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Jussi Vahtera - One of the best experts on this subject based on the ideXlab platform.

  • organisational downsizing and increased use of Psychotropic Drugs among employees who remain in employment
    Journal of Epidemiology and Community Health, 2007
    Co-Authors: Mika Kivimaki, Timo Klaukka, Teija Honkonen, Kristian Wahlbeck, Marko Elovainio, Jaana Pentti, Marianna Virtanen, Jussi Vahtera
    Abstract:

    Objective: Organisational downsizing is common in modern work life, but its effect on employees’ mental health is not known. The authors examined whether working in downsizing organisations predicts use of Psychotropic Drugs among employees who remain in employment. Design, setting and participants: Prospective cohort study of municipal employees in Finland. 4783 employees worked in downsized units but kept their jobs after downsizing in 1993, 4271 employees lost their jobs during the downsizing, and 17 599 employees did not experience downsizing. The outcome was Psychotropic drug prescriptions (antidepressants, anxiolytics and hypnotics) during 1994–2000 extracted from nationwide registers and linked to the data by means of each participant’s personal identification number. Main results: After adjustment for predownsizing characteristics, employees who were exposed to downsizing but kept their jobs were at a higher risk of being prescribed Psychotropic Drugs (rate ratio 1.49, 95% CI 1.10 to 2.02 in men and 1.12, 95% CI 1.00 to 1.27 in women) than those not exposed to downsizing. The association of downsizing was strongest with hypnotics among the men and with anxiolytics among the women. An increased rate of Psychotropic prescriptions after downsizing was also seen in male workers who lost their job (rate ratio 1.64, 95% CI 1.19 to 2.25). Conclusions: The association between organisational downsizing and increased use of Psychotropic Drugs suggests that this managerial strategy may pose mental health risks among employees.

  • Organisational downsizing and increased use of Psychotropic Drugs among employees who remain in employment.
    J Epidemiol Community Health, 2007
    Co-Authors: Jussi Vahtera
    Abstract:

    Organisational downsizing is common in modern work life, but its effect on employees' mental health is not known. The authors examined whether working in downsizing organisations predicts use of Psychotropic Drugs among employees who remain in employment.

Mary E Tinetti - One of the best experts on this subject based on the ideXlab platform.

  • Drugs and falls in older people a systematic review and meta analysis i Psychotropic Drugs
    Journal of the American Geriatrics Society, 1999
    Co-Authors: Rosanne M Leipzig, Robert G Cumming, Mary E Tinetti
    Abstract:

    OBJECTIVES: To evaluate critically the evidence linking Psychotropic Drugs with falls in older people. DESIGN: Fixed-effects meta-analysis. DATA SOURCES: English-language articles in MEDLINE (1966 – March 1996) indexed under accidents or accidental falls and aged or age factors; bibliographies of retrieved papers. STUDY SELECTION: Systematic evaluation of sedative/hypnotic, antidepressant, or neuroleptic use with falling in people aged 60 and older. DATA EXTRACTION: Study design, inclusion and exclusion criteria, setting, sample size, response rate, mean age, method of medication verification and fall assessment, fall definition, and the number of fallers and non-fallers taking specific classes of Psychotropic Drugs. RESULTS: Forty studies, none randomized controlled trials, met eligibility criteria. For one or more falls, the pooled odds ratio (95% confidence interval) was 1.73 (95%CI, 1.52-1.97) for any Psychotropic use; 1.50 (95%CI, 1.25-1.79) for neuroleptic use; 1.54 (95%CI, 1.40-1.70) for sedative/hypnotic use; 1.66 (95%CI, 1.4-1.95) for any antidepressant use (mainly TCAs); 1.51 (95%CI, 1.14-2.00) for only TCA use; and 1.48 (95%CI, 1.23-1.77) for benzodiazepine use, with no difference between short and long acting benzodiazepines. For neuroleptics in psychiatric inpatients, the pooled OR was 0.41 (95%CI, 0.21-.82); for all other patients, the pooled OR was 1.66 (95%CI, 1.38-2.00). Comparing ≥1 with ≥ 2 falls, mean subject age >75 versus ≥ 75 years old, communities with >35% versus ≥35% fallers, or subject place of residence did not affect the pooled OR. Increased falls occurred in patients taking more than one Psychotropic drug. CONCLUSION: There is a small, but consistent, association between the use of most classes of Psychotropic Drugs and falls. The evidence to date, however, is based solely on observational data, with minimal adjustment for confounders, dosage, or duration of therapy. The incidence of falls and their consequences in this population necessitate that future large randomized controlled trials of any medication in older persons should measure falls prospectively as an adverse outcome event.

