{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T03:14:25Z","timestamp":1778210065779,"version":"3.51.4"},"reference-count":60,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bundesinstitut f\u00fcr Arzneimittel und Medizinprodukte (BfArM)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Naunyn-Schmiedeberg's Arch Pharmacol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    In psychiatric care, polypharmacy is common practice. The more drugs are used, the higher the likelihood of drug-drug interactions (DDI) and, consequently, the occurrence of adverse drug reactions (ADR). The aim of our study was to identify DDI between psychiatric drugs and to analyze their associated factors in spontaneous ADR reports contained in the European ADR database EudraVigilance. Out of 9287 ADR reports from EudraVigilance, 1811 reports with potential DDI (pDDI) were detected by the ABDATA interaction analysis. During the individual case assessment of the most frequently identified pDDI (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091342), 206 reports with DDI were found. These 206 reports were analyzed descriptively. Patients who experienced DDI were on average 52.6 (\u00b1\u200918.8) years old. Reports describing DDI were clearly more often classified as serious than those without DDI (81.1% versus 59.0%,\n                    <jats:italic>p<\/jats:italic>\n                    -value\u2009&lt;\u20090.005). The DDI most frequently identified were\n                    <jats:italic>tachycardia and QT prolongation<\/jats:italic>\n                    (23.3%, 48\/206),\n                    <jats:italic>extrapyramidal symptoms<\/jats:italic>\n                    (16.0%, 33\/206),\n                    <jats:italic>sedation<\/jats:italic>\n                    (11.7%, 24\/206) and\n                    <jats:italic>seizures<\/jats:italic>\n                    (11.7%, 24\/206). Mirtazapine\u2013quetiapine (26.3%, 10\/48) was the interacting drug pair most commonly associated with\n                    <jats:italic>tachycardia and QT prolongation<\/jats:italic>\n                    . Patients experiencing\n                    <jats:italic>tachycardia and QT prolongation<\/jats:italic>\n                    were, on average, older (63.0 (\u00b1\u200916.2) years) and took more drugs (8.0 (\u00b1\u20095.3)) than the overall group of patients with DDI (6.0 (\u00b1\u20093.9)). DDI pose a considerable risk to patients treated with several combinations of psychiatric drugs. Checks for interactions and tight monitoring after initiating drug therapy can help to avoid serious DDI. Special attention should be paid to older patients taking more than one QT-interval prolonging drug.\n                  <\/jats:p>","DOI":"10.1007\/s00210-025-04956-5","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:24:20Z","timestamp":1769059460000},"page":"9607-9626","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of drug-drug interactions between psychiatric drugs in spontaneous adverse drug reaction reports from EudraVigilance"],"prefix":"10.1007","volume":"399","author":[{"given":"Diana","family":"Dubrall","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Christ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"B\u00f6hme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharina","family":"Scholl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"4956_CR1","unstructured":"ABDATA Pharma-Daten-Service (2025) ABDA-Datenbank. Eschborn, Germany. https:\/\/abdata.de\/produkte\/abdadatenbank2\/.