scholarly journals What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication

2017 ◽  
Vol 47 (13) ◽  
pp. 2369-2378 ◽  
Author(s):  
T. Wykes ◽  
J. Evans ◽  
C. Paton ◽  
T. R. E. Barnes ◽  
D. Taylor ◽  
...  
Keyword(s):  
Side Effects ◽  
Antipsychotic Medication ◽  
Side Effect ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Service Users ◽  
Good Reliability ◽  
Starting Point ◽  
Two Samples ◽  
Life Impact

BackgroundCapturing service users’ perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications.AimTo develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure.MethodAn initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact.ResultsMSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted ‘putting on weight’ which was more distressing, more severe and had more life impact in those for whom it was most important.ConclusionsMSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.

Establishing a physical health monitoring service for patients on depot antipsychotic medication

2016 ◽  
Vol 33 (S1) ◽  
pp. S564-S564
Author(s):  
M. Gill ◽  
M. McCauley
Keyword(s):  
Side Effects ◽  
Physical Health ◽  
Antipsychotic Medication ◽  
Health Monitoring ◽  
Side Effect ◽  
Blood Test ◽  
Best Practice ◽  
Self Report ◽  
Physical Parameters ◽  
Depot Antipsychotic

IntroductionPatients with major mental illness are recognised to be at risk of premature death for a multitude of reasons. Those with schizophrenia and bipolar disorder are at highest risk.ObjectivesInternational best practice recommends monitoring of blood tests, physical parameters such as weight, BMI, waist circumference and blood pressure, and side effects of patients prescribed antipsychotic medication. A clinic was established to target these interventions.AimsThis initiative aimed to improve the physical health monitoring of patients prescribed depot antipsychotic medication in a catchment area of approximately 36,000 in Ireland.MethodsA twice-yearly, multidisciplinary monitoring clinic was established. A protocol was drawn up, following a literature review and inspection of current international guidelines, and a proforma assisted as an aide-mémoire. A self-report questionnaire, the Glasgow Antipsychotic Side Effect Scale, was used to enquire about side effects.ResultsEvaluation took place in descriptive form with audit used to examine outcomes. Full blood test monitoring improved from 9% of patients to 61% in one year, with 78% of patients having had at least one blood test recorded. Prior to the clinic's establishment, only one patient had had any physical parameters recorded, but this improved to 96% recorded after the clinics were run. Side effect documentation also improved.ConclusionsThe clinic was well-received and led to improved teamwork. Future recommendations include organising the clinic so as to include simultaneous blood testing. A similar project is being planned to target all patients attending who are prescribed antipsychotic medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Hostility Conflict and Reporting of Side Effects by Psychiatric Outpatients

1980 ◽  
Vol 47 (1) ◽  
pp. 319-324 ◽  
Author(s):  
Robert W. Downing ◽  
Karl Rickels
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Self Report ◽  
Partial Replication ◽  
Drug Trials ◽  
Psychiatric Outpatients ◽  
Double Blind ◽  
The Relationship ◽  
Report Measure

The Irritability, Indirect Hostility, Verbal Hostility, and Resentment scales from the Buss-Durkee Hostility Inventory, along with a newly constructed scale intended as a self-report measure of Hostility Conflict, were administered to 84 non-psychotic, primarily anxious psychiatric outpatients receiving an active anxiolytic and participating in one of several 4-wk. double-blind drug trials. Patients who complained of one or more side effects after 2 wk. of treatment were classified as side reactors; the remaining patients, as non-side reactors. Compared to non-side reactors, the side reactors obtained higher hostility conflict scores and lower scores on the Irritability and Indirect Hostility scales. Also, the relationship between side effect status and hostility conflict was stronger in those patients who obtained higher scores on the Irritability, Indirect Hostility, and Verbal Hostility scales and among patients obtaining lower scores on the Resentment scale. Findings were regarded as providing partial replication of and further verification of earlier results.

