Identifying Psychiatric Drugs Leading to Emergency Room Visits

Justin Karter
14
111

Adverse effects from psychiatric drugs account for almost one in ten adult emergency room visits related to prescription medications and one in five of these visits result in hospitalization.

“Considering the growing exposition to antipsychotics in the general population and the increasing off-label use of antipsychotics, the findings of this study urge providers to prescribe antipsychotics cautiously and only after exploring the feasability of using alternative treatments,” Dr. Lucien Roulet, wrote in a commentary to be published in the journal of Evidence-Based Mental Health.

More than ten-percent of adults in the United States are currently prescribed at least one psychiatric medication, but there is currently a lack of research on the prevalence of adverse drug events (ADEs) associated with these prescriptions outside of clinical trials. A 2014 study, published in JAMA Psychiatry, analyzed emergency department records from 2009 to 2011 to attempt to estimate the frequency and seriousness of adverse drug events related to the use of psychiatric drugs.

As a result of this first-of-its-kind analysis, researchers identified several psychiatric drug prescriptions that lead to a substantial percentage of emergency room visits. Antipsychotics and antidepressants were the leading cause of emergency room visits for adverse effects from psychotropic drugs. Together, they accounted for nearly two-thirds of all such visits, with antipsychotics making up 31.3% and antidepressants 30.5%. Shockingly, the insomnia Z-drug, Zolpidem, accounted for more than one in five (21%) of all psychiatric drug related emergency room visits on its own.

“These results should incite providers to take a critical look at the trend in prescribing Z-drugs and to only prescribe the latter after considering non-pharmacological measures to manage insomnia, especially in adults 65 years or older.”

The prevalence of mental health problems is estimated to be high worldwide, with a large number of patients exposed to psychiatric medications in developed countries. The efficacy of psychopharmacological treatments has been called into question, however, and this study suggests that providers should also carefully assess the risk of adverse effects before they decide to prescribe psychiatric medications.

“In conclusion, this proper pharmacoepidemiological study provides strong evidence data to balance the current process of medicalisation of psychopathology under both patients and society pressure.”

 

*

Hampton, L. M., Daubresse, M., Chang, H. Y., Alexander, G. C., & Budnitz, D. S. (2014). Emergency department visits by adults for psychiatric medication adverse events. JAMA psychiatry71(9), 1006-1014. (Full Text)

Roulet, L. (2015). Identifying psychiatric medications causing high numbers and rates of emergency department visits among US adults. Evidence Based Mental Health18(4), e6-e6. (Abstract)

Support MIA

MIA relies on the support of its readers to exist. Please consider a donation to help us provide news, essays, podcasts and continuing education courses that explore alternatives to the current paradigm of psychiatric care. Your tax-deductible donation will help build a community devoted to creating such change.

$
Select Payment Method
Personal Info

Credit Card Info
This is a secure SSL encrypted payment.

Billing Details

Donation Total: $20

14 COMMENTS

  1. I will never forget going to the ER sick from Zyprexa withdrawal, nausea vomiting anxiety and insomnia from hell…

    After I am seen the nurse comes over and tells me “The doctor can write you some more Zyprexa if we ask him nicely.

    Gee thanks, if I “ask nicely” I can get more of the same effing poison that made me this sick !

    I actually expected for them to tell me the reason you are having nausia and vomiting is _______ , using medical terms, and the remedy is ________.

    I came back in 2 weeks after failing to successfully taper down from the small Rx I asked ‘nicely’ for demanding an explanation for the withdrawal sickness and got sent up to psych where they tried to push Geodon on me but I refused and got by on and left with an Ativan Rx.

    No matter how many times I asked to speak to a gastrointestinologist or anyone who might explain the nausea and vomiting they ignored me.

    This was almost 10 years ago when prescribing that Zyprexa poison off label was at its peak.

    It’s still the same stupidity today, people come into the ER with mental and physical side effects or in withdrawals and they call it the “underlying illness” and throw more pills at you.

    They never ask “what happened” or what were you like before taking psychiatric drugs, nope its just give us all your stuff get in the gown wile we observe your reaction to observation detainment and use that as further proof you are sick and need more psychiatry.

    So whats the solution ? An “Iatrogenic Mental Illness screening tool”

    https://www.madinamerica.com/forums/topic/iatrogenic-mental-illness-screening-tool/

    Using an a proper screening tool hospitals cold identify people psychiatry is just making sicker and help them get off the drugs and this ER problem would largely go away cause we tend be the ones that come back over and over again.