\u00a0Accessed 16 Dec 2025"},{"issue":"12","key":"4956_CR2","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1080\/17425255.2020.1821646","volume":"16","author":"JM Azorin","year":"2020","unstructured":"Azorin JM, Simon N (2020) Antipsychotic polypharmacy in schizophrenia: evolving evidence and rationale. Expert Opin Drug Metab Toxicol 16(12):1175\u20131186. https:\/\/doi.org\/10.1080\/17425255.2020.1821646","journal-title":"Expert Opin Drug Metab Toxicol"},{"issue":"3","key":"4956_CR3","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1111\/bcpt.13384","volume":"126","author":"L Baandrup","year":"2020","unstructured":"Baandrup L (2020) Polypharmacy in schizophrenia. Basic Clin Pharmacol Toxicol 126(3):183\u2013192. https:\/\/doi.org\/10.1111\/bcpt.13384","journal-title":"Basic Clin Pharmacol Toxicol"},{"issue":"2","key":"4956_CR4","doi-asserted-by":"publisher","first-page":"215","DOI":"10.4103\/ipj.ipj_24_17","volume":"26","author":"B Chaudhari","year":"2017","unstructured":"Chaudhari B, Saldanha D, Kadiani A, Shahani R (2017) Evaluation of treatment adherence in outpatients with schizophrenia. Indian J Psychiatry 26(2):215\u2013222. https:\/\/doi.org\/10.4103\/ipj.ipj_24_17","journal-title":"Indian J Psychiatry"},{"issue":"2","key":"4956_CR5","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1093\/schbul\/sbn018","volume":"35","author":"CU Correll","year":"2009","unstructured":"Correll CU, Rummel-Kluge C, Corves C, Kane JM, Leucht S (2009) Antipsychotic combinations vs monotherapy in schizophrenia: a meta-analysis of randomized controlled trials. Schizophr Bull 35(2):443\u2013457. https:\/\/doi.org\/10.1093\/schbul\/sbn018","journal-title":"Schizophr Bull"},{"key":"4956_CR6","unstructured":"CredibelMeds. (n.d.) QTDrug Lists. https:\/\/www.crediblemeds.org. Accessed 16 Dec 2025"},{"key":"4956_CR7","unstructured":"D'Souza RS, Aslam SP, Hooten WM (2025) Extrapyramidal side effects. [Updated 2025 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534115\/. Accessed 16 Dec 2025"},{"issue":"6","key":"4956_CR8","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.eurpsy.2009.01.005","volume":"24","author":"M De Hert","year":"2009","unstructured":"De Hert M, Dekker JM, Wood D, Kahl KG, Holt RI, M\u00f6ller HJ (2009) Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 24(6):412\u2013424. https:\/\/doi.org\/10.1016\/j.eurpsy.2009.01.005","journal-title":"Eur Psychiatry"},{"key":"4956_CR9","unstructured":"DGPPN e.V. (Hrsg.) (2019) f\u00fcr die Leitliniengruppe: S3-Leitlinie Schizophrenie. Langfassung, 2019, Version zuletzt ge\u00e4ndert am 15. https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/038-009.html. Accessed 16 Dec 2025"},{"issue":"6 Suppl 1","key":"4956_CR10","doi-asserted-by":"publisher","first-page":"S55","DOI":"10.1097\/01.nrl.0000340792.61037.40","volume":"14","author":"RA D\u00edaz","year":"2008","unstructured":"D\u00edaz RA, Sancho J, Serratosa J (2008) Antiepileptic drug interactions. Neurologist 14(6 Suppl 1):S55-65. https:\/\/doi.org\/10.1097\/01.nrl.0000340792.61037.40","journal-title":"Neurologist"},{"issue":"5","key":"4956_CR11","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.1008","volume":"10","author":"AS Doherty","year":"2022","unstructured":"Doherty AS, Shahid F, Moriarty F, Boland F, Clyne B, Dreischulte T, Fahey T, Kennelly SP, Wallace E (2022) Prescribing cascades in community-dwelling adults: a systematic review. Pharmacol Res Perspect 10(5):e01008. https:\/\/doi.org\/10.1002\/prp2.1008","journal-title":"Pharmacol Res Perspect"},{"issue":"23","key":"4956_CR12","doi-asserted-by":"publisher","first-page":"393","DOI":"10.3238\/arztebl.2018.0393","volume":"115","author":"D Dubrall","year":"2018","unstructured":"Dubrall D, Schmid M, Ale\u0161ik E, Paeschke N, Stingl J, Sachs B (2018) Frequent adverse drug reactions, and medication groups under suspicion. Dtsch Arztebl Int 