David J Nutt - One of the best experts on this subject based on the ideXlab platform.

  • Psychotropic Drugs cardiac arrhythmia and sudden death
    Journal of Clinical Psychopharmacology, 2003
    Co-Authors: Harry J Witchel, Jules C Hancox, David J Nutt
    Abstract:

    A variety of Drugs targeted towards the central nerv- ous system are associated with cardiac side effects, some of which are linked with reports of arrhythmia and sudden death. Some Psychotropic Drugs, particularly tricyclic antidepressants (TCAs) and antipsychotic agents, are correlated with iatrogenic prolonga- tion of the QT interval of the electrocardiogram (ECG). In turn, this is associated with the arrhythmia torsades de pointes (TdP). This review discusses the association between Psychotropic agents, arrhythmia and sudden death and, focusing on TCAs and anti- psychotics, considers their range of cellular actions on the heart; potentially pro-arrhythmic interactions between Psychotropic and other medications are also considered. At the cellular level TCAs, such as imipramine and amitriptyline, and antipsychotics, such as thioridazine, are associated with inhibition of potassium channels encoded by HERG. In many cases this cellular action correlates with ECG changes and a risk of TdP. However, not all psycho- tropic agents that inhibit HERG at the cellular level are associated equally with QT prolongation in patients, and the potential for QT prolongation is not always equally correlated with TdP. Differ- ences in risk between classes of Psychotropic Drugs, and between individual Drugs within a class, may result from additional cellular effects of particular agents, which may influence the consequent effects of inhibition of repolarizing potassium current. ( J Clin Psychopharmacol 2003;23: 58-77)

Kaisu H Pitkala - One of the best experts on this subject based on the ideXlab platform.

Nor Zuraida Zainal - One of the best experts on this subject based on the ideXlab platform.

  • prescription patterns for Psychotropic Drugs in cancer patients a large population study in the netherlands
    Psycho-oncology, 2013
    Co-Authors: Chong Guan Ng, Marco P M Boks, Hugo M Smeets, Nor Zuraida Zainal
    Abstract:

    BACKGROUND: Psychotropic Drugs are commonly prescribed for various psychological complaints in cancer patients. We aim to examine the prescription pattern in cancer patients of three common Psychotropic Drugs: benzodiazepine, antidepressant and antipsychotic. METHODS: This is a retrospective case-control study. Data were extracted from the Agis Health Database. This insurance database contains the healthcare consumption of 1.3 million inhabitants of the Netherlands. We analyzed the use of Psychotropics in cancer patients and an equally sized randomly selected control group of noncancer patients from 2006 to 2008. Odds ratio (OR) were adjusted for age, gender, immigrant status, neighborhood socio-economic status, and premorbid medical condition. Additionally, the numbers of new user in the 3 months after cancer was diagnosed and in the 3 months before death were compared. RESULTS: A total of 113 887 cancer patients and 121 395 control subjects were included. Cancer patients were significantly more often prescribed Psychotropic Drugs (adjusted OR: benzodiazepines = 1.70, CI = 1.67-1.74; antidepressants = 1.38, CI = 1.34-1.42; and antipsychotics = 1.70, CI = 1.62-1.77). Lower socio-economic status, immigrant, and premorbid chronic medical conditions were significantly associated with higher risk of Psychotropic use. Odds for a new prescription for all three Psychotropic Drugs were significantly less in the first 3 months after cancer diagnosis than the 3 months before death (benzodiazepine, OR = 0.673, CI = 0.647-0.705; antidepressant, OR = 0.592, CI = 0.544-0.644; antipsychotic, OR = 0.177, CI = 0.165-0.190) CONCLUSIONS: Psychotropic drug prescription is common in cancer patients, starts soon after diagnosis, and increases in the terminal stage. Prescription rates were significantly higher in patients from lower socio-economic group, immigrants, or with premorbid chronic medical condition.Copyright © 2012 John Wiley & Sons, Ltd.