Antipsychotic Medication Induced Movement Disorders: The Case of Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia

Abstract

Background: Neuroleptic-induced movement disorders constitute a worldwide problem in the treatment of schizophrenia because of the limited affordability of atypical antipsychotic drugs. The observable features of acute Parkinsonism; such as limb stiffness and slowness of movement are a social and functional handicap. The same is true for the restless movements and agitation associated with acute akathisia. Tardive dyskinesia, on the other hand is a permanent condition that affects quality of life. However, very few studies have been conducted to estimate the prevalence of Neuroleptic-induced movement disorders and their associated factors among psychotic patients in Ethiopia. Thus the aim of this study was to determine the prevalence of conventional antipsychotic induced movement disorders and associated factors among psychotic patients treated at Amanuel mental specialized Hospital. Method: Hospital based cross-sectional study was conducted by using established clinical rating scales to identify cases of conventional antipsychotic-induced movement disorders in Amanuel mental specialized Hospital on a sample of 377 psychotic outpatients. Systematic random sampling method was employed to select subjects. Logistic regression was used for comparison of the subjects with and without Neuroleptic-induced movement disorders. Results: the prevalence of Neuroleptic-induced movement disorders, namely; neuroleptic-induced Parkinsonism, neuroleptic-induced Akathisia and neuroleptic-induced tardive dyskinesia were found to be 46.4%, 28.6% and 11.9% respectively. Khat (Catha Edulis) use, AOR=1.93, 95%CI: 1.01-3.66, was factors remained to be associated with the presence of NIA. Alcohol use, AOR = 3.25, 95%CI: 1.04-10.16, was associated with TD. Being on chlorpromazine equivalent dose range of >=400mg/day, AOR =4.32, 95%CI: 2.25-8.30, AOR = 3.677, 95%CI: 1.807-7.482, AOR=4.157, 95%CI: 1.165-14.834 were associated with Parkinsonism, Akathisia and TD respectively. Conclusions and Recommendation: Considerable number of patients with psychotic disorders suffered from a conventional antipsychotic -induced movement disorder. Khat, alcohol and high dose of drugs were found to be associated with conventional antipsychotic Induced movement disorders. Designing treatment guideline, increasing availability of drugs with minimal side effects and psycho-education for patients and their family is essential to reduce these devastating side effects.