115(23):393\u2013400. https:\/\/doi.org\/10.3238\/arztebl.2018.0393","journal-title":"Dtsch Arztebl Int"},{"issue":"1","key":"4956_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-025-07352-8","volume":"2","author":"D Dubrall","year":"2025","unstructured":"Dubrall D, Weber R, B\u00f6hme M, Schmid M, Sachs B, Scholl C (2025) Analysis of drug-drug interactions in spontaneous adverse drug reaction reports from EudraVigilance focusing on psychiatric drugs and somatic medication. BMC Psychiatry 2(1):914. https:\/\/doi.org\/10.1186\/s12888-025-07352-8","journal-title":"BMC Psychiatry"},{"issue":"4","key":"4956_CR14","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s11920-012-0284-9","volume":"14","author":"BA English","year":"2012","unstructured":"English BA, Dortch M, Ereshefsky L, Jhee S (2012) Clinically significant psychotropic drug-drug interactions in the primary care setting. Curr Psychiatry Rep 14(4):376\u2013390. https:\/\/doi.org\/10.1007\/s11920-012-0284-9","journal-title":"Curr Psychiatry Rep"},{"key":"4956_CR15","unstructured":"European Medicines Agency (n.d.) Extended EudraVigilance medicinal product dictionary (XEVMPD) training. https:\/\/www.ema.europa.eu\/en\/human-regulatory\/post-authorisation\/data-medicines-iso-idmp-standards\/extended-eudravigilance-medicinal-product-dictionary-xevmpd-training. Accessed 16 Dec 2025"},{"key":"4956_CR16","unstructured":"European Medicines Agency (2017) Guideline on good pharmacovigilance practices (GVP) module VI \u2013 collection, management and submission of reports of suspected adverse reactions to medicinal products (Rev 2). https:\/\/www.ema.europa.eu\/en\/documents\/regulatory-procedural-guideline\/guideline-good-pharmacovigilance-practices-gvp-module-vi-collection-management-submission-reports_en.pdf. Accessed 16 dec 2025"},{"key":"4956_CR17","unstructured":"European Medicines Agency (n.d.) Human regulatory. https:\/\/www.ema.europa.eu\/en\/human-regulatory\/research-development\/pharmacovigilance\/eudravigilance. Accessed 16 Dec 2025"},{"key":"4956_CR18","unstructured":"European Medicines Agency (2002) Referral Leponex and associated names. https:\/\/www.ema.europa.eu\/en\/documents\/referral\/summary-information-referral-opinion-following-arbitration-pursuant-article-30-council-directive\/83\/ec-leponex-associated-names-international-non-proprietary-name-inn-clozapine-background-inform_en.pdf. Accessed 16 Dec 2025"},{"key":"4956_CR19","unstructured":"Federal Institute for Drugs and Medical Devices (n.d.) ATC code. https:\/\/www.bfarm.de\/SharedDocs\/Downloads\/DE\/Kodiersysteme\/ATC\/atc-ddd-amtlich-2023.pdf?__blob=publicationFile. Accessed 16 Dec 2025"},{"issue":"3","key":"4956_CR20","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1055\/s-0032-1332831","volume":"40","author":"M Hahn","year":"2013","unstructured":"Hahn M, Reiff J, Hiemke C, Braus DF (2013) Arzneimittelinteraktionen in der Psychiatrie [Drug-drug-interactions in psychiatry]. Psychiatr Prax 40(3):154\u2013158. https:\/\/doi.org\/10.1055\/s-0032-1332831","journal-title":"Psychiatr Prax"},{"issue":"7","key":"4956_CR21","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1007\/s00115-017-0412-1","volume":"89","author":"M Hahn","year":"2018","unstructured":"Hahn M, Roll SC, Klein J (2018) Arzneimitteltherapiesicherheit an der station\u00e4r-ambulanten Schnittstelle [Drug therapy safety at the transition from hospital to community medicine]. Nervenarzt 89(7):796\u2013800. https:\/\/doi.org\/10.1007\/s00115-017-0412-1","journal-title":"Nervenarzt"},{"issue":"9","key":"4956_CR22","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/s0895-4356(02)00450-x","volume":"55","author":"J Hasford","year":"2002","unstructured":"Hasford J, Goettler M, Munter KH et