scholarly journals Monitoring side-effects of antipsychotics using the glasgow antipsychotic side-effect scale

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S106-S107
Author(s):  
James Sterritt
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Training Session ◽  
Treatment Compliance ◽  
Psychiatric Ward ◽  
Antipsychotic Treatment ◽  
Staff Education ◽  
National Guidelines ◽  
Improve Compliance

AimsAntipsychotic drugs frequently produce side-effects which represent common reasons for noncompliance. National guidelines, published by the National Institute of Care and Health Excellence, the Royal College of Psychiatrists, and the Maudsley Prescribing Guidelines in Psychiatry, stipulate that patients prescribed antipsychotic drugs should be reviewed for side-effects on a weekly basis. This completed audit cycle, conducted on a mixed acute general adult psychiatric ward, examined whether patients were being assessed for side-effects of antipsychotic drugs using a standardised, self-reporting scale – the Glasgow Antipsychotic Side-effect Scale (GASS) – as per national guidelines. As identification of side-effects is important in tailoring treatment to improve compliance, auditing monitoring practice was important in realising these outcomes.MethodRetrospectively, 26 inpatients were identified over a two-month period who were prescribed antipsychotic drugs. Their notes were reviewed for documented weekly GASS scores for the duration of antipsychotic treatment. Initial data demonstrated 0% compliance with guidelines, as no patients completed a weekly GASS. The intervention to improve compliance was a training session for ward staff on implementing the GASS. Data were subsequently collected prospectively over three weeks for 15 patients.ResultSeven patients completed the GASS weekly over three weeks, representing 47% compliance. Two patients (13%) completed two forms, three (20%) completed one form, and three (20%) completed no forms. There was a positive correlation between being offered the GASS and completing it – only one patient declined to complete it and was not offered it during the third week. Of the remaining 14 patients, if the GASS was offered there was 100% rate of completion. Staff did not offer the GASS to every patient each week, which accounted for most cases of non-completion. Some patients with pre-existing symptoms of physical illnesses included these on the GASS, which complicated interpretation. Future interventions could include further staff education, and involving a ward pharmacist to review results during medication reviews to optimise treatment compliance, as no medication changes resulted directly from patients completing the GASS.ConclusionCompliance with completing the GASS weekly improved following staff education, identifying the main factor affecting compliance as staff not offering the GASS to patients. Patients generally engaged well with side-effect monitoring, as most completed the GASS when offered. Further staff education may produce even greater compliance with guidelines, and involving pharmacy staff to review GASS scores and inform medication choices may lead to use of the GASS resulting in more tolerable and effective treatment plans.

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 Family’s experience in Caring of Cancer Patient undergoing Oral Chemotherapy : A Study Phenomenology

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nurul Huda ◽  
Erwin Erwin ◽  
Eka Febriyanti
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Cancer Patient ◽  
Side Effect ◽  
Oral Chemotherapy ◽  
Family Experience ◽  
Home Setting ◽  
Manage Care ◽  
Improve Compliance ◽  
Chemotherapy Agents

ABSTRACTThe use of Oral Chemotherapy is increasing nowadays. Family who directly involve in caring the patient should be aware of the side effect and how to handle this agent safely. Phenomenology approach of qualitative study was conducted to get illustration regarding family experience in managing care of patient receiving oral chemotherapy. Data was collected by semi structured interviewed. Study gathered from 10 participants who meet criteria. The current study showed that three temathic item related to how they manage care to their family’s member. Those are 1) Lack of knolwedge about oral chemotherapy, 2) Confusing in handling safe oral chemotherapy and 3) lack of ability in caring patients when  side effect appeared and following adherence. These three things are considered lacked by the patients.  Therefore, health care professional especially nurses are expected to give more education and attention about administering oral chemotherapy agents, safe handling, adherence and managing side effects  both of in clinical and home setting. Multi-component interventions that include education, equipment, and technology can improve compliance with oral chemotherapy and will help families to secure and provide the appropriate affection to them.ABSTRAKPenggunaan kemoterapi oral semakin meningkat saat ini. Keluarga yang secara langsung terlibat dalam merawat pasien harus menyadari efek samping dan cara menangani terapi ini dengan aman. Penelitian kualitatif dengan pendekatan fenomenologi dilakukan untuk mendapatkan gambaran mengenai pengalaman keluarga dalam mengelola perawatan pasien yang menerima kemoterapi oral. Data dikumpulkan secara semi terstruktur melalui wawancara. Penelitian ini terdiri dari 10 partisipan keluarga yang memenuhi kriteria inklusi. Hasil penelitian menunjukkan  terdapat tiga tema terkait bagaimana keluarga merawat pasien dengan oral chemotherapy di rumah. Ketiga tema tersebut adalah 1) kurangnya pengetahuan keluarga tentang oral kemoterapi, 2) kebingungan keluarga dalam penanganan keamanan oral chemotherapy dan 3) ketidakmampuan keluarga dalam menangani efek samping dan menjaga kepatuhan. Ketiga hal ini dianggap masih belum bisa dilakukan oleh keluarga dan membutuhkan bimbingan serta informasi dari petugas kesehatan. Oleh karena itu, petugas kesehatan professional terutama perawat diharapkan dapat memberikan edukasi dan perhatian yang lebih kepada keluarga  tentang bagaimana pemberian kemoterapi oral yang baik, penanganan yang aman serta peningkatan kepatuhan dalam menjalani perawatan. Memberikan intervensi multikomponen yang mencakup pendidikan, peralatan pendukung, dan teknologi dipercayai dapat meningkatkan kemampuan dalam perawatan dan kepatuhan dalam menjalani kemoterapi oral, sehingga  dapat membantu keluarga untuk memberikan rasa aman dan kasih sayang yang kepada pasien.

