Adverse Drug Reactions in Psychiatry: An Alarming Scenario

In the world, India is the largest producer of pharmaceuticals. It is very much essential that the treatment with these drugs should be efficacious, safe and cost effective. Every year, introduction of newer drugs and the production of various pharmaceutical products were increasing. World Health Organization (WHO) realized the need for a responsible surveillance system in order to ban the noxious drugs in the market. Both in hospitalized and ambulatory patients, ADRs are the significant cause of morbidity and mortality. Around 6-15% of the hospitalized patients may experience a serious ADR and nearly 6.5% of the hospital admissions are admission due to ADR. Some of the new ADRs that can be seen with psychotropic drugs are Risperidone associated with an increased risk of stroke in elderly patients with dementia and dopamine receptor agonists (Cabergoline and Pergolide) associated with cardiac valve fibrosis. So many drugs act at more than one receptor type. Tricyclic antidepressants shows their therapeutic effect by the stimulation of monoaminergic pathways by a reduction in monoamine reuptake, but tricyclic antidepressants also show the antimuscaranic activity and this is responsible for adverse effects like retention of urine, drymouth and constipation. To avoid the noxious reactions of psychotropic drugs, pharmacovigilance plays a pivotal role in detecting the adverse drug reactions that alert the psychiatrist in their management. In developing countries like India, pharmacovigilance activities are still in initial stage and especially in case of psychotropic drugs only few reports are available on this concern. A wide range of surveillance programs on adverse drug reactions of psychotropic drugs should be emphasized, in our Indian scenario to strengthen the database.