Evaluation of antipsychotic side effects on schizophrenia patients at Dr Radjiman Wediodiningrat Hospital, Indonesia
DOI:
https://doi.org/10.46542/pe.2024.243.191196Keywords:
Antipsychotic, Extrapyramidal syndrome, Hospital, Schizophrenia, Side effectAbstract
Background: Schizophrenia is the most common mental illness with a poor prognosis. Antipsychotics are the major treatment for Schizophrenia.
Objective: This study examines schizophrenia patients' side effects and antipsychotic medication.
Method: A retrospective study with cross-sectional observational analysis was conducted in June 2023, with only the data from schizophrenia patients in Dr. Radjiman Wediodiningrat Hospital, Indonesia. Data were collected from the prescription records of schizophrenia inpatients from January to June 2023. The Chi-square test was used to analyse and measure the relationship between the incidence of adverse events with antipsychotics in schizophrenia patients.
Result: Schizophrenia inpatients were majority male (74.7%) and the age 18-35 years was 41%. This study showed that the pattern of prescription of antipsychotics is atypical monotherapy (37.6%) and combinations (24.9%) were the most antipsychotics prescribed. Most of the schizophrenia outpatients have extrapyramidal syndrome side effects (31.9%), such as rigidity (12.2%), tremor (3.5%), dystonia (6.6%), and other side effects (11.8%).
Conclusion: This study highlighted that atypical antipsychotics were the most common choice for treatment in the inpatient setting. Atypical have a lower risk of extrapyramidal side effects than typical. The negative effects of atypical antipsychotics, including metabolic syndrome, have not been identified. Thus, more research is required.
References
Dania, H., Barliana, M. I., Perwitasari. D. A., & Abdulah, R. (2019). Effect of atypical antipsychotic on blood pressure in inpatients with schizophrenia of Prof. Dr. Soerojo Mental Health Hospital Magelang. Journal of Pharmacy and Bioallied Sciences, 11(4), 580‒586. https://doi.org/10.4103/jpbs.JPBS_211_19
Defronzo, R. A. (1980). Pathophysiologic approach to hyponatremia. Archives of Internal Medicine, 140(7), 897. https://doi.org/10.1001/archinte.1980.00040020897004
Doane, J. P., Sajatovic, M., Weiden, P. J., O'Sullivan, A. K., Maher, S., Bjorner, J. B., Kessler, A. S., Conlin, J., Bessonova, L., & Velligan, D. I. (2020). Antipsychotic treatment experiences of people with schizophrenia: Patient perspectives from an online survey. Patient Preference and Adherence, 14(2), 2043–2054. https://doi.org/10.2147/PPA.S270020
Haddad, P. M., Das, A., Keyhani, S., & Chaudhry, I. B. (2012). Antipsychotic drugs and extrapyramidal side effects in first episode psychosis: A systematic review of head–head comparisons. Journal of Psychopharmacology, 26(5), 15–26. https://doi.org/10.1177/0269881111424929
Hirigo, A. T., Teshome, T., Gitore, W. A., W., & Worku, E. (2021). Prevalence and associated factors of dyslipidemia among psychiatric patients on antipsychotic treatment at Hawassa University Comprehensive Specialized Hospital. Nutrition and Metabolic Insights, 14, 1–10. https://doi.org/10.1177/11786388211016842
Holt, R. I. G. (2019). Association between antipsychotic medication use and diabetes. Current Diabetes Reports, 19(10), 19–96. https://doi.org/10.1007/s11892-019-1220-8
