Adverse drug reactions

Learning outcomes

By the end of the module, you should be able to:


  • summarise the differences between dose-related and idiosyncratic adverse drug reactions (ADRs)


  • describe the major categories of ADRs associated with psychotropic medication


  • take appropriate corrective action when common ADRs to psychotropic medication occur


  • explain the importance of assessing risks and benefits for every individual patient in relation to their medication


  • locate further information to guide prescribing of psychotropic medication


  • report ADRs appropriately


  • prescribe controlled drugs correctly.    


Module introduction

Medicines can have both desirable and undesirable effects and prescribing them involves weighing their risks and benefits. This module discusses some of the unwanted effects of psychiatric medications, exploring their categorisation and pharmacological underpinnings and highlighting how we can prevent as well as recognise and treat ADRs when they occur.


It is outside the scope of the module to detail every adverse reaction associated with every drug we use in psychiatry. However, it will help you to think about why ADRs occur, using examples, and hopefully you will be able to apply this thinking to your clinical practice. If you are looking for up-to-date advice about ADRs to specific drugs we would advise you to check the most recent BNF or the Maudsley Prescribing Guidelines (Taylor et al, 2018).


There are serious issues around ADRs. They are responsible for around 5% of hospital admissions (Pirmohamed, 1998), and negatively impact on quality of life, treatment and the doctor-patient relationship. ADRs can also lead to discontinuation of medication: 8% of people who have been prescribed SSRIs and 4–9% who have been prescribed antipsychotics discontinue them during clinical trials due to adverse reactions (Machado, 2006; Sprague, 2004). 


In addition, ADRs are estimated to cost the NHS around £466 million per year (Hitchen, 2006) and have further economic implications due to inhibiting those affected from being able to work and impairing recovery.


The following 3-minute video highlights the importance of understanding this area – not just for exams, but for our patients:


View video


Learning notes

We recommend that you make some notes as you work through this module.


The 'TrOn Notebook' facility can be accessed throughout the module (allowing you to make notes on each page), and these notes will be saved in your personal area 'My TrOn', for future reference. However, you will not be able to print these notes as one single document.


If you would prefer to make your notes in a separate document you may wish to download the 'learning notes' below. This downloadable Word document will allow you to keep a personalised record of your learning, which you can then save and/or print for future reference.


Download the learning notes document for this module


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