Clinical validation of the self-reported Glasgow Antipsychotic Side-effect Scale using the clinician-rated UKU side-effect scale as gold standard reference

2020 ◽  
Vol 34 (8) ◽  
pp. 820-828
Author(s):  
Marlene Schouby Bock ◽  
Oona Nørgaard Van Achter ◽  
David Dines ◽  
Maria Simonsen Speed ◽  
Christoph U Correll ◽  
...  
Keyword(s):  
Side Effects ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Side Effect ◽  
Self Report ◽  
Measurement Based Care ◽  
Gold Standard Reference ◽  
Antipsychotic Side Effects

Background: Antipsychotics are key for the treatment of psychotic and several non-psychotic disorders. Unfortunately, antipsychotic medications are associated with side effects, which may reduce quality of life and treatment adherence. Therefore, regular screening of antipsychotic side effects is essential. The Glasgow Antipsychotic Side-effect Scale is a patient self-report scale developed for this purpose. However, the Glasgow Antipsychotic Side-effect Scale has only been validated against another self-report side effect measure, which is suboptimal. Objective: We aimed to validate the Glasgow Antipsychotic Side-effect Scale using the clinician-rated Udvalg for Kliniske Undersøgelser side-effect rating scale as the gold standard reference. Results: 81 antipsychotic-treated outpatients with schizophrenia-spectrum disorders (age = 42±13 years; males = 43%, schizophrenia = 77%, illness duration: median = 11 years) completed the Glasgow Antipsychotic Side-effect Scale and were subsequently scored on the Udvalg for Kliniske Undersøgelser by trained raters. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for paired Glasgow Antipsychotic Side-effect Scale and Udvalg for Kliniske Undersøgelser items. Sensitivity of Glasgow Antipsychotic Side-effect Scale items ranged from 33–96%, with 19 (86%) having >75% sensitivity. Lowest sensitivity emerged for “nocturnal enuresis” (33%), “galactorrhea” (50%) and “hyperkinesia” 14–99%, with 14 items (64%) having >75% specificity, being lowest for “asthenia” (14%), “polyuria/polydipsia” (35%), “sedation” (41%), “akathisia” (53%), “dystonia” (65%), “hyperkinesia” (68%), “hypokinesia” (70%) and “accommodation” (70%). Positive predictive value ranged from 7–85%, with six items (27%) having a positive predictive value >75%. Negative predictive value ranged from 40–98%, with 21 items (95%) having a negative predictive value >75%. The mean time to complete the Glasgow Antipsychotic Side-effect Scale was 4±2 minutes. Conclusion: The Glasgow Antipsychotic Side-effect Scale demonstrated satisfactory validity as a self-rated tool for antipsychotic side effects and may aid measurement-based care and decision-making.

scholarly journals How frequent are acute reactions to COVID-19 vaccination and who is at risk?

2021 ◽  
Author(s):  
Nancy A Dreyer ◽  
Matthew W Reynolds ◽  
Lisa M Albert ◽  
Emma Brinkley ◽  
Tom Kwon ◽  
...  
Keyword(s):  
Side Effects ◽  
Medical Care ◽  
Side Effect ◽  
Median Number ◽  
Long Term Effects ◽  
Short Term ◽  
Web Based ◽  
Post Vaccination ◽  
Life Impact ◽  
The Usa

Introduction: Our objective was to describe and compare self-reported side effects of COVID-19 vaccines in the USA. Methods: A web-based registry enrolled volunteers who received a COVID-19 vaccine between March 19 and July 15, 2021. We collected self-reported short-term side effects, medical consultation, hospitalization, and quality of life impact following completed vaccination regimens (Pfizer, Moderna, J&J). Results: We recruited 6,966 volunteers who completed their full course of vaccination (median age 48 years, IQR 35.0-62.0; 83.6% female): Pfizer 3,486; Moderna 2,857; J&J 623. Few (3.1%) sought medical care for post-vaccination side effects. Hospitalization (n=17; 0.3%) and severe allergic reactions (n=39; 0.6%) also were rare. Those with autoimmune disease or lung disease were approximately twice as likely to seek medical care (adjusted odds ratio (aOR) 2.01 [95% CI: 1.39;2.92] and 1.70 [95% CI: 1.12;2.58] respectively). 92.4% of participants reported >1 side effect (median 3), with injection site reactions (78.9%), fatigue (70.3%), headache (49.0%) reported most frequently. More side effects were reported after the second dose of two-dose vaccines (medians: 1 vs. 2 for Pfizer and 1 vs. 3 for Moderna for first and second doses respectively) versus 3 for J&J's single-dose vaccine. For the employed, the median number of workdays missed was one. Diabetics and those vaccinated against influenza were substantially less likely to report >3 symptoms (aOR 0.68, 95% CI 0.56,0.82 and aOR 0.82, 95% CI 0.73,0.93, respectively.) Discussion: The total side effect burden was, not unexpectedly, greater with two-dose regimens but all three vaccines appear relatively safe. Very few subjects reported side effects serious enough to warrant medical care or reported post-vaccination hospitalization. While these findings do not address possible long-term effects, they do inform on their short-term safety and tolerability and will hopefully provide some reassurance and positively inform the benefit-risk and pharmacoeconomic assessment for all three vaccines. Clinicaltrials.gov NCT04368065

scholarly journals Do Newer Antidepressant Drugs Really Have Reduced Side Effects? Examining a Random “Real World” Sample of 300+ Receivers of Medications

