Ken was 28 and had ADHD. He had become confused and couldn’t keep a job.
He was dismissed from his last job after one week. He has several worrisome symptoms.
He is very depressed, lethargic and felt physically cold for hours each day. He had reversed day and night. He went to sleep at 4AM. He was isolated. And had thoughts of self-harm.
RCM Health reviewed the case. And looked more deeply into his medications prescribed by one of his doctors, a part-time semi-retired pediatrician who focused on treating patients with ADHD.
We explored the published literature about his medications and using AI found that one of his medications, Vyvanse in high doses could cause cognitive issues. This was likely a case of neurotoxicity. RCM Health used AI to explore the case to understand what might be the root cause for his cognitive issues.
Here is what the AI told our team:
Confusion due to neurotoxicity is a recognized risk with Vyvanse, primarily in overdose or misuse scenarios, and clinicians should monitor for neuropsychiatric symptoms, especially in high-risk populations.
Attempt At Collaboration With The Prescribing Doctor
We arranged to talk to the doctor who prescribed the medication. He agreed.
At the time of the call, we discussed our findings in the literature. He refused to acknowledge the possibility of a drug complication. He refused to consider tapering the medication. This doctor did not reference the literature. He went on only his personal experience which was limited in scope and nature. That was a problem for this patient.
Complications To Prescribed Medications:
The percentage of patients who experience complications related to their medications—commonly referred to as adverse drug events (ADEs)—varies by clinical setting and patient population. In ambulatory care, 25 percent of patients reported at least one adverse drug event over a defined period, with 13 percent of these events classified as serious and 11 percent as preventable.
Among hospitalized inpatients, a meta-analysis found that 19 percent experienced medication-related adverse events during their hospital stay, with approximately 32 percent of these events considered preventable.
After hospital discharge, up to 23 percent of patients experienced an adverse event within five weeks, with 72 percent of these events being drug-related and up to one-third preventable, according to the Agency for Healthcare Research and Quality. In the context of high-risk medications and transitions of care, 27.7 percent of patients experienced at least one adverse drug-related incident within 45 days of discharge.
In summary, between 19 and 25 percent of patients experience complications related to their medications in typical inpatient and ambulatory settings, with higher rates observed during transitions of care and among those prescribed high-risk medications.
Important To Be Aware Of Complications With Medications:
Ken was tapered off his medication. He got appropriate treatment and healthcare services, and did well.
It is essential that patients be aware of the potential complications with their medications and seek a medical second opinion when appropriate.
To Learn More:
info@rcmhealth.ca
647-350-5500.