    • The “antipsychotics” / neuroleptics are known to cause psychosis, especially when combined with the currently recommended “bipolar” drugs, including the antidepressants or benzos, via a known medical drug interaction problem called “anticholinergic intoxication syndrome” or “anticholinergic toxidrome.”

      These are the known adverse central symptoms of anticholinergic intoxication syndrome according to drugs.com:

      “Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

      These drug interactions look almost exactly the same to medical professionals as the theorized “schizophrenia.”

      No doubt, there is a problem with today’s psychiatric “wonder drugs,” and today’s psychiatric recommended cures for real life concerns.

      • Ya, they called the withdrawal from that Zyprexa poison “schizoaffective” disorder. WTF all I had when I started was insomnia.

        I just can’t figure out when I am writing about the psychiatric nightmare how to explain how these drugs can trash your whole thinking and feeling using words.

        And I have met people half way through the psych drug nightmare, if they are lucky, and tried to explain to them that the crazy drug combo they are ingesting is likely causing there problems not helping them.

        The latest one telling me about ‘needing’ Vyvance and it helps her to focus and be still and Abilify at night to sleep and the anti depressant and Topamax …

        Did you know the number one side effect of Abilify is inability to sit still crawl out of your skin feeling you just complained of?
        What were you like before taking all these drugs ??
        If these drugs help you so much why are you here ? (and so screwed up)

        Just like me 10 years ago the sickness the drugs cause also causes you to think you need them and to continue taking them.

        That Vyvance high and anxiety crash every day ‘Abilify’ along with all those other crap drugs, what a horrible way to live.

        • I also had drug withdrawal induced mania misdiagnosed as a “schizoaffective.” What a sick joke the psychiatrists are. And my initiating etiology was my doctor’s desire for me to quit smoking, and her desire to have me gaslighted to cover up her husband’s “bad fix” on a broken bone of mine, I learned years later.

  2. I theorize that ER chemical restraints (Ativan 2mg + Haldol 10mg + Benadryl 50mg) is high enough to contribute severe withdrawal and returning patients.

    Imagine a violently drunken man gets taken by legal authorities into ER and then gets sedated by chemical restraints. I bet there’s a likelihood that same man will eventually end up in psych ward or homeless and crazy, because he’s been “poisoned” by that one dose of chemical restraint.

  3. When I was a teenager I was having a bad time and got hold of some anti-psychotics which some people I knew would take to hallucinate and have a great time (like tripping on acid). Well, hallucinate I did, but it was several hours after I’d taken them so I’d dismissed the drugs as having worked. It was also due to what Peter Breggin calls medication spellbinding where I didn’t realize it was the drugs causing the effects. So off to hospital I went, got talked down to by the psychiatrist there, then got taken to a mad house.

    I needed help. Instead I got locked up. Once inside no doctors or nurses talked to me or asked me what was going on in my life. They just gave me drugs as treatment. Including anti-psychotic drugs. They gave me as a ‘treatment’ the very same drugs that sent me loopy in the first place. It’s like prescribing heroin for a heroin overdose. Absolute insanity. But hey, that’s how psychiatry rolls. Psychiatrists don’t treat the insane. They are the insane.

    So anyways, after I got discharged, they gave me some prescriptions for psychiatric drugs (including anti-psychotics and anti-depressants). Which I soon after took a handful of. Aaaaaand then got sent back to the mental hospital. They gave me the drugs that put me back inside the mad house. And again, once inside, nobody talked to me. They just gave me more pills. Insane much?

    I’m pretty sure as a result of that chemical cocktail I took I got what ‘Someone Else’ mentioned above as anticholinergic toxidrome. At the time I had memory loss, disorientation, incoherence, hallucinations, and delirium, and long lasting effects that still persist today of memory loss, twitching or jerking movements, and seizures. Atleast now I know where the seizures likely came from. Those things suck.

  4. I am enjoying many of the comments today. I am a victim of the “pain” drs. here in the u.s. I was a prescribed addict to opiates for 11 yrs. In June of 2015 I made the decision to take my life and dignity back and gave them up. I feel better now than I have in 11 yrs. My point is, when I went to the Dr. that had been prescribing for me and told him I wanted off of Suboxone he basically said I was not “thinking clearly” and would regret doing so then wanted me to see another Dr. Which meant more drugs, less help. During the previous yrs I had been prescribed many psychiatric drugs, for sleeplessness, anxiety, mood stabilizers, anti-depressants etc. What a merry go round. Now I’m not on anything bsides my diabetes drug and a few aspirins but even those are making me smh. Point is, I am not the only person out there who is/was caught on the that slippery slope. Thanx for the education and platform.

