Table 4 Classification of first ranked psychotropic drug interactions, the two most frequent psychotropics involved and mechanism of interaction in 2000, and 2016, among patients in three nursing homes with 386 and 416 patients the respective years
2000 | 2016 | 2000 | 2016 | ||||||
|---|---|---|---|---|---|---|---|---|---|
Patients n (%) | Patients n (%) | p-value | First (%) | Second (%) | Mechanism | First (%) | Second (%) | Mechanism | |
Interactions | 63 (100.0) | 146 (100.0) | < 0.001 | ||||||
Pharmacodynamic | 44 (69.8) | 135 (92.5) | Citalopram (50.0) | Risperidone (22.7) | Priapism/QT-prolongationc | Mirtazapine (43.2) | Oxazapem (34.2) | Sedationt | |
Pharmacokinetic | 19 (30.2) | 11 (7.5) | Carbamazepine (42.1) | Risperidone (21.1) | Risperidone reduceds | Valproic acid (45.5) | Carbamazepine (36.4) | CBZ-metabolite increaseds | |
Recommended action | 0.006 | ||||||||
Avoid | 7 (11.1) | 5 (3.4) | Levomepromazine (71.4) | Haloperidol (57.1) | QT-prolongationt | Haloperidol (80.0) | Citalopram (80.0) | QT-prolongationt | |
Monitor or adjust dose | 21 (33.3) | 79 (54.1) | Carbamazepine (28.6) | Olanzapine (19.0) | Olanzapine reduceds | Mirtazapine (77.2) | Oxazepam (36.7) | Sedationt | |
Informative | 35 (55.6) | 62 (42.5) | Citalopram (51.4) | Risperidone (34.3) | Priapism/QT-prolongationc | Escitalopram (43.5) | Oxazepam (38.7) | Sedationt | |
Documentation | 0.001 | ||||||||
Study | 13 (20.7) | 11 (7.5) | Carbamazepine (46.2) | Nortriptyline (23.1) | Nortriptyline reduced | Mirtazapine (54.5) | Diazepam (45.5) | CNS depression | |
Case | 14 (22.2) | 15 (10.3) | Risperidone (57.1) | Citalopram (50.0) | Priapism/QT-prolongation | Mirtazapine (40.0) | Olanzapine (40.0) | Sedation | |
Theoretical | 36 (57.1) | 120 (82.2) | Citalopram (38.9) | Levomepromazine (19.4) | QT-prolongation | Mirtazapine (44.2) | Oxazepam (40.0) | Sedation | |
Severity | 0.222 | ||||||||
Severe | 35 (55.5) | 64 (43.8) | Citalopram (42.9) | Risperidone (40.0) | Priapism/QT-prolongationc | Mirtazapine (43.8) | Escitalopram (37.5) | Serotonine syndromet | |
Moderate | 27 (42.9) | 81 (55.5) | Citalopram (25.9) | Zopiclone (22.2) | Sedationt | Oxazepam (60.5) | Mirtazapine (45.7) | Sedationt | |
Mild | 1 (1.6) | 1 (0.7) | Zopiclone (100.0) | Carbamazepine (100.0) | Sedationt | Zopiclone (100.0) | Carbamazepine (100.0) | Sedationt | |