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Psychiatric medications common cause of ED visits in US

Many adverse drug events treated in US emergency departments can be attributed to psychiatric medications, according to recent study findings published in JAMA Psychiatry.

Lee M. Hampton, MD, MSc, of the division of healthcare quality promotion at the CDC, and colleagues estimated the annual number of US ED visits from 2009 to 2011 due to adverse drugs events (ADEs) to determine how many could be attributed to therapeutic use of psychiatric medications.

Lee M. Hampton

During the study period there were an estimated 89,094 annual psychiatric medication ADE ED visits. Nineteen percent of these resulted in hospitalizations and 49.4% were among adults aged 19 to 44 years.

The most common psychiatric medications causing ADE ED visits annually were sedatives and anxiolytics (estimated 30,707), followed by antidepressants (estimated 25,377), antipsychotics (estimated 21,578), lithium salts (estimated 3,620) and stimulants (estimated 2,779). Lithium salts were implicated in 16.4 ADE ED visits per 10,000 outpatients visits in which they were prescribed, compared with 11.7 for antipsychotics, 3.6 for sedatives and anxiolytics, 2.9 for stimulants, and 2.4 for antidepressants.

More than 11% of all adult psychiatric medication ADE ED visits involved zolpidem tartrate (11.5%), as well as 21% among adults aged 65 and older.

“Last year, the leaders of the American Psychiatric Association, psychiatrists' professional organization, urged doctors to use antipsychotics cautiously and only after exploring the feasibility of using alternate treatments,” Hampton told Healio.com. “Our report reinforces that it is important for doctors and patients to heed the warning from the American Psychiatric Association to be cautious in their use of antipsychotics. Doctors and patients should also be cautious in using zolpidem and other sedatives, particularly because there are many treatment options for insomnia, the condition which zolpidem is intended to treat and which other sedatives are sometimes used to treat.” — by Amber Cox

Lee M. Hampton, MD, MSc, can be reached at 1600 Clifton Road, Mailstop A-24, Atlanta, GA 30329; email: lhampton@cdc.gov.

Disclosure: One researcher reports financial ties with the FDA’s Drug Safety and Risk Management Advisory Committee and IMS Health.