Evidence map›Paper›PMID 40537875›Full record

Observational studyAddiction science & clinical practice2025

Pharmacotherapy of psychiatric inpatients with mental and behavioral disorders caused by sedatives or hypnotics (F13): Results from an observational pharmacovigilance program between 2000 and 2017.

Philipp Pauwels, Beatrice Haack, Sermin Toto, Johanna Seifert, Renate Grohmann, Martin Heinze, Oliver Zolk, Phileas Johannes Proskynitopoulos, Michael Schneider, Timo Greiner

Abstract readObservational Study
In one paragraph

Observational study in Addiction science & clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Philipp PauwelsBrandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany. philipp.pauwels@mhb-fontane.de.
Beatrice HaackBrandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany.
Sermin TotoDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hannover, Germany.
Johanna SeifertDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hannover, Germany.
Renate GrohmannDepartment of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.
Martin HeinzeBrandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany.
Oliver ZolkInstitute of Clinical Pharmacology of the Brandenburg Medical School, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany.
Phileas Johannes ProskynitopoulosDepartment of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hannover, Germany.
Michael Schneider *Brandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany.
Timo Greiner *Brandenburg Medical School, University Clinic for Psychiatry and Psychotherapy, Immanuel Klinik Rüdersdorf, 15562, Rüdersdorf, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe treatment of choice for substance use disorder (SUD) caused by sedatives, hypnotics, and anxiolytics (SHA) is to slowly taper the dose of the implicated substance to the point of abstinence, thereby minimizing withdrawal symptoms. Concomitant pharmacotherapy may be indicated to manage excessive withdrawal or rebound symptoms. This study investigated the use of psychotropic drugs for the treatment of SHA-dependent SUD patients in Germany.

methodsData were obtained from the German Drug Safety Program in Psychiatry ("Arzneimittelsicherheit in der Psychiatrie"; AMSP) from 2000 to 2017. SHA SUD was classified using the 10th Edition of the International Classification of Disease (ICD-10).

resultsThe present study included 1,015 patients with a primary diagnosis of mental and behavioral disorders due to use of sedatives or hypnotics (F13.1-F13.9). The most common comorbid psychiatric diagnoses were additional SUDs (F1, n = 279), especially alcohol use disorder (F10; n = 124), and mood disorders (F3; n = 201). A total of 95.6% of patients received one or more psychotropic drugs, most commonly antidepressant drugs (63.1% of patients), tranquillizing drugs (55.5%), and antipsychotic drugs (46.7%). The most common combination was an antidepressant drug and a tranquillizing drug (33.0%). Overall, psychotropic drugs with sedating properties (e.g., mirtazapine, quetiapine, doxepin, and trimipramine) were preferred. An increase in use over the 17-year observation period was observed for tranquillizing drugs and, most pronounced, for antipsychotic drugs.

conclusionWe found high rates of non-SHA drugs among patients treated for SHA-SUD. The prevalent use of psychotropic drugs with strong sedating properties indicates a symptom-oriented treatment approach, which is often "off-label" but may be clinically necessary. Main limitation is the cross-sectional design of the AMSP databank. Therefore, we cannot provide any follow up data on the patient collective especially regarding outcome.

Indexed as

Anti-Anxiety AgentsHypnotics and SedativesMental DisordersPharmacovigilanceSubstance-Related DisordersAdultAgedAntipsychotic AgentsFemaleGermanyHumansInpatientsMaleMiddle AgedPsychotropic DrugsSubstance Withdrawal SyndromeAnti-Anxiety AgentsAntipsychotic AgentsHypnotics and SedativesPsychotropic DrugsAMSPAnxiolyticsF13HypnoticsPharmacovigilancePsychotropic drugsSedativesTranquilizing drugs

Identifiers

PMID40537875
PMCPMC12180187

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.