Prevalence of Inaccurately Labeled Psychotropic Allergies Within a State Psychiatric Facility

Signature Grand, Davie, Florida, USA

Background. The prevalence of true allergies to psychotropic medications remains unclear. One limiting factor in assessing this issue has been the historical practice of recording adverse drug reactions, such as an extrapyramidal side effect in the allergy section of a medical record. Objective. To determine the prevalence of documented allergies to psychotropics and the prevalence of inaccurately labeled allergies. Methods. This evaluation utilized a pharmacy database audit to review the allergies documented during January 2004 to January 2007. A sample group from those patients labeled with a psychotropic allergy was interviewed to determine and confirm the associated allergy. Attending psychiatrists and medical charts were consulted upon a patient’s inability to complete the interview. Results. A review of pharmacy records revealed 134 patients (~10%) with 172 incidents of individually documented psychotropic allergies. Patient interviews determined that 93% (n = 25) of the sample population actually experienced an adverse drug reaction (ADR), and not a true allergic reaction. The remaining 7% (n = 2) declared a nonspecific dermatitis as the associated reaction, and could not be ruled out as a true allergic reaction. Conclusion. The prevalence of inaccurately labeled allergies to psychotropics was exceptionally high in the sample population. Potentially, 100% of the sample population experienced an adverse reaction when considering the widely documented dermatological reactions associated with many psychotropic medications. As a result, future therapeutic decision making could be inappropriately weighted and a potential pharmacological regimen may be disregarded due to the allergy label.