al (2002) Physicians\u2019 knowledge and attitudes regarding the spontaneous reporting system for adverse drug reactions. J Clin Epidemiol 55(9):945\u2013950. https:\/\/doi.org\/10.1016\/s0895-4356(02)00450-x","journal-title":"J Clin Epidemiol"},{"issue":"5","key":"4956_CR23","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2165\/00002018-200629050-00003","volume":"29","author":"L Hazell","year":"2006","unstructured":"Hazell L, Shakir SAW (2006) Under-reporting of adverse drug reactions: a systematic review. Drug Saf 29(5):385\u2013396. https:\/\/doi.org\/10.2165\/00002018-200629050-00003","journal-title":"Drug Saf"},{"key":"4956_CR24","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.946351","volume":"13","author":"M Hecker","year":"2022","unstructured":"Hecker M, Frahm N, Bachmann P et al (2022) Screening for severe drug-drug interactions in patients with multiple sclerosis: a comparison of three drug interaction databases. Front Pharmacol 13:946351. https:\/\/doi.org\/10.3389\/fphar.2022.946351","journal-title":"Front Pharmacol"},{"issue":"2","key":"4956_CR25","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s00702-020-02291-y","volume":"128","author":"G Hefner","year":"2021","unstructured":"Hefner G, Hahn M, Hiemke C, Toto S, Wolff J, Roll SC, Klimke A (2021) Pharmacodynamic drug-drug interactions of QT-prolonging drugs in hospitalized psychiatric patients. J Neural Transm (Vienna) 128(2):243\u2013252. https:\/\/doi.org\/10.1007\/s00702-020-02291-y","journal-title":"J Neural Transm (Vienna)"},{"key":"4956_CR26","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1055\/s-0043-116492","volume":"51","author":"C Hiemke","year":"2018","unstructured":"Hiemke C, Bergmann N, Clement HW, Conc A, Deckert J, Domschke J et al (2018) Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry 51:9\u201362. https:\/\/doi.org\/10.1055\/s-0043-116492","journal-title":"Pharmacopsychiatry"},{"issue":"1","key":"4956_CR27","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-04324-0","volume":"22","author":"J Hu","year":"2022","unstructured":"Hu J, McMillan SS, Theodoros T, Collins JC, El-Den S, O\u2019Reilly CL et al (2022) Psychotropic medication use in people living with severe and persistent mental illness in the Australian community: a cross-sectional study. BMC Psychiatry 22(1):705. https:\/\/doi.org\/10.1186\/s12888-022-04324-0","journal-title":"BMC Psychiatry"},{"issue":"8","key":"4956_CR28","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1007\/s40264-020-00939-y","volume":"43","author":"S Hult","year":"2020","unstructured":"Hult S, Sartori D, Bergvall T, Hedfors Vidlin S, Grundmark B, Ellenius J et al (2020) A feasibility study of drug-drug interaction signal detection in regular pharmacovigilance. Drug Saf 43(8):775\u2013785. https:\/\/doi.org\/10.1007\/s40264-020-00939-y","journal-title":"Drug Saf"},{"key":"4956_CR29","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.923939","volume":"13","author":"H Jiang","year":"2022","unstructured":"Jiang H, Lin Y, Ren W, Fang Z, Liu Y, Tan X et al (2022) Adverse drug reactions and correlations with drug\u2013drug interactions: a retrospective study of reports from 2011 to 2020. Front Pharmacol 13:023939. https:\/\/doi.org\/10.3389\/fphar.2022.923939","journal-title":"Front Pharmacol"},{"issue":"12","key":"4956_CR30","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1007\/s40263-013-0114-6","volume":"27","author":"WK Kennedy","year":"2013","unstructured":"Kennedy WK, Jann MW, Kutscher EC (2013) Clinically significant drug interactions with atypical antipsychotics. CNS Drugs 27(12):1021\u20131048. https:\/\/doi.org\/10.1007\/s40263-013-0114-6","journal-title":"CNS