Perspectives of healthcare professionals of the neuropsychiatric side effects associated with efavirenz and its management

This work intended to analyze the advertising of medicines requiring medical prescription, divulged into three journals of the neurology and cardiology areas addressed to healthcare professionals. The analysis was based on current legislation, among other criteria, as well as specific literature. The presence of the following items was investigated: registration number, drug name, specific indications, contraindications; cautions and warnings; adverse reactions; possible side effects; posology; legibility of technical-scientific information and bibliographic references, phrases and/or expressions about the medication benefits, as compared to other drugs; safety warnings, healing promises and pictures of people smiling, and the quotations confirmation based on bibliographic references. Among the evaluated legal criteria, it was observed the absence of legibility in technical-scientific information in 85% of advertisements; absence of side effects in 23%; absence of cautions and warnings in 15%; of contraindications in 12.8%; of posology in 6.4%; of registration numbers in 2.7% and of the Common Brazilian Denomination/Common International Denomination (Denominação Comum Brasileira/Denominação Comum Internacional - DCB/DCI) in 0.6%. Out of 130 statements respecting advantages face to others drugs, 23.8% were not confirmed and out of 48 divulged safety messages, 41.7% could not be found in quoted references. The pictures of people smiling was a resource used in 42.2% of advertisements. Out of 1362 references analyzed, 19.7% were not found and 37.1% of quoted affirmations weren't confirmed.

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A Questionnaire-based Study of the Views of Schizophrenia Patients and Psychiatric Healthcare Professionals in Japan about the Side Effects of Clozapine

Clinical Psychopharmacology and Neuroscience ◽

10.9758/cpn.2016.14.3.286 ◽

2016 ◽

Vol 14 (3) ◽

pp. 286-294 ◽

Cited By ~ 6

Author(s):

Ippei Takeuchi ◽

Manako Hanya ◽

Junji Uno ◽

Yuhei Amano ◽

Keiko Fukai ◽

...

Keyword(s):

Side Effects ◽

Healthcare Professionals

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Depressive Symptoms Predict Increased Incidence of Neuropsychiatric Side Effects in Patients Treated with Efavirenz

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/01.qai.0000221691.61972.34 ◽

2006 ◽

Vol 42 (4) ◽

pp. 514-515 ◽

Cited By ~ 26

Author(s):

Larry Boly ◽

Virginia Cafaro ◽

Toby Dyner

Keyword(s):

Depressive Symptoms ◽

Side Effects ◽

Neuropsychiatric Side Effects

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Neuropsychiatric Side Effects of Drugs in the Elderly

The Journal of Nervous and Mental Disease ◽

10.1097/00005053-198207000-00015 ◽

1982 ◽

Vol 170 (7) ◽

pp. 433

Author(s):

Kenneth Solomon

Keyword(s):

Side Effects ◽

The Elderly ◽

Neuropsychiatric Side Effects

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Predictors of Discontinuation of Efavirenz as Treatment for HIV, Due to Neuropsychiatric Side Effects, in a Multi-Ethnic Sample in the United Kingdom

AIDS Research and Human Retroviruses ◽

10.1089/aid.2019.0193 ◽

2020 ◽

Vol 36 (6) ◽

pp. 459-466

Author(s):

Johnson Kai Chun Law ◽

Laurie T. Butler ◽

Matthew M. Hamill

Keyword(s):

United Kingdom ◽

Side Effects ◽

The United Kingdom ◽

Neuropsychiatric Side Effects

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Antimicrobial-induced cognitive side effects

Mental Health Clinician ◽

10.9740/mhc.2016.07.207 ◽

2016 ◽

Vol 6 (4) ◽

pp. 207-214 ◽

Cited By ~ 7

Author(s):

Amanda Warstler ◽

Jennifer Bean

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Side Effects ◽

Clinical Symptoms ◽

Case Reports ◽

Time Frame ◽

Drug Induced ◽

Pubmed Search ◽

Neuropsychiatric Side Effects ◽

Cognitive Side Effects

Abstract Introduction: Antimicrobial-induced cognitive side effects are often overlooked or underreported. Literature often reports symptoms of antimicrobial-induced cognitive impairment under more general blanket terms, such as neuropsychiatric side effects, neurotoxicity, or drug-induced delirium or encephalopathy. Methods: A PubMed search using terms including antibiotics, antifungals, antivirals, antimalarials, side effects, cognitive, neurotoxicity, encephalopathy, and delirium was conducted. Respectively, symptoms of cognitive impairment were teased out of the multiple neurologic complications presented for each case and reported based on antimicrobial class. Articles were excluded if they focused solely on neuropsychiatric side effects such as seizures, psychosis, hallucinations, or mood disturbances, were conducted in animals, or involved antiretroviral medication therapies. Results: Of over 50 case reviews, case reports, retrospective chart reviews, and prospective cohort studies analyzed, 25 were deemed appropriate for purposes of this review. Common antimicrobial-induced cognitive side effects for all antimicrobial classes included confusion, delirium, encephalopathy, and impaired concentration or attention. Recurring risk factors included, but were not limited to, older age and renal impairment. Mechanisms of cognitive impairment were relatively specific to each antimicrobial class. Discussion: Awareness of the potential for antimicrobial-induced cognitive side effects, including the general time frame of symptom onset and symptom presentation, is critical in challenging patient cases. This review article aims to summarize the risk factors, clinical symptoms, mechanisms, and management of antimicrobial-induced cognitive side effects. Pharmacists can play a key role in prevention through adjustment of medications for renal or hepatic dysfunction, avoidance of polypharmacy, and knowledge of critical drug interactions that may precipitate cognitive decline.

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