scholarly journals Examining side effect variation of antipsychotic treatment in schizophrenia spectrum disorders

2020 ◽  
Author(s):  
Maria S. Neumeier ◽  
Stephanie Homan ◽  
Stefan Vetter ◽  
Erich Seifritz ◽  
John M. Kane ◽  
...  
Keyword(s):  
Weight Gain ◽  
Side Effects ◽  
Precision Medicine ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Second Generation Antipsychotics ◽  
Spectrum Disorders ◽  
The Right

Background: Side effects of antipsychotic drugs play a key role in non-adherence and discontinuation of treatment in schizophrenia spectrum disorders (SSD). Precision medicine aims to minimize such side effects by selecting the right treatment for the right patient. However, to determine the extent of precision medicine that is required, we need to (1) show that there is indeed variation in side effects and (2) estimate the amount of variation in those side effects between patients. While clinical observations suggest that such variation may be considerable, a statistical comparison of side effect variation between active and control treatments is required to confirm this. Here, we hypothesized to find larger side effect variation in treatment compared with control in patients treated with first and second generation antipsychotics. Methods: We included double-blind, placebo-controlled, randomized controlled trials (RCTs) of adults with a diagnosis of SSD and prescription for licensed antipsychotic drugs. Standard deviations of the pre-post treatment differences of weight gain, prolactin levels,and corrected QT (QTc) times were extracted. Data quality and validity were ensured by following the PRISMA guidelines. The outcome measure was the overall variability ratio of treatment to control across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model. Results: We included N = 16578 patients for weight gain, N = 16633 patients for prolactin levels, and N = 10384 patients for QTc time. Variability ratios (VR) were significantly increased for weight gain (VR = 1.08; 95% CI: 1.02 - 1.14; P = 0.004) and prolactin levels (VR = 1.38; 95% CI: 1.17 - 1.62; P < 0.001) but did not reach significance for QTc time (VR = 1.05; 95% CI: 0.98 - 1.12; P = 0.135). Conclusion: We found increased variability in major side effects in patients with SSD under treatment with second generation antipsychotics, suggesting that subgroups of patients or even individual patients may benefit from improved treatment allocation through stratified or personalized medicine, respectively.

Towards More Effective Antipsychotic Treatment

1994 ◽  
Vol 165 (S25) ◽  
pp. 22-31 ◽  
Author(s):  
John M. Kane ◽  
Hugh L. Freeman
Keyword(s):  
Side Effect ◽  
Negative Symptoms ◽  
Antipsychotic Drugs ◽  
Mechanisms Of Action ◽  
Effective Control ◽  
Antipsychotic Treatment ◽  
Side Effect Profile ◽  
Proven Efficacy ◽  
Dopamine Hypothesis ◽  
Neurological Effects

The development of antipsychotic drugs has followed two complementary approaches, either towards highly specific actions (e.g. on the dopamine receptor) or targeting a broad range of receptors. The properties of ‘atypical’ agents challenge the original dopamine hypothesis and suggest roles for a variety of dopamine receptors and for other pathways, such as serotonin. Older drugs, despite their proven efficacy in relieving many schizophrenic symptoms, have several drawbacks, being ineffective in some patients, relatively ineffective against negative symptoms, and causing adverse neurological effects which may, in turn, be associated with poor compliance. Among newer agents, currently available ones, such as clozapine and risperidone, offer the possibility of more effective control of negative symptoms and an improved side-effect profile, while others are in earlier stages of development. However, much still remains to be understood about their mechanisms of action.

scholarly journals Priapism in Antipsychotic Drug Use: A Rare but Important Side Effect

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Igne Sinkeviciute ◽  
Rune A. Kroken ◽  
Erik Johnsen
Keyword(s):  
Side Effects ◽  
Drug Use ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Illicit Drug ◽  
Principal Mechanism ◽  
Adrenergic Antagonists ◽  
Urological Emergency ◽  
Multiple Episodes ◽  
Acceptable Side

