Drug safety in patients with psychotic disorders

PhD ceremony: mw. S.G. Schorr, 14.45 uur, Academiegebouw, Broerstraat 5, Groningen

Thesis: Drug safety in patients with psychotic disorders

Promotor(s): prof.dr. J.R.B.J.Brouwers

Faculty: Mathematics and Natural Sciences

Contact: Susanne Schorr, tel. 00 49 176 4133 8-71, e-mail: susanneschorr@yahoo.de

This thesis investigated different aspects of drug safety in patients with psychotic disorders. We found that in routine practice the drug treatment was potentially inappropriate and could be improved. Additionally, many patients were suffering from physical illnesses or symptoms. Many of these symptoms were potential adverse drug reactions of antipsychotic drugs. In this thesis, the adverse drug reactions related to an increased cardiovascular and metabolic risk were investigated in depth. The prevalence of metabolic syndrome in a cohort of patients with psychotic disorders in the Netherlands was similar to other European countries. Following these patients for one year, we found that having the metabolic syndrome was not a static or progressive condition, but was dynamic. One treatment option in patients with psychotic disorders is changing the drug therapy to an antipsychotic drug with a potentially lower potency of causing metabolic side effects. This thesis showed that in routine practice, this could lead to considerable weight loss in some patients. Increasingly, risk score models are used to estimate the cardiovascular risk of patients. We have shown that such models have to be used cautiously in patients with psychotic disorders and the methodology of cardiovascular risk quantification in this population should be further developed.