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Title: The association of prescribed drugs with psychiatric adverse drug reactions : analysis of data from the clinical practice research datalink (CPRD) and Yellow Card Scheme
Author: Thomas, Kyla Hayley
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2013
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Smoking cessation medicines, such as varenicline and bupropion, have been shown to be clinically effective and cost effective. However, there have been ongoing concerns that these medicines may cause psychiatric adverse drug reactions (ADRs) such as suicide. Safety warnings in relation to these drugs have been issued by regulatory agencies in the UK and USA. The aim of this thesis was to use data from two key pharmacoepidemiology and pharmacovigilance tools in the UK, the Yellow Card Scheme and the Clinical Practice Research Datalink (CPRD), to identify the risk of depression, non-fatal self-harm and suicide, associated with varenicline. First, I described the drug classes which have been associated with frequent Yellow Card reports of depression, non-fatal self-harm and suicide. I found that many different drugs are associated with reports of depression and suicide related events. These include drugs used for non psychiatric indications such as the smoking cessation medicines varenicline and bupropion, isotretinoin (used in acne treatment) and the antiretroviral drug efavirenz, in addition to drugs used for psychiatric indications such as the selective serotonin reuptake inhibitors (SSRls), antipsychotic medications and hypnotics. There was strong positive correlation between reporting rates of depression and suicide related events for psychiatric and non psychiatric drugs, providing indirect evidence of possible causal associations.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available