Shah et al Journal of Drug Delivery & Therapeutics; 2014, 4(1), 49-52 49
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RESEARCH ARTICLE
A LONGITUDINAL STUDY OF MONITORING ADVERSE DRUG REACTIONS AT
PSYCHIATRY OUT-PATIENT-DEPARTMENT IN OUR TERTIARY CARE TEACHING
HOSPITAL, SURENDRANAGAR
*Shah VM
1
, Mehta DS
2
1
P.G. student, Department of pharmacology, C.U.S.M.C., Surendranagar, Gujarat, India
2
Professor & Head, Department of pharmacology, C.U.S.M.C., Surendranagar, Gujarat, India
*Corresponding Author’s E-mail: Vidisha_pharmac@yahoo.com
INTRODUCTION:
Adverse drug reactions (ADRs) are as important in
psychiatric practice as they are in any other branch of
medicine. The safety of medicines is an essential part of
patient safety. Global drug safety depends on strong
national systems that monitor the development and
quality of medicines, report their harmful effects, and
provide accurate information for their safe use. ADRs are
defined as an „unexpected, unintended, undesired or
excessive response to a drug‟, which would include
„allergic reactions and idiosyncratic reactions that are an
abnormal susceptibility to a drug peculiar to the
individual‟.
1
All noxious and unintended responses to a
medicinal product related to any dose should be
considered adverse drug reaction.
2
ADRs only affect a
minority of those taking a particular drug. It is often seen
that commonly prescribed drugs, elicit ADR in some, at
the same time many remain unaffected.
Pharmacovigilance is, “The Pharmacological Science
relating to the detection, assessment, understanding and
prevention of adverse effects, particularly long term and
short term side effects of medicines.”
3
Pharmacovigilance in psychiatry units can play a vital
role in detecting ADRs and alerting physicians to the
possibility and circumstances of such events, thereby
protecting the user population from avoidable harm.
4
Many psychotropic drugs are available in India and their
use is increasing day by day. Commonly used
psychotropic drugs in psychiatry O.P.D. are the drugs
used for psychoses, depression, epilepsy, mania,
migraine and insomnia. These drugs are capable of
causing a number of ADRs,
5,6
some of which may be
fatal. Most commonly ADRs are seen with
antipsychotics and mood stabilizers. ADRs associated
with psychotropic drugs can lead to noncompliance, and
at times discontinuation of therapy.
7
In India,
pharmacovigilance activities are still in the nascent stage
and the data of ADRs particularly related to psychotropic
drugs need to be strengthened.
8
Objectives:
To determine the incidence of ADRs and to
assess the causality of ADRs in psychiatry O.P.D. at our
tertiary care teaching hospital.
MATERIALS AND METHODS:
A longitudinal observational study was carried
out at our psychiatry out-patient-department (OPD) in a
tertiary care teaching hospital. This hospital caters to the
health care needs of thousands of patients from
Surendranagar city, many villages and town around the
city. It was part of ongoing pharmacovigilance activity at
the Institute which had the necessary administrative and
Institutional Ethics Committee (IEC) clearance.
The data was collected prospectively of the
patients reporting to psychiatry OPD. The study was
carried out for 3 months between May 2012 and July
2012. Out of 4169 patients attending to psychiatry OPD
within these 3 months, the patients with ADRs were
evaluated. Diagnosis of ADR was made by psychiatrist.
All the doctors, residents, interns, and nursing staff were
informed to notify any suspected ADRs. Patient details
(age, sex, body weight), adverse event history, history of
medication suspected of having caused the ADR, and
details of concomitant medication use were recorded in
ABSTRACT
Objectives: Adverse Drug Reactions (ADRs) are common to the psychotropic drugs in our teaching hospital and here, we
study to determine suspected ADRs in psychiatry O.P.D. Materials and Methods: In order to evaluate the incidence of
ADRs in psychiatry O.P.D., we performed a longitudinal observational study between May 2012 and July 2012. All the
patients were interviewed for basic details, history of medications and for the relevant history for ADRs. All details were
captured in a format as adopted in the Indian National Pharmacovigilance Programme. Causality was assessed by criteria of
World Health Organization-Uppsala Monitoring Center (WHO-UPC). Result: We observed 4169 patients (males 64.28%,
females 35.71%, median age 40 years), of who 28 were diagnosed as having at least one ADR; Cases who had insufficient
evidence about causality (WHO-UMC causality status "unlikely") were excluded from further analysis. Out of 28 events
recorded, 12 (42.85%) were "probable" and 12(42.85%) were "possible". Rest of them was labeled as “certain". Total of 43
ADRs were noted in 28 patients. Maximum number of ADR noted was nausea which was followed by weight gain. Highest
number of ADRs was reported with Amitriptyline and Duloxetine.
Key Words: Adverse Drug Reactions (ADRs), Psychiatry O.P.D., Psychotropic drugs.