    • Bigfish

      Congratulations in finding a way to get off these drugs INSPITE of those who were suppose to be giving you medical care.

      You might want to click on ” writers” at the top of the blog page and read my blog (Richard D. Lewis) titled “The Manufacture and Maintenance of Oppression: A Very Profitable Business.” Also read two blogs by Jill Littrel titled “The Medical Model Discovers Heroin Addiction” and “Always a Mystery: Why Do Drugs Come and Go?” These three blogs speak to your situation in many ways.

      Richard

  5. I was admitted to an ER based on my long term use of Celexa and Xanax, both of which stimulated my urge to drink large quantities of alcohol. I was manic beyond belief and the alcohol was my attempt at self-medicating away the mania. Obviously, this didn’t work. The drugs and the alcohol made for an interesting and dangerous combination. Once home, I realized that I had to come off the drugs.

    The ER physician, notably, would not recognize the role the drugs played in my admission and referred it as a case of excessive drink.

    Since weaning myself off of SSRI/benzos, I never again had the urge to drink myself into a crazed stupor. This is likely because the drugs (especially the Xanax) stimulate the same receptors that alcohol hits. It should be noted that Xanax or another benzo is often used to treat alcoholics in detox.

    • I’m glad to see this. I have a friend on that combo and she is both manic and a very hard drinker. And once she gets going on the alcohol it’s like there’s no one home. I knew that antidepressants can trigger alcohol cravings and induce compulsive drinking but I didn’t think about it in her case. Getting off the bad stuff might solve her alcohol problem.

  6. Also want to mention that three (plus) years post self-withdrawal, I am doing pretty well with minor annoyances (tinnitus) that are holdovers from my psych drug use.

    Please take heart, and know that you too can be free of these dangerous drugs. It may take months and even years to feel yourself again, but that’s the road that must be traveled.

    There is a young lady who posts a blog here who has chronicled in great detail her path from psych meds; her posts are a very good read. She was on multiple drugs, some very powerful ones too.

  7. The time I’d been tapered off 75mg Effexor in two weeks, went to the emergency room with incredible upper abdominal pain, ghost white, and sweating, and lost consciousness while asking the third time if I could lie down…that was a couple of days after a prescribed 2-week taper from 75mg to Omg. I had a massive violent seizure and hit my hit on floor so hard the nurses heard it from all corners of the ward. The nurse who refused me a place to lie down wrote in her notes that I was on Effexor, seroquel, and something else ridiculous. No one linked the drugs to the seizure, and neither did I. Were you ever asked how long you’d been on them, whether you recently changed or missed a dose, or whether you just stoped taking something? I wasn’t.

    Mind you they didn’t the event into their log so it didn’t need explaining. I came across my records recently, and saw that I wrote “I told her I had stopped taking them 3 days ago” next to her note about drugs. Despite the symptoms of shock and impending death I arrived with, she didn’t take my BP. After the seizure it was 65/45. I was only 50. I know that sounds old to younger people but I was fit as a fiddle (which also sounds old). So that was Effexor/Seroquel withdrawal.

    The next time I went to that place I was on Straterra for just a few days, unaware that it was an SNRI. I could only tell them that I wanted to die, that I couldn’t take it anymore. My legs had a horrible feeling in them..I think it was some twisted kind of akathisia, The told me I tested positive for Lithium. I told them I wasn’t on it. I hadn’t had it for a few years, since I escaped from fake bipolar racket. But they left it in my notes. I brought the Straterra with me, and the nurse who looked at it said “this is speed.” Well, no it isn’t. It’s an SNRI and it was the problem.

    They were close to committing me but I convinced them of the distinction between suicidal and wishing to not be alive. I asked for an Ativan and was refused because of that priggish anti-addiction 12-step thing that pervades the consciousness of health care workers. I know and believe Ativan is powerfully addicting and murder to get off of, buI was in the state it’s meant for, for short-term use. A social workers said “ATIVAN? Why don’t you just drink a glass of WINE?” I said “I think I will,” and told them I was all done being taken care of. Drank a bottle of wine when I got home, too.

    Since getting off the drugs I couldn’t care less about alcohol. I drank my way through a year and a half of hell. People said the drinking was causing the misery, but it wasn’t. I started a modified (not hardcore) ketogenic diet, and nearly 24/7 feeling that I was in hell lifted, and I didn’t have to try to quit drinking. I just lost interest. Now I waste half of every beer I open. I’ve been on nothing for almost three years and have had no mania, psychosis, or ER visits. Fancy that.