{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:05Z","timestamp":1787293445950,"version":"build-2736575974"},"reference-count":74,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Older adults with depressive episodes are frequently treated in the context of psychiatric multimorbidity, somatic co-treatment, and polypharmacy, increasing their vulnerability to drug-drug interactions (DDIs) and cumulative medication-related risk. This study characterized DDI burden and exploratory prescribing risk profiles among psychogeriatric outpatients, focusing on patients with depressive episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of psychiatric outpatient visits in 2023. The primary subgroup consisted of those diagnosed with a depressive episode. Patients with at least one diagnosis of a depressive episode formed the primary depression-focused subgroup. Potential DDIs were assessed using DrugBank and classified as major, moderate, or minor. These potential DDIs were database-identified and were not clinically confirmed adverse drug events. Visit-and patient-level analyses described potential DDI burden, medication risk burden, psychiatric co-diagnoses, and diagnosis-specific potential DDI pairs. Multivariable logistic and negative binomial regression models were fitted among patients with depressive episodes. Patient-level exploratory prescribing risk profiles were derived in the full cohort using DDI and medication risk burden features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 309 patients and 1242 eligible visits; 242 patients had at least one depressive episode diagnosis. Anxiety disorders were the predominant co-diagnosis among patients with depressive episodes, being recorded in 193 patients (79.8%) and co-occurring with depressive episode at the same visit in 177 patients (73.1%). Nearly half (50.4%) of visits from depressive-episode patients included at least one database-identified major potential DDI, while 93.7% had at least one moderate potential DDI. Leading moderate DDI pairs mainly involved benzodiazepine\/Z-drug and benzodiazepine\/antidepressant combinations. Leading major DDI pairs included cardiovascular, carbamazepine-related, and trazodone-related interactions. Medication load was the variable most consistently associated with potential DDI burden, while diagnostic complexity contributed to cumulative annual major DDI burden. A higher-burden exploratory prescribing risk profile identified 86 patients with depressive episodes (35.5%), highlighting a clinically important subgroup characterized by greater polypharmacy, potential DDI burden, and geriatric medication risk scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Database-identified potential DDI burden was substantial among older adults with depressive episodes and was driven mainly by medication load. Anxiety overlap, recurrent sedative-related moderate potential DDIs, and higher-burden prescribing risk profiles highlight the need for structured, regimen-level medication review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1915707","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:35:14Z","timestamp":1787290514000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploratory prescribing risk profiles and drug drug interaction burden in older adults with depressive episodes"],"prefix":"10.3389","volume":"17","author":[{"given":"Florina-Diana","family":"Goldi\u015f","sequence":"first","affiliation":[{"name":"Center for Drug Data Analysis, Cheminformatics, and the Internet of Medical Things, Victor Babe\u015f University of Medicine and Pharmacy","place":["Timi\u015foara, Romania"]},{"name":"Doctoral School of Pharmacy, Victor Babe\u015f University of 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