{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T16:10:27Z","timestamp":1772122227235,"version":"3.50.1"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291722000952_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antipsychotic polypharmacy (APP) occurs commonly but it is unclear whether it is associated with an increased risk of adverse drug reactions (ADRs). Electronic health records (EHRs) offer an opportunity to examine APP using real-world data. In this study, we use EHR data to identify periods when patients were prescribed 2 + antipsychotics and compare these with periods of antipsychotic monotherapy. To determine the relationship between APP and subsequent instances of ADRs: QT interval prolongation, hyperprolactinaemia, and increased body weight [body mass index (BMI) \u2a7e 25].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291722000952_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted anonymised EHR data. Patients aged 16 + receiving antipsychotic medication at Camden &amp; Islington NHS Foundation Trust between 1 January 2008 and 31 December 2018 were included. Multilevel mixed-effects logistic regression models were used to elucidate the relationship between APP and the subsequent presence of QT interval prolongation, hyperprolactinaemia, and\/or increased BMI following a period of APP within 7, 30, or 180 days respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291722000952_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 35 409 observations of antipsychotic prescribing among 13 391 patients. Compared with antipsychotic monotherapy, APP was associated with a subsequent increased risk of hyperprolactinaemia (adjusted odds ratio 2.46; 95% CI 1.87\u20133.24) and of registering a BMI &gt; 25 (adjusted odds ratio 1.75; 95% CI 1.33\u20132.31) in the period following the APP prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291722000952_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our observations suggest that APP should be carefully managed with attention to hyperprolactinaemia and obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291722000952","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T07:59:50Z","timestamp":1651219190000},"page":"4220-4227","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Antipsychotic polypharmacy and adverse drug reactions among adults in a London mental health service, 2008\u20132018"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-4906","authenticated-orcid":false,"given":"Justin C.","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7479-3459","authenticated-orcid":false,"given":"Johan H.","family":"Thygesen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-615X","authenticated-orcid":false,"given":"Nomi","family":"Werbeloff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-3862","authenticated-orcid":false,"given":"Joseph F.","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1539","authenticated-orcid":false,"given":"David P. J.","family":"Osborn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"S0033291722000952_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145712000399"},{"key":"S0033291722000952_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-017-4767-6"},{"key":"S0033291722000952_ref9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.11.1774"},{"key":"S0033291722000952_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2020.08.026"},{"key":"S0033291722000952_ref28","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024122706337"},{"key":"S0033291722000952_ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.4320"},{"key":"S0033291722000952_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbw058"},{"key":"S0033291722000952_ref14","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800504"},{"key":"S0033291722000952_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.specom.2004.02.004"},{"key":"S0033291722000952_ref5","unstructured":"CRIS Natural Language Processing. (n.d.). CRIS NLP Applications Library. Retrieved from https:\/\/www.maudsleybrc.nihr.ac.uk\/facilities\/clinical-record-interactive-search-cris\/cris-natural-language-processing\/."},{"key":"S0033291722000952_ref15","unstructured":"NHS Business Services Authority. (n.d.-a). English Prescribing Data (EPD). Retrieved from https:\/\/www.nhsbsa.nhs.uk\/prescription-data\/prescribing-data\/english-prescribing-data-epd."},{"key":"S0033291722000952_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2010.10.010"},{"key":"S0033291722000952_ref26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190703"},{"key":"S0033291722000952_ref16","unstructured":"NHS Business Services Authority. (n.d.-b). NHS England Items and Fees. Retrieved from https:\/\/www.nhsbsa.nhs.uk\/prescription-data\/dispensing-data\/nhs-england-items-and-fees-dispensed."},{"key":"S0033291722000952_ref19","first-page":"421","article-title":"The effects of novel and newly approved antipsychotics on serum prolactin levels: A comprehensive review","volume":"28","author":"Peuskens","year":"2014","journal-title":"CNS Drugs"},{"key":"S0033291722000952_ref1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e32835d9efb"},{"key":"S0033291722000952_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2007.08.001"},{"key":"S0033291722000952_ref8","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2012.683523"},{"key":"S0033291722000952_ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008721"},{"key":"S0033291722000952_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717003051"},{"key":"S0033291722000952_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12906"},{"key":"S0033291722000952_ref20","doi-asserted-by":"publisher","DOI":"10.1177\/0269881107087346"},{"key":"S0033291722000952_ref10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053943"},{"key":"S0033291722000952_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-015-0557-z"},{"key":"S0033291722000952_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2017.12.010"},{"key":"S0033291722000952_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2020.110138"},{"key":"S0033291722000952_ref23","doi-asserted-by":"publisher","DOI":"10.1177\/070674371506000503"},{"key":"S0033291722000952_ref25","doi-asserted-by":"publisher","DOI":"10.1159\/000126822"},{"key":"S0033291722000952_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-13-71"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291722000952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T22:14:48Z","timestamp":1689891288000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291722000952\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,29]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["S0033291722000952"],"URL":"https:\/\/doi.org\/10.1017\/s0033291722000952","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.11.28.21266870","asserted-by":"object"}]},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,29]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}