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A Clinical Pharmacist-Led Study of Drug-Drug Interactions in Patients with Psychiatric Disorders

Juno J Joel

The majority of patients seeking medical management for psychiatric illnesses such as depression and schizophrenia seek it in primary care and clinical settings. 1 Drug-related problems are a common cause of morbidity and can result in death in severe medical cases [1-15]. It is estimated that drug-drug interactions account for 6% to 10% of adverse events, with the majority of them avoidable with proper monitoring. 3 Since the introduction of typical antipsychotics in the 1950s, they have been regarded as a cornerstone in the treatment of schizophrenia and related illnesses. However, atypical antipsychotics were thought to have fewer side effects and to be more effective, particularly in the treatment of some negative symptoms such as flattened effect and lack of emotion. Antipsychotics with other concomitant drugs can cause potential drug-drug interactions (pDDIs), as patients may be on multiple medications due to comorbidities. 5 These drug-drug interactions (DDIs) can also cause blood pressure fluctuations, sedation, central nervous system (CNS) toxicity, cardiac arrhythmias, and other side effects. It is difficult to avoid DDIs among these patients for a variety of reasons, including long-term drug therapy and polypharmacy, posing a challenge to treating physicians. Drug interactions can have a negative impact on morbidity, mortality, hospitalisation length, health-care costs, and quality of life.The patient’s age and gender, changes in pharmacokinetic parameters, polypharmacy, medication errors, and comorbid conditions are all common risk factors for DDIs.Drug-drug interactions are significantly reduced when risk factors are identified and minimised. DDIs are one of the most common causes of unexpected clinical responses in patients, particularly those on polypharmacy. In some cases, vigilant investigation with appropriate substitution and dose reduction may be required to prevent adverse incidents and improve patient safety. As a result, the current study was designed to determine the prevalence and severity of drug-drug interactions among participants.