Drug Interactions in Patients with Alcohol Use Disorder: Results from a Real-world Study on an Addiction-specific Ward

Overview

Journal Ther Adv Drug Saf

Publisher Sage Publications

Date 2025 Jan 20

PMID 39830585

Authors

Sebastian Schroder

Christina Massarou

Tabea Pfister

Stefan Bleich

Phileas Johannes Proskynitopoulos

Johannes Heck

Martin Schulze Westhoff

Alexander Glahn

Affiliations

Soon will be listed here.

Abstract

Background: The majority of patients with alcohol use disorder (AUD) regularly take medication. Alcohol interacts negatively with many commonly prescribed drugs. However, little is known about the characteristics and frequency of potential alcohol-medication and drug-drug interactions in patients with AUD.

Objectives: This study aimed to determine the prevalence and characteristics of drug interactions in patients with AUD during withdrawal therapy on an addiction-specific ward.

Design: Retrospective cohort study.

Methods: Medication charts were analyzed and screened for potential alcohol-medication and drug-drug interactions. For the screening of potential alcohol-medication interactions, the drugs.com classification was utilized and potential drug-drug interactions were identified using the mediQ electronic interaction program.

Results: In our study, almost two-thirds (66.3%; 1089/1643) of all patient cases were prescribed at least one drug that could potentially interact with alcohol. Four percent of all alcohol-medication interactions were classified as severe, 91.8% as moderate, and 4.3% as mild. Drug classes commonly involved in serious interactions with alcohol were analgesics and drugs used in diabetes. A total of 811 potential drug-drug interactions were identified, of which 3.3% were classified as severe and 96.5% as moderate. Psychoanaleptics (ATC N06) and psycholeptics (ATC N05) were most frequently associated with moderate to severe interactions.

Conclusion: Potential alcohol-medication and drug-drug interactions are common in hospitalized patients with AUD. Improvements in the quality of prescribing should focus on the use of psychotropic drugs.

References

Holton A, Gallagher P, Fahey T, Cousins G . Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes. BMC Geriatr. 2017; 17(1):148. PMC: 5512950. DOI: 10.1186/s12877-017-0532-2. View

Juurlink D, Mamdani M, Lee D, Kopp A, Austin P, Laupacis A . Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med. 2004; 351(6):543-51. DOI: 10.1056/NEJMoa040135. View

Seifert J, Eckermann G, Heck J, Bleich S, Dabbert D, Grohmann R . [Understanding and assessing the antidepressant drug-associated risk of bleeding]. Fortschr Neurol Psychiatr. 2023; 92(11):458-467. DOI: 10.1055/a-2089-3490. View

Hefner G, Hahn M, Hiemke C, Toto S, Wolff J, Roll S . Pharmacodynamic Drug-Drug interactions of QT-prolonging drugs in hospitalized psychiatric patients. J Neural Transm (Vienna). 2021; 128(2):243-252. DOI: 10.1007/s00702-020-02291-y. View

Adams W . Interactions between alcohol and other drugs. Int J Addict. 1995; 30(13-14):1903-23. DOI: 10.3109/10826089509071060. View

Masnoon N, Shakib S, Kalisch-Ellett L, Caughey G . What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017; 17(1):230. PMC: 5635569. DOI: 10.1186/s12877-017-0621-2. View

Wium-Andersen I, Wium-Andersen M, Fink-Jensen A, Rungby J, Jorgensen M, Osler M . Use of GLP-1 receptor agonists and subsequent risk of alcohol-related events. A nationwide register-based cohort and self-controlled case series study. Basic Clin Pharmacol Toxicol. 2022; 131(5):372-379. DOI: 10.1111/bcpt.13776. View

Spaeth M, Bleich S, Hillemacher T . [Motivational interviewing with alcohol-dependent patients]. Fortschr Neurol Psychiatr. 2017; 85(9):549-565. DOI: 10.1055/s-0043-115216. View

Jesse S, Brathen G, Ferrara M, Keindl M, Ben-Menachem E, Tanasescu R . Alcohol withdrawal syndrome: mechanisms, manifestations, and management. Acta Neurol Scand. 2016; 135(1):4-16. PMC: 6084325. DOI: 10.1111/ane.12671. View

10.

Chang T, Park H, Kim D, Jeon E, Rhee C, Kalantar-Zadeh K . Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study. Sci Rep. 2020; 10(1):18964. PMC: 7609640. DOI: 10.1038/s41598-020-75888-8. View

11.

Parry C, Patra J, Rehm J . Alcohol consumption and non-communicable diseases: epidemiology and policy implications. Addiction. 2011; 106(10):1718-24. PMC: 3174337. DOI: 10.1111/j.1360-0443.2011.03605.x. View

12.

Shehab N, Lovegrove M, Geller A, Rose K, Weidle N, Budnitz D . US Emergency Department Visits for Outpatient Adverse Drug Events, 2013-2014. JAMA. 2016; 316(20):2115-2125. PMC: 6490178. DOI: 10.1001/jama.2016.16201. View

13.

Schulze Westhoff M, Schroder S, Heck J, Pfister T, Jahn K, Krause O . Determinants of severe QT prolongation in a real-world gerontopsychiatric setting. Front Psychiatry. 2023; 14:1157996. PMC: 10076587. DOI: 10.3389/fpsyt.2023.1157996. View

14.

Haut M, Cowan D . The effect of ethanol on hemostatic properties of human blood platelets. Am J Med. 1974; 56(1):22-33. DOI: 10.1016/0002-9343(74)90747-5. View

15.

Jobski K, Kollhorst B, Schink T, Garbe E . The Risk of Opioid Intoxications or Related Events and the Effect of Alcohol-Related Disorders: A Retrospective Cohort Study in German Patients Treated with High-Potency Opioid Analgesics. Drug Saf. 2015; 38(9):811-22. DOI: 10.1007/s40264-015-0312-x. View

16.

Immonen S, Valvanne J, Pitkala K . The prevalence of potential alcohol-drug interactions in older adults. Scand J Prim Health Care. 2013; 31(2):73-8. PMC: 3656398. DOI: 10.3109/02813432.2013.788272. View

17.

Druschky K, Bleich S, Grohmann R, Engel R, Kleimann A, Stubner S . Use and safety of antiepileptic drugs in psychiatric inpatients-data from the AMSP study. Eur Arch Psychiatry Clin Neurosci. 2017; 268(2):191-208. DOI: 10.1007/s00406-017-0827-5. View

18.

Hobbs J, Kushner M, Lee S, Reardon S, Maurer E . Meta-analysis of supplemental treatment for depressive and anxiety disorders in patients being treated for alcohol dependence. Am J Addict. 2011; 20(4):319-29. PMC: 3124006. DOI: 10.1111/j.1521-0391.2011.00140.x. View

19.

Castle I, Dong C, Haughwout S, White A . Emergency Department Visits for Adverse Drug Reactions Involving Alcohol: United States, 2005 to 2011. Alcohol Clin Exp Res. 2016; 40(9):1913-25. PMC: 5008983. DOI: 10.1111/acer.13167. View

20.

Mitchell J, Grossman L, Coker A, Messing R . The anticonvulsant levetiracetam potentiates alcohol consumption in non-treatment seeking alcohol abusers. J Clin Psychopharmacol. 2012; 32(2):269-72. DOI: 10.1097/JCP.0b013e318248ba69. View