Adverse Effects Of Antipsychotic Drugs Research Articles

Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles

Autonomic adverse effects of antipsychotic drugs (APs) cause clinical challenges, but few studies have investigated sex differences and their underlying biological pathways. Sex-specific regulation of relevant hormones could be involved. We investigated sex differences in autonomic adverse effects related to olanzapine, quetiapine, risperidone, and aripiprazole, and the role of hormones related to APs. Patients with severe mental disorders (N = 1318) were included and grouped based on AP monotherapy: olanzapine (N = 364), quetiapine (N = 211), risperidone (N = 102), aripiprazole (N = 138), and no AP (N = 503). Autonomic symptoms from the Udvalg for Kliniske Undersøgelser (UKU) side effect scale was analyzed with logistic regression, adjusting for age, diagnosis, and polypharmacy. Further, we analyzed associations between autonomic symptoms and hormones related to APs. We found associations between autonomic adverse effects and APs, with sex-specific risk for palpitations/tachycardia associated with hormonal changes related to APs. Results showed increased salivation associated with aripiprazole, reduced salivation with quetiapine, and nausea/vomiting and palpitations/tachycardia with olanzapine, and higher risk of nausea/vomiting, diarrhea, constipation, polyuria/polydipsia, and palpitations/tachycardia in females. Significant sex x AP interaction was found for palpitations/tachycardia, with higher risk in risperidone-treated males, which was associated with different hormone profiles of prolactin, cortisol, and insulin. Our findings implicate a role of several hormones in the sex-specific autonomic adverse effects related to APs.

Adverse Effects of Antipsychotic Drugs - A Review

Antipsychotic drugs which are also known as Neuroleptics are group of psychotropic drugs or psychopharmacological agents1 that are primarily used to manage psychoses including delusions, hallucinations, paranoia, or disordered thought. Besides their antipsychotic action, they had been reported to have some adverse effects which can be seen in Cardiovascular system, Metabolic system, Skeletal and Muscular system, Cognitive and Emotional side effects, and Sexual dysfunction. These adverse effects were mainly observed when they used for longer duration or taken in larger doses or with sudden change in their dose. Keywords: Antipsychotic drugs, Adverse events, Side effects, Extrapyramidal symptoms

Factors associated with increased risk of lurasidone-induced somnolence: Two case-control studies based on one bioequivalence trial in healthy volunteers

Somnolence is a common adverse effect of antipsychotic drugs used to treat psychotic disorders. It causes problems in many areas of life, such as gainful employment, driving, childcare, and social interactions. Somnolence is a major problem for a relatively new antipsychotic drug, lurasidone, whose dose-effect relationship remains unclear. Based on data from a bioequivalence study of two 40 mg lurasidone hydrochloride tablets, we designed two case-control studies to explore the correlation between somnolence and exposure to lurasidone and determine the factors associated with lurasidone-induced somnolence. In the first case-control study, lurasidone was administered to healthy volunteers; 30 experienced somnolence (as pre-defined) but 29 did not. Moreover, plasma concentration at 1 h was significantly associated with somnolence (OR = 1.124; p = 0.001). In the second case-control study, 48 volunteers administered lurasidone were classified into somnolence and no-somnolence groups based on different time-related criteria. We observed a positive association between plasma concentration at 0.75 h and somnolence (OR = 1.024; p = 0.002). Receiver operating characteristic analysis revealed that a plasma lurasidone concentration >21.65 ng/mL 1 h after administration strongly predicted somnolence. Our findings in healthy volunteers need to be further validated in patients in clinical settings to determine the optimal dose and duration of lurasidone administration.

