Use and tolerability of newer antipsychotics and antidepressants: a chart review in a paediatric setting

Alacqua, Marianna; Trifirò, Gianluca; Arcoraci, Vincenzo; Germanò, Eva; Magazù, Angela; Calarese, Tiziana; Vita, Giuseppa Di; Gagliano, Catalda; Spina, Edoardo

doi:10.1007/s11096-007-9139-6

Cited by 22 publications

(8 citation statements)

References 30 publications

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“…The appropriate use of drugs and population characteristics play a key role in the development of ADEs. However, many patients are inappropriately treated [44][45][46][47][48][49][50][51][52][53] and available evidence indicates that approximately 50% of ADEs are preventable [54,55]. In our study, we found a high rate of avoidable ADEs.…”

Section: Discussionsupporting

confidence: 44%

Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

Giudice

Mocciaro

Giardina

et al. 2019

BMC Pharmacol Toxicol

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Background: Adverse drug events (ADEs) are a significant cause of emergency department (ED) visits, with a major impact on healthcare resource utilization. A multicentre observational study, aimed to describe frequency, seriousness and preventability of ADEs reported in four EDs, was performed in Sicily (Italy) over a 1-year period. Methods: Two trained monitors for each ED supported clinicians in identifying ADEs of patients admitted to EDs between June 1st, 2013 and May 31st, 2014 through a systematic interview of patients or their caregivers and with an additional record review. A research team analyzed each case of suspected ADE, to make a causality assessment applying the Naranjo algorithm and a preventability assessment using Schumock and Thornton criteria. Absolute and percentage frequencies with 95% confidence interval (CI) and medians with interquartile ranges (IQR) were estimated. Logistic regression models were used to evaluate independent predictors of serious and certainly preventable ADEs. Results: Out of 16,963 ED visits, 575 (3.4%) were associated to ADEs, of which 15.1% resulted in hospitalization. ADEs were classified as probable in 45.9%, possible in 51.7% and definite in 2.4% of the cases. Moreover, ADEs were considered certainly preventable in 12.3%, probably preventable in 58.4%, and not preventable in 29.2% of the cases. Polytherapy influenced the risk to experience a serious, as well as a certainly preventable ADE. Whilst, older age resulted an independent predictor only of serious events. The most common implicated drug classes were antibiotics (34.4%) and anti-inflammatory drugs (22.6%). ADEs due to psycholeptics and antiepileptics resulted preventable in 62.7 and 54.5% of the cases, respectively. Allergic reactions (64%) were the most frequent cause of ADE-related ED visits, followed by neurological effects (10.2%) that resulted preventable in 1.9 and 37.3% of the cases, respectively. Conclusion: ADEs are a frequent cause of ED visits. The commonly used antibiotics and anti-inflammatory drugs should be carefully managed, as they are widely involved in mild to severe ADEs. Polytherapy is associated with the occurrence of serious, as well as certainly preventable ADEs, while older age only with serious events. A greater sensitivity to drug monitoring programs among health professionals is needed.

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Section: Discussionsupporting

confidence: 44%

Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

Giudice

Mocciaro

Giardina

et al. 2019

BMC Pharmacol Toxicol

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“…We identified 135 studies (57 new studies after the 2012 report 14 ) meeting our review criteria; of these, 126 (93%) reported on harms (Figure 1). 24 …”

Section: Resultsmentioning

confidence: 99%

Harms of Antipsychotics in Children and Young Adults: A Systematic Review Update

et al. 2018

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“…[ 10 ] The increase in FBG and TG could be the result of altered insulin secretion. [ 37 ] SGA treatment may directly affect insulin secretion[ 37 ] through several underlying mechanisms: Increased adipose tissue potentially results in insulin resistance, glucose intolerance, and diabetes, the increase in fatty acids could alter glucose metabolism, or the pancreatic β-cell response is diminished. [ 38 ]…”

Section: Discussionmentioning

confidence: 99%

Some side effects and effcts on physical activity of second-generation antipsychotics: A study in children and adolescents

2014

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Background:This study was designed to investigate the metabolic adverse effects (AEs) of second-generation antipsychotics (SGAs) and their relationship with physical activity and non-metabolic AE in children and adolescents.Materials and Methods:After exclusion of patients with metabolic syndrome, 62 patients (34 children, 28 adolescents) of both genders who were candidates for SGA therapy were selected. Metabolic parameters included fasting blood glucose (FBG), triglyceride (TG), blood pressure (BP), and waist circumference (WC); non-metabolic AEs and physical activity were evaluated at baseline, 1 month, and 3 months after starting the treatment.Results:Mean of post-treatment FBG and TG were significantly higher than the baseline values (P < 0.0001). Compared to the baseline value, significantly more patients developed abnormally high (AbH) FBG at the end point (P = 0.02). There was no significant difference in the frequency of patients with AbH-FBG either at the baseline or at the end point (P > 0.05). The frequency of patients with AbH-TG at the end point was not significantly higher than those with baseline AbH-TG (P = 0.10). Although no patient was obese at baseline, 11 (18%) patients developed abdominal obesity at the end point (P < 0.0001). There was no significant difference in the frequency of non-metabolic AE (P > 0.05). There was no significant correlation between metabolic and non-metabolic AE (P > 0.05). Frequency of inactive patients was significantly more than the baseline value (P-0.008), and abdominal obesity was significantly more prevalent in less active participants (P = 0.03).Conclusion:The present study showed the AE of SGA on FBG and TG, but no effect on BP and WC. We also found that children are more prone to develop abnormally high FBG.

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Use and tolerability of newer antipsychotics and antidepressants: a chart review in a paediatric setting

Abstract: ADRs occurred frequently during first 3 months of treatment with atypical antipsychotics and, to a lesser extent, with SSRIs in children and adolescents. Further investigations are urgently needed to better define the benefit/risk ratio of psychotropic medications in paediatric setting.

Cited by 22 publications

References 30 publications

Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

Characterization and preventability of adverse drug events as cause of emergency department visits: a prospective 1-year observational study

Harms of Antipsychotics in Children and Young Adults: A Systematic Review Update

Some side effects and effcts on physical activity of second-generation antipsychotics: A study in children and adolescents

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