Psychosomatics 43:228-233, June 2002
© 2002 The Academy of Psychosomatic Medicine
Adverse Reactions to Antidepressants in Consultation-Liaison Psychiatry Inpatients
Graeme C. Smith, M.B.B.S., M.D., M.P.M., F.R.A.N.Z.C.P., F.A.P.M.,
David M. Clarke, M.B.B.S., M.P.M., Ph.D., F.R.A.C.G.P., F.R.A.N.Z.C.P.,
Dennis Handrinos, M.B.B.S., M.P.M., F.R.A.N.Z.C.P., and
Thomas Trauer, B.A. (Hons.), Ph.D., A.B.Ps.S., M.A.Ps.S.
Received August 15, 2001; revised January 15, 2002; accepted January 30, 2002. From the Consultation-Liaison Psychiatry Research Unit, Monash University Department of Psychological Medicine and Southern Health, Melbourne, Australia. Address for correspondence and reprints: Professor G. C. Smith, Monash University Department of Psychological Medicine, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia. E-mail; graeme.smith{at}med.monash.edu.au
In a practice-based, prospective study of 1,551 inpatients referred to a consultation-liaison psychiatry service and prescribed an antidepressant, an adverse drug reaction judged sufficient to warrant discontinuation of the drug was noted in 158 (10.2%). The factors associated were older age (P < 0.05); ICD-9 genitourinary disorder (mainly renal failure) (P < 0.01); DSM-IV "delirium, dementia, etc." (P < 0.05); length of stay (P < 0.001); number of visits (P < 0.001); and time spent on case (P < 0.05). Neither psychological functioning (GAF) nor physical functioning (Karnofsky ratings) were associated with a reaction, nor was multiple psychotropic drug prescription. Tricyclics were more likely than selective serotonin reuptake inhibitors/norepinephrine reuptake inhibitors to be associated with a reaction (P < 0.05). Consultation-liaison psychiatrists need to be well informed about pharmacodynamics and drug interactions in patients with physical/psychiatric comorbidity.
Key Words: Consultation-Liaison • Antidepressants
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