A comprehensive analysis of medical malpractice claims related to psychotropic substances: which psychotrop substances should be considered more medico-legal cautious?

Int J Psychiatry Clin Pract. 2025 Apr 28:1-9. doi: 10.1080/13651501.2025.2496504. Online ahead of print.

ABSTRACT

INTRODUCTION: Psychotropic drugs are commonly employed in the treatment of various psychiatric disorders, yet they carry a number of risks due to their potential side effects and interactions with other drugs. Some medical errors in the prescribing of psychotropic medication may have adverse consequences for patients, which may result in physical harm or even death. The objective of this study is to define the processes to be considered by investigating medical malpractice claims related to psychotropic drug treatment.

METHOD: A retrospective examination was conducted of the sociodemographic and clinical characteristics of medical malpractice cases alleged and reported by the relevant boards of the Turkish Council of Forensic Medicine (2nd Specialised Board, 7th Specialised Board, 8th Specialised Board, and 3rd Supreme Board) between 2013 and 2022.

RESULTS: The majority of cases were male (72%), with an average age of 33.10 ± 16.63 years. The most common diagnosis was schizophrenia (28%), and the most frequent malpractice claims involved the effects of antipsychotic medications (50%). The most common side effects leading to claims were cardiac side effects (34%) in cases that resulted in death (p < 0.001) and extrapyramidal system side effects in other cases (14%) (p < 0.001). It was observed that 29 cases (58%) resulted in death. Antidepressants were more often claimed for causing deaths (p = 0.045), while mood stabilisers were more often claimed for resulting in injuries (p = 0.039). In 81% of non-fatal cases, the clinical side effect in question was determined to be related to the treatment (p = 0.002) and was managed appropriately as a complication (p < 0.001).

CONCLUSION: Psychotropic drugs can carry serious risks, especially cardiac and extrapyramidal side effects. Careful monitoring and management of these medicines are essential for patient outcomes and safety. These side effects may lead to medical error claims in some cases; however, when managed correctly, they are not considered malpractice.

PMID:40293179 | DOI:10.1080/13651501.2025.2496504