian University, Munich, Germany
- Zhang, Xueqiong Ludwig-Maximilian University, Munich, Germany
- Stassen, Hans Psychiatric Hospital, Kilchberg, Zurich, Switzerland
- Grohmann, Renate Ludwig-Maximilian University, Munich, Germany
- Bridler, René Psychiatric Hospital, Kilchberg, Zurich, Switzerland
- Hasler, Gregor ORCID University of Bern, Switzerland
- Toto, Sermin Hannover Medical School, Hannover, Germany
- Bleich, Stefan Hannover Medical School, Hannover, Germany
- Kasper, Siegfried Medical University of Vienna, Austria
- 2019
Published in:
- European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 2019, vol. 29, no. 1, p. 111-121
Case control study
Case/non-case
Risk factors
Sex gender difference
Cutaneous adverse drug reaction
Drug safety
English
Cutaneous adverse drug reactions (CADRs) in patients with psychotropic drugs are common. Large studies on the relevant drugs and other risk factors are still scarce. 594 cases of severe CADRs ("cases") were compared with 8085 cases of other adverse drug reactions ("non-cases") documented in a pharmacovigilance program in psychiatry (AMSP) from 1993 to 2014. Logistic regression was carried out to determine risk factors and between-drug differences.
CADRs were relatively more prevalent in patients treated with clomipramine, maprotiline, carbamazepine, lamotrigine, acamprosate, clomethiazole and disulfiram as well as with antidepressants and anticonvulsants as drug classes (p < 0.01). For these drugs, significantly more women were found in patients using maprotiline, lamotrigine (not carbamazepine) and in the groups of antidepressants, tricyclics and anticonvulsants (p < 0.01). Women were more vulnerable to CADRs (67% in cases and 56% in non-cases, p < 0.01). The significantly higher rate of CADRs in women was mainly observed under age of 50 years, i.e. during female reproductive years. In a multivariate logistic regression, female sex, the diagnostic group ICD F1 (substance abuse), maprotiline, carbamazepine, lamotrigine and clomethiazole were identified as risk factors of CADRs.
The case/non-case approach allowed to identify risk factors based on empirical data rather than experts' evaluations. The new findings of substance abuse and clomethiazole as risk factors for CADRs have to be confirmed in further studies. Since CADRs can be life-threatening, it is important to be aware of risk factors, especially women during their reproductive period and with lamotrigine treatment.
CADRs were relatively more prevalent in patients treated with clomipramine, maprotiline, carbamazepine, lamotrigine, acamprosate, clomethiazole and disulfiram as well as with antidepressants and anticonvulsants as drug classes (p < 0.01). For these drugs, significantly more women were found in patients using maprotiline, lamotrigine (not carbamazepine) and in the groups of antidepressants, tricyclics and anticonvulsants (p < 0.01). Women were more vulnerable to CADRs (67% in cases and 56% in non-cases, p < 0.01). The significantly higher rate of CADRs in women was mainly observed under age of 50 years, i.e. during female reproductive years. In a multivariate logistic regression, female sex, the diagnostic group ICD F1 (substance abuse), maprotiline, carbamazepine, lamotrigine and clomethiazole were identified as risk factors of CADRs.
The case/non-case approach allowed to identify risk factors based on empirical data rather than experts' evaluations. The new findings of substance abuse and clomethiazole as risk factors for CADRs have to be confirmed in further studies. Since CADRs can be life-threatening, it is important to be aware of risk factors, especially women during their reproductive period and with lamotrigine treatment.
- Faculty
- Faculté des sciences et de médecine
- Department
- Master en médecine
- Language
-
- English
- Classification
- Pathology, clinical medicine
- License
- CC BY-NC-ND
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1016/j.euroneuro.2018.10.010
- ISSN 0924-977X
- Persistent URL
- https://folia.unifr.ch/unifr/documents/327742
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