Hori, H., Furukori, N. Y., Hasegawa, N., Iga, J. I., Ochi, S., Ichihashi, K., Furihata, R., Kyo, Y., Takaesu, Y., Tsuboi, T., Kodaka, F., Onitsuka, T., Okada, T., Murata, A., Kashiwagi, H., Iida, H., Hashimoto, N., Ohi, K., Yamada, H., & Hashimoto, R. (2022). Prescription of anticholinergic drugs in patients with schizophrenia: Analysis of antipsychotic prescription patterns and hospital characteristics. Frontiers in Psychiatry, 13, 1–11. https://doi.org/10.3389/fpsyt.2022.823826
Indonesian Ministry of Health. (2018). Basic Health Research 2018. National Report on Indonesia Basic Health Research Data, 44(8), 181–222. http://www.yankes.kemkes.go.id/assets/downloads/PMK
Julaeha, J., Athiyah, U., & Hermansyah, A. (2020). The prescription patterns of second-generation antipsychotics in schizophrenia outpatient setting. Journal of Basic and Clinical Physiology and Pharmacology, 30(6). https://doi.org/10.1515/jbcpp-2019-0289
Julaeha, J., Athiyah, U. M. I., Yuliana, V., Ayuningtyas, J. P., & Hermansyah, A. (2021). Schizophrenia, metabolic syndrome and the opportunity for developing pharmacist-led toolkit for Education and Metabolic Syndrome Screening (EMESYS): A review. International Journal of Pharmaceutical Research, 13(02), 3407–3413. https://doi.org/10.31838/ijpr/2021.13.02.154
Lähteenvuo, M., & Tiihonen, J. (2021). Antipsychotic polypharmacy for the management of schizophrenia: evidence and recommendations. Drugs, 81(11), 1273–1284. https://doi.org/10.1007/s40265-021-01556-4
Lee, J., Green, M. F., Nuechterlein, K. H., Swerdlow, N. R., Greenwood, T. A., Hellemann, G. S., Lazzeroni, L. C., Light, G. A., Radant, A. D., Seidman, L. J., Siever, L. J., Silverman, J. M., Sprock, J., Stone, W. S., Sugar, C. A., Tsuang, D. W., Tsuang, M. T., Turetsky, B. I., Gur, R. C., & Braff, D. L. (2020). The effects of age and sex on cognitive impairment in schizophrenia: Findings from the Consortium on the Genetics of Schizophrenia (COGS) study. PLoS one, 15(5), 1–11. https://doi.org/10.1371/journal.pone.0232855
Li, X., Zhou, W., & Yi, Z. (2022). A glimpse of gender differences in schizophrenia. General Psychiatry, 35(4), 2–4. https://doi.org/10.1136/gpsych-2022-100823
Pringsheim, T., Doja, A., Belanger, S., Patten, S., Casselman, L., Davidson, J., Grisaru, S., Ho, J., Jabbal, R., MacKean, G., McCrindle, B., McLennan, J., Palda, V., Panagiotopoulos, C., Pearce, M., Ponesse, J., Thomas, R., Waheed, W., & Wilkes, C. (2011). Treatment recommendations for extrapyramidal side effects associated with second-generation antipsychotic use in children and youth. Paediatrics and Child Health, 16(9), 590–598. https://doi.org/10.1093/pch/16.9.590
Ramsi, R. K., & Zulaikha, A. (2022). Pathophysiology and management of extrapyramidal syndrome. AVERROUS: Malikussaleh Journal of Medicine and Health, 8(2), 64. https://doi.org/10.29103/averrous.v8i2.8770
Stroup, T. S., & Gray, N. (2018). Management of common adverse effects of antipsychotic medications. World Psychiatry, 17(3), 341–356. https://doi.org/10.1002/wps.20567
World Health Organization. (2022). Schizophrenia. https://www.who.int/news-room/fact-sheets/detail/schizophrenia
Winarti, A. R. (2019). Prevalence of schizophrenia in South Jakarta Administration City in 2017. Public Health, 10(1), 15–24. https://doi.org/10.26553/jikm.2019.10.1.15-24
Wubeshet, Y. S., Mohammed, O. S., & Desse, T. A. (2019). Prevalence and management practice of first-generation antipsychotics induced side effects among schizophrenic patients at Amanuel Mental Specialized Hospital, central Ethiopia: A cross-sectional study. BMC psychiatry, 19(1), 32. https://doi.org/10.1186/s12888-018-1999-x
