The extensive title is followed by a misleading article that omits more questions and presents facts in a biased manner, rather than clarifying them or opening up approaches to clarification.
For example, both tables separated the group of psycholeptic drugs in ways that were impossible to comprehend—in part using pharmacologically/pharmaceutically very dubious allocations: Table 1 lists “psycholeptics (antipsychotics)” separately from “psychoanaleptics (antidepressants)”; the rate for psychoactive (not including antiepileptic) drugs is 13.9%. Table 2 lists these medications differently again: diazepines are listed with clozapine and olanzapine, whereas risperidone is listed separately from selective serotonin reuptake inhibitors (SSRIs), and so on. In total the neuroleptics group (excluding anticonvulsive drugs) accounts for 9% and 5%. Artificially separating out the reporting rates thus results in a lack of clarity, rather than validity, in the differentiated analysis of an unquestionably complex subject.
The problem of drug interactions is not mentioned at all. The—in all experience—substantial proportion of polypharmacy and drug combinations (not least in neuroleptic/antipsychotic therapy) was neither addressed nor quantified in the methods section or the discussion.
The relevance of adverse drug reactions as listed by rates, with regard to threat to life, extent of impaired quality of life, unfitness to work, emergency hospital admission, and follow-on costs did not receive any attention whatsoever in the extensive set of figures.
Dr. med. Burger Lichtenstein
Facharzt für Innere Medizin i. R.
|1.||Dubrall D, Schmid M, Alešik E, Paeschke N, Stingl J, Sachs B: Frequent adverse drug reactions, and medication groups under suspicion—a descriptive analysis based on spontaneous reports to the German Federal Institute for Drugs and Medical Devices from 1978–2016. Dtsch Arztebl Int 2018; 115: 393–400 VOLLTEXT|