Drugs"},{"issue":"4","key":"4956_CR31","doi-asserted-by":"publisher","first-page":"257","DOI":"10.4103\/2279-042X.192461","volume":"5","author":"R Kheshti","year":"2016","unstructured":"Kheshti R, Aalipour M, Namazi S (2016) A comparison of five common drug-drug interaction software programs regarding accuracy and comprehensiveness. J Res Pharm Pract 5(4):257\u2013263. https:\/\/doi.org\/10.4103\/2279-042X.192461","journal-title":"J Res Pharm Pract"},{"issue":"9","key":"4956_CR32","doi-asserted-by":"publisher","first-page":"4067","DOI":"10.1111\/bcp.15341","volume":"88","author":"E Kontsioti","year":"2022","unstructured":"Kontsioti E, Maskell S, Bensalem A et al (2022) Similarity and consistency assessment of three major online drug-drug interaction resources. Br J Clin Pharmacol 88(9):4067\u20134079. https:\/\/doi.org\/10.1111\/bcp.15341","journal-title":"Br J Clin Pharmacol"},{"key":"4956_CR33","doi-asserted-by":"publisher","first-page":"508","DOI":"10.3238\/arztebl.2019.0508","volume":"116","author":"T Kratz","year":"2019","unstructured":"Kratz T, Diefenbacher A (2019) Psychopharmacological treatment in older people\u2014avoiding drug interactions and polypharmacy. Dtsch Arztebl Int 116:508\u2013518. https:\/\/doi.org\/10.3238\/arztebl.2019.0508","journal-title":"Dtsch Arztebl Int"},{"key":"4956_CR34","doi-asserted-by":"publisher","unstructured":"Leone R, Magro L, Moretti U, Cutroneo P, Maschini M, Motola D et al (2010) Identifying adverse drug reactions associated with drug-drug interactions: data mining of a spontaneous reporting database in Italy. Drug Saf 33(8):667\u2013675. https:\/\/doi.org\/10.2165\/11534400-000000000-00000","DOI":"10.2165\/11534400-000000000-00000"},{"key":"4956_CR35","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.624562","volume":"11","author":"L Letinier","year":"2020","unstructured":"Letinier L, Ferreira A, Marceron A, Babin M, Micallef J, Miremont-Salame G et al (2020) Spontaneous reports of serious adverse drug reactions resulting from drug-drug interactions: an analysis from the French pharmacovigilance database. Front Pharmacol 11:624562. https:\/\/doi.org\/10.3389\/fphar.2020.624562","journal-title":"Front Pharmacol"},{"key":"4956_CR36","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.622862","volume":"11","author":"L Magro","year":"2020","unstructured":"Magro L, Arzenton E, Leone R, Stano MG, Vezzaro A, Rudolph A et al (2020) Identifying and characterizing serious adverse drug reactions associated with drug-drug interactions in a spontaneous reporting database. Front Pharmacol 11:622862. https:\/\/doi.org\/10.3389\/fphar.2020.622862","journal-title":"Front Pharmacol"},{"key":"4956_CR37","unstructured":"Md+Calc (n.d.) Tisdale risk score for Qt prolongation. https:\/\/www.mdcalc.com\/calc\/10293\/tisdale-risk-score-qt-prolongation. Accessed 16 Dec 2025"},{"key":"4956_CR38","unstructured":"Medical Dictionary for Regulatory Activities (MedDRA) (n.d.) https:\/\/www.meddra.org\/. Accessed 16 Dec 2025"},{"issue":"11","key":"4956_CR39","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1007\/s00277-020-04215-y","volume":"99","author":"A Mijovic","year":"2020","unstructured":"Mijovic A, MacCabe JH (2020) Clozapine-induced agranulocytosis. Ann Hematol 99(11):2477\u20132482. https:\/\/doi.org\/10.1007\/s00277-020-04215-y","journal-title":"Ann Hematol"},{"key":"4956_CR40","doi-asserted-by":"publisher","first-page":"604","DOI":"10.3325\/cmj.2011.52.604","volume":"52","author":"N Mirosevic Skvrce","year":"2011","unstructured":"Mirosevic Skvrce N, Macolic Sarinic V, Mucalo I, Krnic D, Bozina N, Tomic S (2011) Adverse drug reactions caused by drug-drug interactions reported to Croatian agency for medicinal products and medical devices: a retrospective