Potential Antipsychotic Side Effects and Adverse Events of Assisted Living Residents With Dementia

This presentation provides the findings from a descriptive study examining the potential adverse events and side effects of antipsychotic medications prescribed to assisted living (AL) residents with dementia drawn from interviews with family members and chart review on 238 AL residents, from 91 AL communities in seven US states. We found that 85% of family reported that medication had been administered for agitation or aggression, 93% of the sample experienced at least one potential side effect, and 19% experienced five or more. The most common potential side effects were neurologic/psychological effects (89% of residents), and somnolence during the day (81%). Six percent of the sample experienced at least one potential adverse event. This work implies a need for caution when prescribing antipsychotics to older adults with dementia in AL. Medication management efforts should extend to monitoring AL residents for potential side effects and adverse events from specific psychoactive medications.

Profile of Leptin Levels in Schizophrenic patients Receiving Antipsychotic Therapy in Prof. Dr. HB Saanin Hospital Padang

<p class="Englishversionofabstract">Weight-gain is one of the antipsychotic side effects, and it can increase the risk factor of metabolic syndrome. Several studies relate it to increase leptin levels. This research was conducted to determine the profile of leptin levels in schizophrenic patients who were receiving antipsychotic therapy at Prof. DR. HB Saanin Mental Hospital. The research was conducted from November 2019 to January 2020 on schizophrenic patients who were taking antipsychotic drugs. This research was conducted on 50 samples by using consecutive sampling techniques. Data analysis using univariate are presented in geometric mean and CI 95%. Moreover, a Comparison of leptin levels between groups was performed by T-test and one-way ANOVA. The average leptin level from 50 samples of schizophrenic patients was 5.12µg/ml (CI 95%=3.32-7.90). The highest average leptin level is from the 46-55 year age group which is 11.32µg/ml (CI 95% =5.24 - 24.42), female is 13.29µg/ml (CI 95%=5.84-30.26), BMI ≥30kg/m2 is 12.84µg/ml (CI 95%=4.31-38.23), subjects with above-average waist circumference is 5.54µg/ml ( CI 95%=3.45-8.90), and the atypical group of drugs is 6.08µg/ml (IK 95%=3.41-10.84). Increasing levels of leptin occur in schizophrenic patients who were 46-55 y.o, female BMI ≥30kg/m2, above-average waist circumference, and receiving atypical antipsychotics.</p>

Identification of Antipsychotic Side Effects with Glassgow Antipsychotic Side-Effect Scale (GASS)

Schizophrenia is ranked 4th of the top 10 diseases that burden worldwide. If the population of Indonesia reaches 200 million, it estimates that around two million have Schizophrenia. Based on Data from the World Health Organization (WHO), it estimates that around 24 million people worldwide have schizophrenia.2 the American Psychiatric Association (APA) were reported the incidence of Schizophrenia in the United States is about 1% of the adult population with a total of more than 2 million people. Schizophrenic patients were treated by antipsychotic agents that act to inhibit dopamine receptors, especially D2, and also inhibit adrenergic acetylcholine receptors and serotonin 5-HT2A. It can manifest side effects like extrapyramidal syndrome, amenorrhea, drowsiness, and others. This research aims to the identification of antipsychotic side effects with Glasgow Antipsychotic Side-effect Scale (GASS). 100 schizophrenics in HB. Saanin Mental Hospital were participating in this descriptive study after fulfilling the criteria of inclusion and exclusion. This study used the GASS questionnaire to interview subjects who were signing informed consent and get an explanation about this study. In this study, 92% of subjects reported mild side effects. The frequent complaints were extrapyramidal effects, sedation and CNS effects, anticholinergic effects, and weight gain (93%,80%,70 0% and 70% respectively). We found women complained of the side effects more often (16.38 ± 5.275) than men (12.58 ± 5.484) significantly with the value P = 0.001. Gass instruments can use screening antipsychotic side effects. This study concludes the most side effects complaints being extrapyramidal and drowsiness, and women more commonly found side effects than men.

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

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.

Check the effects: systematic assessment of antipsychotic side-effects in an inpatient cohort

Background: Antipsychotics are associated with a range of side-effects that can influence patients’ subjective well-being negatively resulting in poor adherence. In order to limit the negative consequences of side-effects, they should be regularly systematically assessed. The aim of this study was to systematically assess antipsychotic side-effects in an inpatient cohort using validated rating scales. Methods: Eligible individuals prescribed an antipsychotic for at least 2 weeks were invited to have their side-effects assessed systematically. Results: A total of 208 individuals were assessed systematically for antipsychotic side-effects; 71.5% ( n = 138) stated that they had not reported side-effects to their clinician prior to the assessment. The most commonly reported side-effects were daytime drowsiness (75%), dry mouth (58.2%) and weight gain (50.0%), while the most distressing side-effects reported were erectile dysfunction (35.0%), sexual dysfunction (26.3%) and amenorrhoea (26.3%). There was no evidence of an association between side-effect severity/number of side-effects reported/distress caused by those taking high dose/combination antipsychotics versus standard dose monotherapy. Conclusion: Side-effects must be regularly and systematically assessed using a validated rating scale. As distress caused by side-effects plays a major role in non-adherence, assessment should examine distress and data on distressing side-effects should be available to those choosing an antipsychotic. Given the lack of correlation between high dose/combination antipsychotics and side-effects, treatment should be tailored to the individual based on response/tolerance and dose reduction/avoidance of polypharmacy should not be recommended to minimise side-effects.