Details:

Alternative Title:
JAMA Psychiatry
Personal Author:
Hampton, Lee M. ; Daubresse, Matthew ; Chang, Hsien-Yen ; Alexander, G. Caleb ; Budnitz, Daniel S.
Hampton, Lee M. ; Daubresse, Matthew ; Chang, Hsien-Yen ; Alexander, G. Caleb ; Budnitz, Daniel S. Less -
Description:
IMPORTANCE

In 2011, an estimated 26.8 million US adults used prescription medications for mental illness.

OBJECTIVE

To estimate the numbers and rates of adverse drug event (ADE) emergency department (ED) visits involving psychiatric medications among US adults between January 1, 2009, and December 31, 2011.

DESIGN AND SETTING

Descriptive analyses of active, nationally representative surveillance of ADE ED visits using the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance system and of drug prescribing during outpatient visits using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey.

PARTICIPANTS

Medical records from national probability samples of ED and outpatient visits by adults 19 years or older were reviewed and analyzed.

EXPOSURES

Antidepressants, antipsychotics, lithium salts, sedatives and anxiolytics, and stimulants.

MAIN OUTCOMES AND MEASURES

National estimates of ADE ED visits resulting from therapeutic psychiatric medication use and of psychiatric medication ADE ED visits per 10 000 outpatient visits at which psychiatric medications were prescribed.

RESULTS

From 2009 through 2011, there were an estimated 89 094 (95% CI, 68 641–109 548) psychiatric medication ADE ED visits annually, with 19.3% (95% CI, 16.3%–22.2%) resulting in hospitalization and 49.4% (95% CI, 46.5%–52.4%) involving patients aged 19 to 44 years. Sedatives and anxiolytics, antidepressants, antipsychotics, lithium salts, and stimulants were implicated in an estimated 30 707 (95% CI, 23 406–38 008), 25 377 (95% CI, 19 051–31 704), 21 578 (95% CI, 16 599–26 557), 3620 (95% CI, 2311–4928), and 2779 (95% CI, 1764–3794) respective ADE ED visits annually. Antipsychotics and lithium salts were implicated in 11.7 (95% CI, 10.1–13.2) and 16.4 (95% CI, 13.0–19.9) ADE ED visits per 10 000 outpatient prescription visits, respectively, compared with 3.6 (95% CI, 3.2–4.1) for sedatives and anxiolytics, 2.9 (95% CI, 2.3–3.5) for stimulants, and 2.4 (95% CI, 2.1–2.7) for antidepressants. The commonly used sedative zolpidem tartrate was implicated in 11.5% (95% CI, 9.5%–13.4%) of all adult psychiatric medication ADE ED visits and in 21.0% (95% CI, 16.3%–25.7%) of visits involving adults 65 years or older, in both cases significantly more than any other psychiatric medication.

CONCLUSIONS AND RELEVANCE

Psychiatric medications are implicated in many ADEs treated in US EDs. Efforts to reduce ADEs should include adults of all ages but might prioritize medications causing high numbers and rates of ED visits.


Keywords:
[+]
Adult Aged Age Factors Anti-Anxiety Agents Antidepressive Agents Antipsychotic Agents Emergency Service, Hospital Female Hospitalization Humans Hypnotics And Sedatives Lithium Compounds Male Mental Disorders Middle Aged Psychotropic Drugs Sex Factors United States Young Adult
Source:
JAMA Psychiatry. 71(9):1006-1014
Pubmed ID:
25006837
Pubmed Central ID:
PMC4703317
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:3b03a924b6ea055ea1b8bcece3e5834f0441b6d4f0c73e9b3af6c45c554808fc
Download URL:
https://stacks.cdc.gov/view/cdc/37359/cdc_37359_DS1.pdf
File Type:

Supporting Files

• 	NIHMS748530-supplement-Online_supplemental_material.pdf	pdf
  	nihms748530.nxml	xml

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