Priapism is a rare but important side effect of antipsychotic drugs which may evolve into a urological emergency. Most antipsychotic drugs are alpha-1 adrenergic antagonists, which is thought to be the principal mechanism involved in antipsychotic-induced priapism. Other aetiologies exist, however. A case is presented with multiple episodes of priapism during the use of several different antipsychotic drugs. The case is representative of many patients treated with antipsychotic drugs, as there were hyperprolactinemia, and illicit drug use, which are known causes of priapism. Moreover, the patient used combinations of antipsychotic drugs. The case thus illustrates the etiological complexity which could delay a diagnosis of antipsychotic-induced priapism, and the problem of establishing a link between priapism and one particular ingredient of a drug combination. The case presents how a treatment regimen was finally established balancing antipsychotic efficacy to acceptable side effects and offers guidance to physicians regarding how antipsychotic-induced priapism may be resolved.

scholarly journals Side Effect of Antipsychotic Drugs on the Gastrointestinal Tract: A Review of the Literature

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Digestive Tract ◽  
Medical Practice ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Review Of The Literature ◽  
Negative Side ◽  
Extensive Range ◽  
Negative Side Effects

The antipsychotic preparations which are widely used in medical practice possess an extensive range of the negative side effects including operating on organs of system of digestion. In the offered review influence of antipsychotics on a digestive tract is considered.

scholarly journals Side Effect of Antipsychotic Drugs on the Gastrointestinal Tract: A Review of the Literature

2020 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Digestive Tract ◽  
Medical Practice ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Review Of The Literature ◽  
Negative Side ◽  
Extensive Range ◽  
Negative Side Effects

The antipsychotic preparations which are widely used in medical practice possess an extensive range of the negative side effects including operating on organs of system of digestion. In the offered review influence of antipsychotics on a digestive tract is considered.

scholarly journals Pharmacogenetics and outcome with antipsychotic drugs

2014 ◽  
Vol 16 (4) ◽  
pp. 555-566 ◽  
Keyword(s):  
Side Effects ◽  
Antipsychotic Drugs ◽  
Genetic Factors ◽  
Standard Treatment ◽  
Interindividual Variability ◽  
Antipsychotic Treatment ◽  
Trial And Error ◽  
Treatment Regimens ◽  
Near Future ◽  
Selection Of

Antipsychotic medications are the gold-standard treatment for schizophrenia, and are often prescribed for other mental conditions. However, the efficacy and side-effect profiles of these drugs are heterogeneous, with large interindividual variability. As a result, treatment selection remains a largely trial-and-error process, with many failed treatment regimens endured before finding a tolerable balance between symptom management and side effects. Much of the interindividual variability in response and side effects is due to genetic factors (heritability, h(2)~ 0.60-0.80). Pharmacogenetics is an emerging field that holds the potential to facilitate the selection of the best medication for a particular patient, based on his or her genetic information. In this review we discuss the most promising genetic markers of antipsychotic treatment outcomes, and present current translational research efforts that aim to bring these pharmacogenetic findings to the clinic in the near future.

Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer’s Disease

2018 ◽  
Author(s):  
Adam P. Mecca ◽  
Rajesh R. Tampi
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Adverse Events ◽  
Atypical Antipsychotic ◽  
Clinical Case ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Multicenter Trial ◽  
Antipsychotic Treatment

This chapter provides a summary of the Clinical Antipsychotic Trials of Intervention Effectiveness—Alzheimer’s disease (CATIE-AD), a multicenter trial that investigated whether atypical antipsychotics are an effective treatment for psychosis, aggression, or agitation in outpatients with Alzheimer’s disease. The chapter briefly reviews the study design, as well as implications and limitations. A relevant clinical case concludes the chapter. In summary, atypical antipsychotic use for up to 36 weeks did not lead to clinical improvement based on time to discontinuation, or symptom reduction. Risk of discontinuation due to adverse events and side-effects with worse with antipsychotic treatment compared to placebo. In patients with psychosis, agitation, or aggression due to Alzheimer’s disease, the efficacy of atypical antipsychotics is questionable and their use comes with considerable risks of side effects and adverse events.

Extrapyramidal Syndromes and New Antipsychotic Drugs: Findings in Patients and Non-human Primate Models

1996 ◽  
Vol 168 (S29) ◽  
pp. 32-39 ◽  
Author(s):  
Daniel E. Casey
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antipsychotic Drugs ◽  
Side Effect Profile ◽  
Neuroleptic Drugs ◽  
Extrapyramidal Side Effects ◽  
Primary Mode ◽  
Neuroleptic Therapy ◽  
Extrapyramidal Syndromes ◽  
Human Primate

Since neuroleptic drugs were introduced in the 1950s they have become the primary mode of therapy for managing both acute and chronic psychoses. Although some antipsychotic drugs are free of disturbing extrapyramidal side-effects (EPS), most have a very narrow therapeutic/toxic index. Clozapine is the best example of an antipsychotic with a wide separation between antipsychotic actions and liability to EPS, but its side-effect profile of sedation, salivation, seizures, and agranulocytosis are factors that limit its use, and clearly indicate the need for further advancement in neuroleptic therapy.

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