Incidence of agranulocytosis adverse effect of antipsychotic drugs in patients with schizophrenia

Incidence of agranulocytosis adverse effect of antipsychotic drugs in patients with schizophrenia

Quetiapine induced ischemic colitis: about two cases

IntroductionDue to its anticholinergic action, antipsychotic drugs, especially phenothiazines and atypical antipsychotics, have been described as a rare cause of drug-induced ischemic colitis. We present two cases of patients that were admitted to the gastroenterology unit of a general hospital and were diagnosed of quetiapine-induced ischemic colitis.ObjectivesTo describe an uncommon side effect of neuroleptic treatment.MethodsCase report and literature review.ResultsFirst patient, aged 73, with history of dysthymia, in treatment with desvenlafaxine, quetiapine, ketazolam, lorazepam, enalapril/hidroclorothiazide, omeprazole, simvastatin, tramadol/paracetamol, alendronate/colecalciferol and hidroferol, consulted in the emergency room for malaise, disorientation, haematuria, abdominal pain and changes in deposition rhythm; family members admitted frequent use of higher than prescribed doses of quetiapine and benzodiazepines. Second patient, aged 63, with history of histrionic personality disorder, in psychopharmacologic treatment with venlafaxine, quetiapine, diazepam, fentanyl, rupatadine, cinitapride, omeprazole, levosulpiride, simvastatin, fluticasone/salmeterol and celecoxib, consulted for abdominal pain and bloody diarrhoea. Colonoscopy findings in both of them were compatible with ischemic colitis. Quetiapine was withdrawn in both cases, as the main diagnostic hypothesis was quetiapine-induced ischemic colitis. The patients achieved full recovery.ConclusionsIschemic colitis is a rare but potentially fatal adverse effect of antipsychotic drugs, with clozapine being the most reported atypical antipsychotic thought to cause it. The risk associated with quetiapine is thought to be lower given its milder anticholinergic effect. Co-prescription with other drugs with anticholinergic actions increases the risk. Clinicians should be aware of this association and the onset of constipation should alert medical staff.DisclosureNo significant relationships.

Association between the glyco-metabolic adverse effects of antipsychotic drugs and their chemical and pharmacological profile: a network meta-analysis and regression.

Glyco-metabolic deteriorations are the most limiting adverse reactions to antipsychotics in the long term. They have been incompletely investigated and the properties of antipsychotics that determine their magnitude are not clarified.To rank antipsychotics by the magnitude of glyco-metabolic alterations and to associate it to their pharmacological and chemical properties, we conducted a network meta-analysis. We searched PubMed, Embase, and Psycinfo on 10 September 2020. We selected studies containing the endpoint-baseline difference or the distinct values of at least one outcome among glucose, HbA1c, insulin, HOMA-IR, triglycerides, total/HDL/LDL cholesterols. Of 2094 articles, 46 were included in network meta-analysis. Study quality was assessed by the RoB 2 and ROBINS-I tools. Mean differences (MD) were obtained by random-effects network meta-analysis; relations between MD and antipsychotic properties were analyzed by linear regressions. Antipsychotic properties investigated were acidic and basic pKa, polar surface area, polarizability, and occupancies of D2, H1, M1, M3, α1A, α2A, 5-HT1A, 5-HT2A, 5-HT2C receptors. We meta-analyzed 46 studies (11 464 patients); on average, studies lasted 15.47 weeks, patients had between 17.68 and 61.06 years of mean age and 61.64% were males. Olanzapine and clozapine associated with greater deteriorations, aripiprazole and ziprasidone with smaller deteriorations. Higher polarizability and 5-HT1A receptor occupancy were associated with smaller deteriorations, H1, M1, and M3 receptor occupancies with larger deteriorations. Drug rankings may guide antipsychotic switching toward metabolically safer drugs. Mechanistic insights may suggest improvements for combination therapies and drug development. More data are required regarding newer antipsychotics.

Maintenance treatment with antipsychotic drugs for schizophrenia.

