Abstract | OBJECTIVES: Successful treatment of delirium depends on the detection of the reversible contributors. Drugs with delirogenic properties are the most prevalent reversible cause of delirium. METHODS: This observational study is based on data from Arzneimittelsicherheit in der Psychiatrie, a multicenter drug surveillance program in German-speaking countries recording severe adverse drug reactions (ADRs) in psychiatric inpatients. The present study analyzes drug-induced delirium (DID) during treatment with antidepressants and antipsychotics. RESULTS: A total of 436 565 psychiatric inpatients were treated with antidepressants and/or antipsychotics during the observation period from 1993 to 2016 in the participating 110 hospitals. Overall, 254 cases (0.06% of all patients treated with antidepressants and/or antipsychotics) of DID were detected. Implicated either in combination or alone (multiple drugs were implicated in 70.1% of DID), clomipramine (0.24%), amitriptyline (0.21%), and clozapine (0.18%) showed the highest incidence rates of DID. When implicated alone (98 cases overall), clozapine (0.11%) followed by amitriptyline (0.05%) were most likely causally associated with the occurrence of DID. Drugs with strong antimuscarinic properties generally exhibited higher risk of DID. CONCLUSIONS:
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Authors | M E Friedrich, R Grohmann, U Rabl, D Winkler, A Konstantinidis, R Engel, J Seifert, S Toto, S Stübner, R Frey, S Kasper |
Journal | The international journal of neuropsychopharmacology
(Int J Neuropsychopharmacol)
Vol. 25
Issue 7
Pg. 556-566
(08 04 2022)
ISSN: 1469-5111 [Electronic] England |
PMID | 35106566
(Publication Type: Journal Article, Multicenter Study, Observational Study)
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Copyright | © The Author(s) 2022. Published by Oxford University Press on behalf of CINP. |
Chemical References |
- Antidepressive Agents
- Antipsychotic Agents
- Muscarinic Antagonists
- Amitriptyline
- Clozapine
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Topics |
- Adverse Drug Reaction Reporting Systems
- Amitriptyline
- Antidepressive Agents
(adverse effects)
- Antipsychotic Agents
(adverse effects)
- Clozapine
- Delirium
(chemically induced, drug therapy, epidemiology)
- Humans
- Incidence
- Muscarinic Antagonists
- Psychoses, Substance-Induced
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