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Author

  • Lücke, Caroline (2)
  • Moeller, Sebastian (2)
  • Müller, Helge H. O. (2)
  • Philipsen, Alexandra (2)
  • Custal, Christina (1)
  • Grömer, Teja W. (1)
  • Gschossmann, Jürgen M. (1)
  • Lam, Alexandra Philomena (1)
  • Schneider, Charlotte E. (1)
  • Sörös, Peter (1)
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  • 2018 (1)
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  • Article (2)

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  • Cannabinoid consumption (1)
  • Off-label prescription (1)
  • Psychosis (1)
  • Psychotropic medication (1)
  • Risk profile (1)
  • Synthetic cannabinoid consumption (1)

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  • Medizinische Fakultät (2)

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Off-label prescription of psychiatric drugs by non-psychiatrist physicians in three general hospitals in Germany (2018)
Lücke, Caroline ; Gschossmann, Jürgen M. ; Grömer, Teja W. ; Moeller, Sebastian ; Schneider, Charlotte E. ; Zikidi, Aikaterini ; Philipsen, Alexandra ; Müller, Helge H. O.
Background Off-label prescribing of psychoactive drugs is a common practice in psychiatry. Here, we sought to investigate the frequency of off-label prescribing in a population of hospitalized patients with a somatic illness who were also suffering from a psychiatric pathology. Methods Using a prospective, observational design, we collected data from 982 hospitalized patients with a somatic illness for whom a psychiatric consultation was requested because of the presence of additional psychiatric symptoms. Data were collected at three hospitals in Germany. Demographic and clinical data, including the previous psychoactive medications and an assessment of the suitability of the previous medications, were recorded and analyzed. Results Data on the previous psychiatric medications were available for 972 patients. In 16.6% of patients, at least one psychoactive drug had been prescribed off-label, 20.2% had received on-label medication, and 63.2% had not received any psychiatric medication. Among all patients receiving psychiatric medication, 45.1% had received off-label medication. The logistic regression analysis showed a significant influence of age on the likelihood of receiving off-label medication (p = 0.018). Benzodiazepines were the most frequent off-label prescription (25.8% of off-label prescriptions), followed by atypical antipsychotics (18.2%) and low-potency antipsychotics (17.2%). Notably, 57.1% of off-label prescriptions were judged to be ‘not indicated’ by experienced psychiatrists. Conclusions Our data show a high frequency of the off-label prescription of psychoactive drugs by physicians treating patients with somatic illnesses in general hospitals. Because more than half of these cases were judged to be “not indicated”, these prescriptions indicate a potential risk to patients. Furthermore, the classes of drugs that were most frequently prescribed off-label, benzodiazepines and antipsychotics, both show a substantial risk profile, particularly for elderly patients.
Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study (2017)
Welter, Stella ; Lücke, Caroline ; Lam, Alexandra Philomena ; Custal, Christina ; Moeller, Sebastian ; Sörös, Peter ; Thiel, Christiane M. ; Philipsen, Alexandra ; Müller, Helge H. O.
Background: Consumption of natural cannabis (NC) and synthetic cannabinoids (SCs) has been associated with psychotic disorders. We compared the prevalence of use, consumer profiles, and psychosis-inducing potential of NC and SCs in a specific high-risk population. Methods: This prospective pilot study included 332 patients (18-64 years, mean 36.83, SD 13.33). Patients' sociodemographics and medical histories as well as illicit substance use and psychiatric symptom histories were collected using a drug consumption survey that assessed the use of new psychoactive substances and the Psychotic Symptoms Interview. Results: In total, 7.2% of all patients, 10.6% of psychotic patients, and 4.5% of nonpsychotic patients reported SC consumption. Compared with SCs, NC was consumed much more frequently by its users (mean 222.73, SD 498.27). NC and SC use induced persistent psychosis. Psychotic symptoms were first experienced by patients with a history of NC or SC use during intoxication and persisted after cessation (>1 year) of drug use. Positive and negative symptoms tended to be more severe in SC and NC users, respectively. Conclusions: NC and SCs may cause different symptom clusters. These relationships should be further evaluated.
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