observational study. Croat Med J 52:604\u2013614","journal-title":"Croat Med J"},{"issue":"7","key":"4956_CR41","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1017\/S1461145713000837","volume":"17","author":"HJ M\u00f6ller","year":"2014","unstructured":"M\u00f6ller HJ, Seem\u00fcller F, Schennach-Wolff R, St\u00fcbner S, R\u00fcther E, Grohmann R (2014) History, background, concepts and current use of comedication and polypharmacy in psychiatry. Int J Neuropsychopharmacol 17(7):983\u2013996. https:\/\/doi.org\/10.1017\/S1461145713000837","journal-title":"Int J Neuropsychopharmacol"},{"issue":"1","key":"4956_CR42","doi-asserted-by":"publisher","first-page":"41","DOI":"10.2165\/00023210-199911010-00004","volume":"11","author":"BM Oberlinghausen","year":"1999","unstructured":"Oberlinghausen BM (1999) Drug interactions with lithium \u2013 a guide for clinicians. CNS Drugs 11(1):41\u201348","journal-title":"CNS Drugs"},{"key":"4956_CR43","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1136\/ejhpharm-2014-000561","volume":"22","author":"A Pauly","year":"2015","unstructured":"Pauly A, Wolf C, Busse M et al (2015) Evaluation of eight drug interaction databases commonly used in the German healthcare system. Eur J Hosp Pharm 22:165\u2013170. https:\/\/doi.org\/10.1136\/ejhpharm-2014-000561","journal-title":"Eur J Hosp Pharm"},{"key":"4956_CR44","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1007\/s00406-024-01867-z","volume":"275","author":"T Ramin","year":"2025","unstructured":"Ramin T, Peter JU, Schneider M et al (2025) Age and sex differences in outpatient antipsychotic prescriptions for schizophrenia: a claims data study. Eur Arch Psychiatry Clin Neurosci 275:1403\u20131417. https:\/\/doi.org\/10.1007\/s00406-024-01867-z","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"issue":"1","key":"4956_CR45","doi-asserted-by":"publisher","DOI":"10.1186\/1744-859X-4-1","volume":"4","author":"M Sala","year":"2005","unstructured":"Sala M, Vicentini A, Brambilla P, Montomoli C, Jogia JR, Caverzasi E, Bonzano A, Piccinelli M, Barale F, De Ferrari GM (2005) QT interval prolongation related to psychoactive drug treatment: a comparison of monotherapy versus polytherapy. Ann Gen Psychiatry 4(1):1. https:\/\/doi.org\/10.1186\/1744-859X-4-1","journal-title":"Ann Gen Psychiatry"},{"issue":"7\u20138","key":"4956_CR46","first-page":"10","volume":"9","author":"RD Sanders","year":"2012","unstructured":"Sanders RD, Gillig PM (2012) Extrapyramidal examinations in psychiatry. Innov Clin Neurosci 9(7\u20138):10\u201316","journal-title":"Innov Clin Neurosci"},{"issue":"5","key":"4956_CR47","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1176\/appi.psy.46.5.464","volume":"46","author":"NB Sandson","year":"2005","unstructured":"Sandson NB, Armstrong SC, Cozza KL (2005) An overview of psychotropic drug-drug interactions. Psychosomatics 46(5):464\u2013494. https:\/\/doi.org\/10.1176\/appi.psy.46.5.464","journal-title":"Psychosomatics"},{"key":"4956_CR48","doi-asserted-by":"publisher","unstructured":"Seifert J, Bleich S, Seifert R (2025) Depression, Angstst\u00f6rungen, bipolare St\u00f6rung, Schizophrenie, Aufmerksamkeitsdefizit-\/Hyperaktivit\u00e4tsst\u00f6rung. In: Ludwig WD, M\u00fchlbauer B, Seifert R (eds) Arzneiverordnungs-Report 2024. Springer Berlin, Heidelberg, pp 485\u2013535. https:\/\/doi.org\/10.1007\/978-3-662-70594-0","DOI":"10.1007\/978-3-662-70594-0"},{"issue":"4","key":"4956_CR49","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s00406-021-01358-5","volume":"272","author":"HH Stassen","year":"2022","unstructured":"Stassen HH, Bachmann S, Bridler R, Cattapan K, Herzig D, Schneeberger A et al (2022) Detailing the effects of polypharmacy in psychiatry: