Cutaneous adverse drug reactions to psychotropic drugs and their risk factors - a case-control study

Greil, Waldemar; Zhang, Xueqiong; Stassen, Hans; Grohmann, Renate; Bridler, René; Hasler, Gregor; Toto, Sermin; Bleich, Stefan; Kasper, Siegfried (2019). Cutaneous adverse drug reactions to psychotropic drugs and their risk factors - a case-control study. European neuropsychopharmacology, 29(1), pp. 111-121. Elsevier 10.1016/j.euroneuro.2018.10.010

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy

UniBE Contributor:

Hasler, Gregor

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0924-977X

Publisher:

Elsevier

Language:

English

Submitter:

Gregor Hasler

Date Deposited:

03 Apr 2019 17:12

Last Modified:

03 Apr 2019 18:12

Publisher DOI:

10.1016/j.euroneuro.2018.10.010

PubMed ID:

30424913

Uncontrolled Keywords:

Case control study, Case non-case Cutaneous adverse drug, reaction Drug safety Risk factors, Sex gender difference

BORIS DOI:

10.7892/boris.122449

URI:

https://boris.unibe.ch/id/eprint/122449

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