Antipsychotic Polypharmacy Is Associated With Adverse Drug Events in Psychiatric Inpatients: The Japan Adverse Drug Events Study. Issue 4 (July 2021)

• Record Type: Journal Article
• Authors: Ayani, Nobutaka; Morimoto, Takeshi; Sakuma, Mio; Kikuchi, Toshiaki; Watanabe, Koichiro; Narumoto, Jin
• Is Part Of: Journal of clinical psychopharmacology. Volume 41:Issue 4(2021)
• Publication Date: 2021-07
• Subjects: adverse drug events -- antipsychotic polypharmacy -- epidemiology -- psychiatry -- patient safety; Psychopharmacology -- Periodicals; Psychopharmacology -- Periodicals; Psychopharmacologie -- Périodiques; Psychopharmacology; Periodicals; 615.78
• DOI: 10.1097/JCP.0000000000001416
• Languages: English
• ISSNs: 0271-0749

Abstract

Abstract: Background: Antipsychotic (AP) polypharmacy (APP), the coprescription of more than 1 AP, is frequently practiced in psychiatric inpatients and is considered to be a risk factor for adverse drug events (ADEs). However, the association between APP and ADEs among psychiatric inpatients has not been well investigated. Methods: The Japan Adverse Drug Events (JADE) study was a series of cohort studies conducted in several clinical settings. In particular, the JADE study for psychiatric inpatients was a retrospective cohort study of 448 psychiatric inpatients with a cumulative 22, 733 patient-days. We investigated the relationship between APP, defined as a concurrent prescription of 2 or more APs and ADEs. We also assessed the relationship between potential risk factors for ADEs due to APs. Results: Among the 448 patients included in this study, 106 patients (24%) had APP and the remaining 342 patients were prescribed 1 AP or none. Risperidone was the most frequent drug (25%, 109/442 AP prescriptions) used, and levomepromazine was most frequently prescribed as a concurrent medication with other APs (91%, 29/32). The median number of ADEs among the patients with APP was significantly higher than in those without APP ( P = 0.001). Antipsychotic polypharmacy was a risk factor for the occurrence of first (adjusted hazard ratio, 1.54; 95% confidence interval, 1.15–2.04) and second (adjusted hazard ratio, 1.99; 95% confidence interval, 1.40–2.79) ADEs. Conclusions: Antipsychotic polypharmacy was a risk factor for the occurrence of single and multiple ADEs. Antipsychotic polypharmacy should be conservatively and minimally practiced.