The symptoms and signs of schizophrenia have been linked to high levels of dopamine in specific areas of the brain (limbic system). Antipsychotic drugs block the transmission of dopamine in the brain and reduce the acute symptoms of the disorder. An original version of the current review, published in 2012, examined whether antipsychotic drugs are also effective for relapse prevention. This is the updated version of the aforesaid review. To review the effects of maintaining antipsychotic drugs for people with schizophrenia compared to withdrawing these agents. We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials including the registries of clinical trials (12 November 2008, 10 October 2017, 3 July 2018, 11 September 2019). We included all randomised trials comparing maintenance treatment with antipsychotic drugs and placebo for people with schizophrenia or schizophrenia-like psychoses. We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CIs) on an intention-to-treat basis based on a random-effects model. For continuous data, we calculated mean differences (MD) or standardised mean differences (SMD), again based on a random-effects model. The review currently includes 75 randomised controlled trials (RCTs) involving 9145 participants comparing antipsychotic medication with placebo. The trials were published from 1959 to 2017 and their size ranged between 14 and 420 participants. In many studies the methods of randomisation, allocation and blinding were poorly reported. However, restricting the analysis to studies at low risk of bias gave similar results. Although this and other potential sources of bias limited the overall quality, the efficacy of antipsychotic drugs for maintenance treatment in schizophrenia was clear. Antipsychotic drugs were more effective than placebo in preventing relapse at seven to 12 months (primary outcome; drug 24% versus placebo 61%, 30 RCTs, n = 4249, RR 0.38, 95% CI 0.32 to 0.45, number needed to treat for an additional beneficial outcome (NNTB) 3, 95% CI 2 to 3; high-certainty evidence). Hospitalisation was also reduced, however, the baseline risk was lower (drug 7% versus placebo 18%, 21 RCTs, n = 3558, RR 0.43, 95% CI 0.32 to 0.57, NNTB 8, 95% CI 6 to 14; high-certainty evidence). More participants in the placebo group than in the antipsychotic drug group left the studies early due to any reason (at seven to 12 months: drug 36% versus placebo 62%, 24 RCTs, n = 3951, RR 0.56, 95% CI 0.48 to 0.65, NNTB 4, 95% CI 3 to 5; high-certainty evidence) and due to inefficacy of treatment (at seven to 12 months: drug 18% versus placebo 46%, 24 RCTs, n = 3951, RR 0.37, 95% CI 0.31 to 0.44, NNTB 3, 95% CI 3 to 4). Quality of life might be better in drug-treated participants (7 RCTs, n = 1573 SMD -0.32, 95% CI to -0.57 to -0.07; low-certainty evidence); probably the same for social functioning (15 RCTs, n = 3588, SMD -0.43, 95% CI -0.53 to -0.34; moderate-certainty evidence). Underpowered data revealed no evidence of a difference between groups for the outcome 'Death due to suicide' (drug 0.04% versus placebo 0.1%, 19 RCTs, n = 4634, RR 0.60, 95% CI 0.12 to 2.97,low-certainty evidence) and for the number of participants in employment (at 9 to 15 months, drug 39% versus placebo 34%, 3 RCTs, n = 593, RR 1.08, 95% CI 0.82 to 1.41, low certainty evidence). Antipsychotic drugs (as a group and irrespective of duration) were associated with more participants experiencing movement disorders (e.g. at least one movement disorder: drug 14% versus placebo 8%, 29 RCTs, n = 5276, RR 1.52, 95% CI 1.25 to 1.85, number needed to treat for an additional harmful outcome (NNTH) 20, 95% CI 14 to 50), sedation (drug 8% versus placebo 5%, 18 RCTs, n = 4078, RR 1.52, 95% CI 1.24 to 1.86, NNTH 50, 95% CI not significant), and weight gain (drug 9% versus placebo 6%, 19 RCTs, n = 4767, RR 1.69, 95% CI 1.21 to 2.35, NNTH 25, 95% CI 20 to 50). For people with schizophrenia, the evidence suggests that maintenance on antipsychotic drugs prevents relapse to a much greater extent than placebo for approximately up to two years of follow-up. This effect must be weighed against the adverse effects of antipsychotic drugs. Future studies should better clarify the long-term morbidity and mortality associated with these drugs.

