ABSTRACT
OBJECTIVE: To describe rates of inpatient prescribing of psychotropic drugs in a rehabilitation and complex continuing care setting. DESIGN: Cross-sectional, observational study. SETTING: Providence Healthcare, Toronto, Ontario, Canada. PATIENTS: Inpatients registered in the hospital on each of four annual audit dates. INTERVENTION: An audit of medication profiles for the presence of psychotropic prescriptions, done yearly on a single day in May 2007, 2008, 2010, and 2011. MAIN OUTCOME MEASURES: The percentage of inpatients prescribed at least one antidepressant, antipsychotic, benzodiazepine, or zopiclone. RESULTS: The percentage of inpatients with at least one prescription for each class of psychotropic drug (ranging from the lowest to highest audit-year results) were as follows: any psychotropic (55% to 63%), benzodiazepines or zopiclone (31% to 40%), antidepressants (24% to 32%), antipsychotics (7% to 13%). Rates of polypharmacy within classes was highest with antidepressants, followed by benzodiazepines (including zopiclone), then antipsychotics. CONCLUSION: Despite the limitations associated with cross-sectional, observational data, rates of prescribing of psychotropic medication, apart from antipsychotics, were high. Future research will be performed to assess appropriateness of prescribing and adverse events.
Subject(s)
Medical Audit , Psychotropic Drugs/therapeutic use , Rehabilitation Centers , Cross-Sectional Studies , Humans , Ontario , Polypharmacy , Practice Patterns, Physicians'Subject(s)
Antipsychotic Agents/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Clozapine/adverse effects , Schizophrenia, Paranoid/drug therapy , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/therapy , Female , Humans , Middle Aged , Risk Factors , Schizophrenia, Paranoid/diagnosisABSTRACT
OBJECTIVE: To report a case of possible cross-sensitivity between selective serotonin-reuptake inhibitors (SSRIs). CASE SUMMARY: A 20-year-old Southeast Asian man developed a maculopapular rash soon after starting paroxetine. Following resolution of this rash, another skin reaction with the same distribution and appearance occurred after sertraline therapy was started. DISCUSSION: Cross-reactivity between drugs with similar structures has been reported; however, cross-reactivity among SSRI antidepressants is unexpected given their differences in chemical structure. CONCLUSIONS: The possibility of cross-reactivity between SSRI antidepressants should be considered by clinicians who wish to switch from one SSRI to another due to a dermatologic reaction.