[Patients with adverse drug reactions have a higher prevalence of emotional disorders]

Abstract

Aim: To examine the frequency of emotional disorders (anxiety and depression) in patients with adverse drug reactions (ADR), compared with that in patients without those disorders.

Study design: Case-control.

Setting: Santa María de Benquerencia Health Centre (Toledo).

Participants: Patients over 14 years old of both sexes managed in a Primary Care Clinic.

Measurements and results: A total of 311 patients (108 cases and 203 controls) were included, of whom 53.7% were male. The mean age was 54.1 years in cases, and 46.0 in controls (t=4.254; P<.001). Antecedents of anxiety were presented in 45.5% of cases, and those of depression in 41.7%, versus 19.7% and 15.3%, respectively, in controls (P<.001). Mean chronic illnesses were 5.8 in cases and 3.5 in controls (P<.001). Mean number of drugs consumed was 3.7 in cases and 1.7 in controls (P<.001). In the logistic regression, the probability of having had anxiety was 2.5 times higher in patients with ADR (95%CI 1.12-4.51), and the probability of having had depression was twice as likely(1.06-3.66). Drug groups with a higher number of ADR were those of the central nervous system, antibiotics and antiinflammatories.

Conclusions: 1) ADR is associated with anxiety and depression, and it can be used as a marker of social issues. 2) Attention must be paid to patients with anxiety or depression when making out prescriptions. 3) Antibiotics, antiinflammatories and drugs acting on the central nervous system are more likely to produce ADR.

Esquema general del estudio: estudio observacional, descriptivo, retrospectivo, de casos y controles, mediante revisión de historias clínicas de una consulta de medicina de familia. Se definió «caso» como aquellos pacientes que habían comunicado reacción adversa a algún medicamento prescrito. Se definió «control» como aquellos pacientes que no habían comunicado reacciones adversas a ningún medicamento prescrito.

Figura 1

Número absoluto de reacciones adversas por grupo farmacológico (código ATC). A: sistema digestivo y metabolismo; B: sangre y órganos hematopoyéticos; C: sistema cardiovascular; D: medicamentos dermatológicos; G: aparato genitourinario y hormonas sexuales; H: preparados hormonales sistémicos, excluidas las hormonas sexuales; J: antiinfecciosos en general para uso sistémico; L: agentes antineoplásicos e inmunomoduladores; M: sistema musculoesquelético; N: sistema nervioso; P: productos antiparasitarios, insecticidas y repelentes; R: sistema respiratorio; S: órganos de los sentidos; V: varios.