TY  - JOUR
A1  - Fekete, Stefanie
A1  - Kulpok, Christine
A1  - Taurines, Regina
A1  - Egberts, Karin
A1  - Geissler, Julia
A1  - Gerlach, Manfred
A1  - Malonga Makosi, Dorothée
A1  - König, Jochem
A1  - Urschitz, Michael S.
A1  - Toni, Irmgard
A1  - Neubert, Antje
A1  - Romanos, Marcel
T1  - Value of a web-based pediatric drug information system to prevent serious adverse drug reactions in child and adolescent psychiatry
JF  - Journal of Neural Transmission
N2  - Psychotropic drugs are frequently prescribed ‘off-label’ to children and adolescents and carry the risk of serious adverse drug reactions (sADR). We examined the frequency of sADRs of psychotropic drugs in pediatric inpatients and explored their potential preventability through following the recommendations of a web-based pediatric drug information system (PDIS). The potential socio-economic impacts of using this online system is also addressed. Routine clinical data from all inpatients treated in a child and adolescent psychiatry department between January 2017 and December 2018 were retrospectively examined for the occurrence of sADRs as defined by the European Medicines Agency. The preventability of the sADRs was assessed based on the information of the PDIS. Furthermore, the expected prolongation of the hospital stay due to sADRs was calculated as well as the associated treatment costs. The study was supported by the Innovation Fund of the Joint Federal Committee, grant number 01NVF16021. In total, 1036 patients were screened of whom 658 (63.5%) received psychopharmacological treatment. In 53 (8.1%) of these patients 54 sADRs were documented, of which 37 sADRs were identified as potentially preventable through PDIS. Mitigating sADR through PDIS would likely have prevented prolonged hospital stays and conferred considerable savings for health insurance companies. PDIS provides systematic and evidence-based information about pediatric psychopharmacotherapy and helps to prevent prescribing errors. Therefore, PDIS is a useful tool to increase drug therapy safety in child and adolescent psychiatry. Further prospective studies are needed to confirm the results.
KW  - adverse effects
KW  - pharmacovigilance
KW  - drug safety
KW  - psychotropic drugs
KW  - mental health
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324817
VL  - 130
IS  - 1
ER  - 
TY  - JOUR
A1  - Taurines, R.
A1  - Fekete, S.
A1  - Preuss-Wiedenhoff, A.
A1  - Warnke, A.
A1  - Wewetzer, C.
A1  - Plener, P.
A1  - Burger, R.
A1  - Gerlach, M.
A1  - Romanos, M.
A1  - Egberts, K. M.
T1  - Therapeutic drug monitoring in children and adolescents with schizophrenia and other psychotic disorders using risperidone
JF  - Journal of Neural Transmission
N2  - Risperidone is commonly used to treat different psychiatric disorders worldwide. Knowledge on dose–concentration relationships of risperidone treatment in children and adolescents with schizophrenia or other psychotic disorders is, however, scarce and no age-specific therapeutic ranges have been established yet. Multicenter data of a therapeutic drug monitoring service were analyzed to evaluate the relationship between risperidone dose and serum concentration of the active moiety (risperidone (RIS) plus its main metabolite 9-hydroxyrisperidone (9-OH-RIS)) in children and adolescents with psychotic disorders. Patient characteristics, doses, serum concentrations and therapeutic outcomes were assessed by standardized measures. The study also aimed to evaluate whether the therapeutic reference range for adults (20–60 ng/ml) is applicable for minors. In the 64 patients (aged 11–18 years) included, a positive correlation between daily dose and the active moiety (RIS\(_{am}\)) concentration was found (r\(_s\) = 0.49, p = 0.001) with variation in dose explaining 24% (r\(_s\)\(^2\) = 0.240) of the variability in serum concentrations. While the RIS\(_{am}\) concentration showed no difference, RIS as well 9-OH-RIS concentrations and the parent to metabolite ratio varied significantly in patients with co-medication of a CYP2D6 inhibitor. Patients with extrapyramidal symptoms (EPS) had on average higher RIS\(_{am}\) concentrations than patients without (p = 0.05). Considering EPS, the upper threshold of the therapeutic range of RIS\(_{am}\) was determined to be 33 ng/ml. A rough estimation method also indicated a possibly decreased lower limit of the preliminary therapeutic range in minors compared to adults. These preliminary data may contribute to the definition of a therapeutic window in children and adolescents with schizophrenic disorders treated with risperidone. TDM is recommended in this vulnerable population to prevent concentration-related adverse drug reactions.
KW  - risperidone
KW  - children
KW  - serum concentration
KW  - schizophrenia
KW  - therapeutic drug monitoring
KW  - pharmacovigilance
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324833
VL  - 129
IS  - 5-6
ER  -