2020 ◽  
Vol 6 (1) ◽  
pp. 75-100
Author(s):  
Nicholas Norman Adams
Keyword(s):  
Side Effects ◽  
Real World ◽  
Side Effect ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Primary Treatment ◽  
Self Report ◽  
Real World Data ◽  
Reported Study ◽  
Atypical Antidepressants

Newer antidepressant drugs are frequently cited as having reduced side effect profiles to that of their older counterparts. However, recent studies have begun to dispute this claim, citing selective sampling, short clinical trials, and clinical trial environments as influencing reported outcomes. At present, little research on antidepressant side effects draws on RWD (Real-World Data). Despite this, interest in examining RWD samples for antidepressant drug side effects is increasing as of 2020. The reported study asked a random sample of 300+ individuals taking a variety of different antidepressant medications to complete online drug side effect self-report scales with previously high validity. Newer antidepressants belonging to the atypical antidepressant drug class were reported as having only slightly reduced side effects of weight gain compared with older SSRI-class medications. No reduced side effects of increased depression, anxiety, sexual dysfunction (SD), sleepiness, or suicidal ideation (SI) were found for the newer atypical-class medications vs older SSRI-class agents. Medication adherence did not differ significantly between SSRI and atypical classes. No evidence for reduced side effects was found for newer SSRI and atypical antidepressants vs older same-class drugs when comparing six new and old medications drawn from atypical and SSRI classes. However, atypical antidepressants were associated with increased use of adjunct medications to bolster primary treatment.

Efficacy and tolerability of switching to long-acting injectable (LAI) aripiprazole in outpatients with schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. s255-s256
Author(s):  
B. Fernández-Abascal Puente ◽  
M. Juncal Ruiz ◽  
R. Landera Rodríguez
Keyword(s):  
Side Effects ◽  
Treatment Regimen ◽  
Treatment Adherence ◽  
Side Effect ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Oral Olanzapine ◽  
Insufficient Response ◽  
Competing Interest ◽  
Long Acting

IntroductionSwitching antipsychotics is a therapeutic alternative for managing side-effects, or efficacy and compliance issues.AimTo evaluate the efficacy and tolerability of switching to LAI-aripiprazole in patients who had insufficient response or were intolerant to the previous antipsychotic, or required a more convenient treatment regimen.MethodsThis was a prospective, observational, 6-months study carried out in 45 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was clinically indicated. Patients who required hospitalization, treatment discontinuation or adding another antipsychotic (including supplementation with oral-aripiprazole) were considered treatment failures. Switching was considered successful if the side-effect/symptom/adherence/convenience improved or, if applicable, disappeared.ResultsPatients aged 38 years, 51% women, and previous antipsychotics comprised: LAI-paliperidone (42%), oral-aripiprazole (22%), oral-olanzapine (11%), oral-risperidone (7%), LAI-risperidone (4%) and others (14%). The efficacy results of the switching are presented in the table. Of the 45 patients, 7 (15%) were considered treatment failures: 3 patients were hospitalized due to recurrence of psychotic symptoms, 2 discontinued LAI-aripiprazole, and 2 required supplementation with oral-aripiprazole (Fig 1).ConclusionsOur results suggest that switching to LAI-aripiprazole is an efficacious strategy for managing some antipsychotic-induced side-effects, persistence of negative symptoms and/or lack of treatment adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Quality of life measurement in schizophrenia: reconciling the quest for subjectivity with the question of reliability

1998 ◽  
Vol 28 (1) ◽  
pp. 165-172 ◽  
Author(s):  
L. VORUGANTI ◽  
R. HESLEGRAVE ◽  
A. G. AWAD ◽  
M. V. SEEMAN
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Social Performance ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Clinical Aspects ◽  
Neurocognitive Deficits ◽  
Global Assessment Scale ◽  
Global Quality Of Life

