<p>Magnitude, Nature, and Risk Factors of Adverse Drug Reactions Associated with First Generation Antipsychotics in Outpatients with Schizophrenia: A Cross-Sectional Study</p>

Abstract

Background: ADRs to antipsychotics are amongst the major challenges in the treatment of patients with psychotic disorders. The extent of patient-reported ADRs assessed in many studies using standardized scales is found to be inconsistent. However, there is a paucity of such research in Eritrea. The aim of the study is therefore to determine the magnitude, nature, and the possible risk factors associated with ADRs of the first generation antipsychotics in outpatients with schizophrenia at Saint Mary Neuro-Psychiatric National Referral Hospital in Asmara, Eritrea, using the LUNSERS self-rating scale. Methods: A cross-sectional, descriptive and analytical study design utilizing a quantitative approach was employed. Data were collected from patients' self-administered questionnaires, interviews, and medical records. The collected variables were analyzed using SPSS 22.0 with descriptive statistics, correlation, t-tests, ANOVA, and multiple regression. Statistical significance was tested at P-value<0.05. Results: In this study, 93.8% of the research participants experienced at least one ADR. LUNSERS total mean score of the relevant items was 28.01 (SD=18.46) with 24.7% of the study participants scoring medium-to-high. The prevalence of the categories of ADRs was psychic (91.3%), autonomic (78.1%), extra-pyramidal (76.9%), miscellaneous (66.5%), hormonal (58.3%), anti-cholinergic (44.2%), and allergic reactions (44.2%). At multivariate level, factors significantly and positively associated with total ADR score were smoking (P=0.028) and being at secondary educational level (P=0.015). Conclusion: There was high prevalence of ADRs with moderate-to-high overall ADR scores in a significant number of patients. The most frequently reported ADRs were psychic, autonomic, extra-pyramidal, hormonal, and miscellaneous. Smoking and secondary level of education were found to be the main determinants of ADRs.

Impact of adverse reactions to first-generation antipsychotics on treatment adherence in outpatients with schizophrenia: a cross-sectional study

“…In the current study, total ADRs score which implies the accumulated number and severity of adverse effects was significantly associated with treatment non-adherence. The adverse effect categories of extrapyramidal, psychic, hormonal, autonomic and miscellaneous which were found to be highly prevalent (58.3 to 91.3%) in this study population [ 24 ] were also found to be significant determinants of non-adherence. This could be due to the fact that the EPS including restlessness, muscle stiffness, slowing of movements and muscle spasms could interfere with the daily living activities and can lead to reduced quality of life which make the patient to stand out as different, hence contributing to stigma and non-adherence.…”

“…Details of the socio-demographic and clinical characteristics of the study participants were reported in our previously published article aimed to determine the magnitude, nature and risk factors associated with first-generation antipsychotics [ 24 ]. In summary, the study participants were 242 patients (response rate = 96.4%) with diagnosed schizophrenia attending outpatient department of the SMNPNRH.…”

“…The detailed methodological approach used in this study was published elsewhere in the previous study [ 24 ]. In brief, it was a cross-sectional study carried out at the outpatient department of the SMNPNRH in Asmara, Eritrea.…”

“…Ultimately, non-adherence to antipsychotic medications often leads to relapse in psychotic disorders, repeated hospitalizations, increased risk of suicide [ 23 ] and higher treatment costs [ 10 ]. In our previously published study, which utilized the same study population as the current one, with the aim of determining the magnitude, nature, and ADR risk factors of first-generation antipsychotics, we found psychic, autonomic, extrapyramidal, hormonal and miscellaneous ADRs to be highly prevalent [ 24 ]. This study was, therefore, aimed at determining the level of adherence and impact of adverse effects of first-generation antipsychotics on treatment adherence in outpatients with schizophrenia at Saint Mary Neuro-Psychiatric National Referral Hospital (SMNPNRH) in Asmara—Eritrea.…”

Best practices for documentation of psychotropic drug-drug interactions in an adult psychiatric clinic

“…Adverse drug events (ADEs) are significant concerns for patients living with psychiatric conditions and are often caused by drug-drug interactions (DDIs). 1 These DDIs commonly involve psychotropics and go under-recognized and under-reported. 2 - 5 The 2020 American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia specifically warns about the potential for DDIs between antipsychotics (APs) and other prescribed medications.…”