Journal of Clinical and Diagnostic Research (Jul 2015)

Evaluation of Potential Drug-Drug Interactions with Antidepressants in Two Tertiary Care Hospitals

  • Muhammad Salman Rafi,
  • Syed Baqir Shyum Naqvi,
  • Muhammad Umair Khan,
  • Muhammad Fayyaz,
  • Nida Ashraf,
  • Maqsood Ahmed Khan,
  • Akram Ahmad,
  • Sameer Dhingra

DOI
https://doi.org/10.7860/JCDR/2015/13437.6207
Journal volume & issue
Vol. 9, no. 7
pp. FC05 – FC08

Abstract

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Background: Limited resources of healthcare system and high use of antidepressants have raised some serious concerns regarding proper surveillance system of prescribed medicines. Not much literature is available from Pakistan regarding the potential drugdrug interactions (pDDIs) associated with antidepressants. Objective: The objective of this study was to assess the frequency of pDDIs associated with antidepressants, their severity, significance and their association with patient characteristics. Materials and Methods: A prospective, observational study was conducted in two major hospitals of Karachi for the period of three months. Patient profiles, medication charts, and physician notes were thoroughly reviewed to gather all the relevant information. Inclusion and exclusion criteria were set prior to data collection. The collected data was then analysed using Micromedex DrugREAX System. Descriptive and binomial logistic regression analysis was used to express results. Results: Of 245 prescriptions reviewed, 141 prescriptions had at least one pDDI (57.5%). A total of 181 pDDIs were identified in prescription containing antidepressant. The ratio of pDDI per prescriptions was 0.78. 42.5% interactions were moderate in severity, 30% of interactions were rapid in onset, and 43% were considered as significant interactions. Polypharmacy (OR=3.41, p<0.001) and presence of chronic problems (OR=2.14, p=0.002) were significantly associated with the occurrence of pDDIs. Citalopram and diclofenac (11.6%) was commonly prescribed interacting pair in this study. Conclusion: The findings of this study recorded high frequency of antidepressants associated pDDIs. Our results confirm the significant association of polypharmacy with the occurrence of pDDIs with antidepressants. Future studies are warranted to establish these results by including hospitals in different parts of the country.

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