Pisa syndrome induced by switching of a choline-esterase inhibitor treatment from donepezil to galantamine: a case report

BackgroundPisa syndrome (PS) is characterized by an abnormally sustained posture, with flexion of the body and head to one side and slight rotation of the trunk. Although PS most commonly arises as an adverse effect of antipsychotic drugs, choline-esterase inhibitors (ChEIs) are also sometimes known to induce PS. Despite the fact that the precise mechanism remains unclear, cholinergic-dopaminergic imbalance has been considered as a possible pathophysiologic mechanism underlying the genesis of PS.Case presentationWe hereby report the case of a 60-year-old woman with Alzheimer’s disease who presented with the signs of PS after her treatment was switched to galantamine, a type of ChEI, even though she had received donepezil, another type of ChEI, for 5 years without any complications. To the best of our knowledge, this is the first report of PS associated with treatment switch from one to another type of ChEI. Galantamine, but not other ChEIs, can enhance striatal dopamine release through allosteric modulation of the nicotinic acetylcholine receptor, and has weaker muscarinic effects than donepezil. Therefore, we propose two novel hypotheses to explain the development of PS, as follows; galantamine, which enhances dopamine release, can induce imbalance of dopamine levels in the striatum of patients with dementia, resulting in PS, and the weaker muscarinic effects of the drug could be one of the factors predisposing to the development of PS.ConclusionThe present case suggests that treatment with galantamine is associated with a higher risk of development of PS than that with other ChEIs, such as donepezil, despite the pharmacological profile of galantamine as a dopamine modulator. Also, this report provides novel insight into another plausible mechanism underlying the development of PS, besides cholinergic-dopaminergic imbalance, namely, dopamine imbalance in the striatum with muscarinic-nicotinic imbalance.

Association between 8 P-glycoprotein (MDR1/ABCB1) gene polymorphisms and antipsychotic drug-induced hyperprolactinaemia.

IntroductionHyperprolactinaemia, a common adverse effect of antipsychotic drugs, is primarily linked to blockade of dopamine D2 receptors in the pituitary gland. Certain antipsychotic drugs, such as, for example risperidone and paliperidone, are more likely to induce hyperprolactinaemia compared to others. This effect is probably caused by a relatively high blood/brain concentration ratio, a consequence of being a substrate of P‐glycoprotein. Genetic variants of P‐glycoprotein with changed functional activity might influence the potential of risperidone and paliperidone to cause hyperprolactinaemia as the altered blood/brain concentration ratio would lead to a reduced therapeutic drug level within essential brain areas making dose adaptations necessary. This increases exposure of dopamine D2 receptors within the pituitary gland.AimsTo investigate possible associations between MDR1/ABCB1 gene polymorphisms and antipsychotic drug‐induced hyperprolactinaemia in Russian patients with schizophrenia and to determine possible differences between risperidone/paliperidone and other antipsychotics.MethodsIn total, 446 patients with schizophrenia were included from 3 psychiatric hospitals in Siberia. Blood samples were obtained in a cross‐sectional study design for DNA extraction and prolactin measurement. Associations between hyperprolactinaemia and 8 MDR1/ABCB1 gene‐polymorphisms were assessed using logistic regression analysis accounting for covariates. The analysis was repeated in a patient subgroup using risperidone or paliperidone.ResultsWe did not observe an association between any of the 8 single nucleotide polymorphisms and the prevalence of antipsychotic‐induced hyperprolactinaemia in the total patient population. However, in the risperidone/paliperidone subgroup, the single nucleotide polymorphism rs2032582 (G2677T) was found to be negatively associated with risperidone/paliperidone‐induced hyperprolactinaemia.ConclusionThis study revealed a significant association between the ABCB1 gene polymorphism rs2032582 (G2677T) and risperidone/paliperidone‐induced hyperprolactinaemia.

Antipsychotic Drugs in People with Psychotic Depression: The Good and the Bad

Data on adverse effects of antipsychotic drugs on brain structure are conflicting. To address this issue, investigators examined MRI data from a

Neutropenia in patients treated with antipsychotic drugs.