longitudinal study of 320 patients hospitalized for depression or schizophrenia. Eur Arch Psychiatry Clin Neurosci 272(4):603\u2013619. https:\/\/doi.org\/10.1007\/s00406-021-01358-5","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"4956_CR50","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2021.100930","volume":"13","author":"S Sunny","year":"2022","unstructured":"Sunny S, Prabhu S, Chand S, Uk N, Chacko CS, Joel JJ (2022) Assessment of drug-drug interactions among patients with psychiatric disorders: a clinical pharmacist-led study. Clin Epidemiol Glob Health 13:100930. https:\/\/doi.org\/10.1016\/j.cegh.2021.100930","journal-title":"Clin Epidemiol Glob Health"},{"issue":"4","key":"4956_CR51","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1586\/17512433.2014.910111","volume":"7","author":"C Tannenbaum","year":"2014","unstructured":"Tannenbaum C, Sheehan NL (2014) Understanding and preventing drug-drug and drug-gene interactions. Expert Rev Clin Pharmacol 7(4):533\u2013544. https:\/\/doi.org\/10.1586\/17512433.2014.910111","journal-title":"Expert Rev Clin Pharmacol"},{"key":"4956_CR52","unstructured":"The Uppsala Monitoring Centre (n.d.) The use of the WHO-UMC system for standardised case causality assessment. https:\/\/www.who.int\/docs\/default-source\/medicines\/pharmacovigilance\/whocausality-assessment.pdf. Accessed 16 Dec 2025"},{"key":"4956_CR53","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3238\/arztebl.m2024.0052","volume":"121","author":"J Thom","year":"2024","unstructured":"Thom J, Jonas B, Reitzle L, Mauz E, H\u00f6lling H, Schulz M (2024) Trends in the diagnostic prevalence of mental disorders, 2012\u20132022\u2014using nationwide outpatient claims data for mental health surveillance. Dtsch Arztebl Int 121:355\u2013362. https:\/\/doi.org\/10.3238\/arztebl.m2024.0052","journal-title":"Dtsch Arztebl Int"},{"issue":"5","key":"4956_CR54","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1001\/jamapsychiatry.2018.4320","volume":"76","author":"J Tiihonen","year":"2019","unstructured":"Tiihonen J, Taipale H, Meht\u00e4l\u00e4 J, Vattulainen P, Correll CU, Tanskanen A (2019) Association of antipsychotic polypharmacy vs monotherapy with psychiatric rehospitalization among adults with schizophrenia. JAMA Psychiatr 76(5):499\u2013507. https:\/\/doi.org\/10.1001\/jamapsychiatry.2018.4320","journal-title":"JAMA Psychiatr"},{"issue":"4","key":"4956_CR55","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1161\/CIRCOUTCOMES.113.000152","volume":"6","author":"JE Tisdale","year":"2013","unstructured":"Tisdale JE, Jaynes HA, Kingery JR, Mourad NA, Trujillo TN, Overholser BR, Kovacs RJ (2013) Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes 6(4):479\u2013487. https:\/\/doi.org\/10.1161\/CIRCOUTCOMES.113.000152","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"4956_CR56","doi-asserted-by":"crossref","unstructured":"Velligan DI, Weiden PJ, Sajatovic M, Scott J, Carpenter D, Ross R, Docherty JP (2009) Expert consensus panel on adherence problems in serious and persistent mental illness. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry 70(Suppl 4):1\u201346. quiz 47\u20138","DOI":"10.4088\/JCP.7090su1cj"},{"issue":"3","key":"4956_CR57","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1111\/j.1467-789X.2004.00141.x","volume":"5","author":"S Virk","year":"2004","unstructured":"Virk S, Schwartz TL, Jindal S, Nihalani J, Jones N (2004) Psychiatric medication induced obesity: an aetiologic review. Obes Rev 5(3):167\u2013170. https:\/\/doi.org\/10.1111\/j.1467-789X.2004.00141.x","journal-title":"Obes Rev"},{"issue":"9","key":"4956_CR58","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1002\/pds.5310","volume":"30","author":"J