Background. The patients' ability to appraise their quality of life in schizophrenia was studied by examining the reliability and the validity of self-rated quality of life estimates.Methods. Sixty-three symptomatically stable patients with schizophrenia (DSM-IV) receiving maintenance treatment were evaluated over a 4-week period. The subjects were asked to appraise their quality of life at weekly intervals on a single item global quality of life measure, as well as the self-administered sickness impact profile. The patients' quality of life was also rated by a clinician using the social performance schedule and the global assessment scale of functioning; and clinical aspects such as the severity of psychotic symptoms, neurocognitive deficits, dose of medications, and side effects were documented with standardized measures.Results. The results indicated that the patients' self-reports were highly consistent over the 4 weeks, and the quality of life ratings correlated significantly with the clinician's estimates. The patients' quality of life was predictably influenced by the severity of their symptoms, side effects, cognitive deficits and the dose of their antipsychotic medication, but the reliability of their reports was not materially affected by these factors.Conclusions. It is concluded that clinically compliant and stable patients with schizophrenia can evaluate and report their quality of life with a high degree of reliability and concurrent validity, implying that self-report measures are potentially useful tools in clinical trials and outcome studies.

An Innovative Approach to Clinical Communication in Schizophrenia: The Approaches to Schizophrenia Communication Checklists

CNS Spectrums ◽  
2001 ◽  
Vol 6 (4) ◽  
pp. 333-338 ◽  
Author(s):  
Sharon G. Dott ◽  
Peter Weiden ◽  
Penelope Hopwood ◽  
A. George Awad ◽  
Jonathan S.E. Hellewell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Side Effect ◽  
Treatment Compliance ◽  
Structured Interview ◽  
Self Report ◽  
Antipsychotic Treatment ◽  
Healthcare Team ◽  
Preliminary Evaluation ◽  
Busy Clinical Setting

ABSTRACTSide effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC–Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.

scholarly journals Can young people reliably rate side effects of low-dose antipsychotic medication using a self-report survey?

2010 ◽  
Vol 22 (4) ◽  
pp. 168-173 ◽  
Author(s):  
Garry Walter ◽  
Simon Byrne ◽  
Oren Griffiths ◽  
Glenn Hunt ◽  
Nerissa Soh ◽  
...  
Keyword(s):  
Side Effects ◽  
Young People ◽  
Antipsychotic Medication ◽  
Low Dose ◽  
Self Report

Walter G, Byrne S, Griffiths O, Hunt G, Soh N, Cleary M, Duffy P, Crawford G, Krabman P, Concannon P, Malhi G. Can young people reliably rate side effects of low-dose antipsychotic medication using a self-report survey?

Enhancing Case Managers' Skills in the Assessment and Management of Antipsychotic Medication Side-Effects

2000 ◽  
Vol 34 (5) ◽  
pp. 814-821 ◽  
Author(s):  
Paul Morrison ◽  
Tom Meehan ◽  
Deanne Gaskill ◽  
Paul Lunney ◽  
Paul Collings
Keyword(s):  
Side Effects ◽  
Training Program ◽  
Antipsychotic Medication ◽  
Side Effect ◽  
Rating Scale ◽  
Intervention Group ◽  
Case Managers ◽  
Short Term ◽  
Medication Side Effects ◽  
Medication Side

Objective: Our goal was to reduce the prevalence of antipsychotic medication side-effects by providing a short-term training program on the assessment and management of side-effects to case managers. Method: Forty-four patients in receipt of community-based mental health services were allocated to comparison (n = 20) and intervention (n = 24) groups based on the health service district in which they resided. While case managers working with the intervention group attended a short-term training program to improve their assessment and management of neuroleptic side-effects, case managers providing services to the comparison group received no additional training. Side-effects were assessed pre- and postintervention using the Liverpool University Neuroleptic Side-effect Rating Scale (LUNSERS). Results: A reduction in the overall prevalence of side-effects in both groups was observed, however, only those patients in the intervention group reported a statistically significant reduction in mean side-effect scores between the pre- and post-measures (Wilcoxon Matched Pairs Signed-ranks Test, z = −2.8411, two-tailed, p < 0.01). In addition, qualitative data collected during the second survey revealed that patients in the intervention group had acquired some positive management strategies for dealing with unwanted side-effects. The strategies were elicited from eight different patients distributed across six of the 12 case managers who took part in the training program. Conclusions: Training cases managers in the assessment and management of side-effects may help to reduce their impact on the lives of people prescribed neuroleptic medication.

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