Wolff","year":"2021","unstructured":"Wolff J, Hefner G, Normann C, Kaier K, Binder H et al (2021) Polypharmacy and the risk of drug-drug interactions and potentially inappropriate medications in hospital psychiatry. Pharmacoepidemiol Drug Saf 30(9):1258\u20131268. https:\/\/doi.org\/10.1002\/pds.5310","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"4956_CR59","doi-asserted-by":"crossref","unstructured":"Zeitlinger M (2016) Drug Interactions. In: M\u00fcller M (ed) Clinical pharmacology: current topics and case studies. Springer, Cham, pp 265\u2013292","DOI":"10.1007\/978-3-319-27347-1_17"},{"issue":"11","key":"4956_CR60","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.2146\/ajhp070279","volume":"65","author":"WR Zemrak","year":"2008","unstructured":"Zemrak WR, Kenna GA (2008) Association of antipsychotic and antidepressant drugs with Q-T interval prolongation. Am J Health-Syst Pharm 65(11):1029\u20131038. https:\/\/doi.org\/10.2146\/ajhp070279","journal-title":"Am J Health-Syst Pharm"}],"container-title":["Naunyn-Schmiedeberg's Archives of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-04956-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00210-025-04956-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00210-025-04956-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T02:44:04Z","timestamp":1778208244000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00210-025-04956-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":60,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["4956"],"URL":"https:\/\/doi.org\/10.1007\/s00210-025-04956-5","relation":{},"ISSN":["0028-1298","1432-1912"],"issn-type":[{"value":"0028-1298","type":"print"},{"value":"1432-1912","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]},"assertion":[{"value":"12 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethics committee of the \u00c4rztekammer Nordrhein waived the need for approval since this is not required for retrospective analyses based of pseudonymized spontaneous reports. For this study, informed consent to participate was not applicable. No surveys or examinations were carried out on patients. The analyzed data is routinely collected and stored in the adverse drug reaction database EudraVigilance from the European Medicines Agency (EMA). Among others, pharmaceutical companies, physicians, pharmacists and patients report these ADRs (information concerning the reporting channels see Dubrall et al.\u00a0\n                      \n                      \u00a0(25)). Further information concerning the processing of personal data in the context of the operation of EudraVigilance Human can be found in the European Medicines Agency\u2019s Data Protection Notice for EudraVigilance Human (\n                      \n                      - human-ev_en.pdf). The Federal Institute for Drugs and Medical Devices (BfArM) as a national competent authority is granted with the highest level of access to EudraVigilance since one of the core duties of the BfArM is to analyze EudraVigilance data to fulfill its pharmacovigilance obligations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"DD and MS are supported by the EVAS project, which is founded by the Federal Institute for Drugs and Medical Devices and the Institute for Medical Biometry, Informatics and Epidemiology at the university hospital Bonn. PC was funded by the Innovationsfonds project PSY-KOMO.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The information and views set out in this manuscript are those of the authors and do not necessarily reflect the official opinion of the Federal Institute for Drugs and Medical Devices.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}