Neutropenia and agranulocytosis are among the most serious and feared adverse effects of antipsychotic drugs. In affected patients there is a risk of both infection and exacerbation of the underlying psychotic disorder, because neutropenia and agranulocytosis often require discontinuation of the antipsychotic drug therapy. The cause is most likely multifactorial. Whenever patients treated with antipsychotic drugs experience fever or other symptoms of infection, neutropenia should be considered as a differential diagnosis.

Assess the Effectiveness of Self-Instructional Module on Knowledge regarding Adverse Effects of Antipsychotic Drugs among Care Takers of Mentally Ill Patients

Assess the Effectiveness of Self-Instructional Module on Knowledge regarding Adverse Effects of Antipsychotic Drugs among Care Takers of Mentally Ill Patients

Subjective well-being, drug attitude, and changes in symptomatology in chronic schizophrenia patients starting treatment with new-generation antipsychotic medication

BackgroundNon-adherence to medication remains a major challenge in the long-term management of patients with schizophrenia. Next to lack of insight into the illness, adverse effects of antipsychotic drugs, cognitive deficits, poor therapeutic alliance, reduced quality of life, missing social support, and negative attitudes toward medication are predictors of non-adherence. This study examined potential correlations between attitudes toward antipsychotic drug therapy, subjective well-being, and symptom change in patients with chronic schizophrenia.Methods30 patients with schizophrenia starting monotherapy with a new-generation antipsychotic were included into the study. The Drug Attitude Inventory (DAI) and the Subjective Well-being under Neuroleptic Treatment Scale, short form (SWN-K), were administered after 2, 4, and 12 weeks of treatment. At the same points in time and at baseline, psychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale (PANSS), and functioning was assessed by means of the Global Assessment of Functioning Scale (GAF). Antipsychotic induced side effects were evaluated by using the Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale.ResultsStudy participants had a mean age of 37.5 ± 9.7 years, baseline symptoms were mild. The PANSS total score improved significantly from baseline to weeks 4 (p = .003) and 12 (p = .001), respectively. Neither the DAI total score nor the SWN-K total score changed significantly over the course of time. The severity of symptoms was not correlated with drug attitude at any time point but was negatively correlated with wellbeing at weeks 2 (r = −.419, p = .021) and 4 (r = −.441, p = .015). There was no significant correlation between DAI and SWN-K total scores at any time point.ConclusionsNext to showing that the DAI and the SWN-K measure different aspects of subjective experiences during antipsychotic treatment these findings emphasize the use of both instruments to optimize adherence to medication.

Audit clinique ciblé des prescriptions d’anticholinergiques correcteurs des troubles neurologiques lors d’un traitement antipsychotique

Antiparkinson medications are recommended as a second-line treatment of the adverse effects of antipsychotic drugs. They are often associated with anticholinergic side effects that can negatively influence observance. In an evaluation of professional practices (EPP), a targeted clinical audit was performed with the theme « the prescription of anticholinergic treatments in the management of neurological adverse effects associated with antipsychotic drugs ». A retrospective audit of the clinical files of hospitalized patients treated with anticholinergics was performed using HAS (Haute Autorité de santé) methodology. Seven evaluation criteria were defined based on existing references. An analysis of the conformity of these criteria suggested three areas of improvement: decrease in the number of anticholinergic prescriptions, optimizing systematic prescriptions, reducing the delay to prescription reevaluation. Actions were taken to communicate with prescribers via a group EPP and pharmaceutical interventions. A second audit was performed to evaluate the changes in professional practices. A decrease in the number of anticholinergic prescriptions was observed from 226 to 174. Anticholinergics were prescribed with a greater number of antipsychotics during the second audit and with higher doses of antipsychotics. In case of association with antipsychotic monotherapy, the proportion of neuroleptics increased from 9% to 13% while with atypical antipsychotics (with fewer adverse effects) it decreased from 19% to 15%. The delay to the re-evaluation of treatments decreased. On the other hand, one third of the prescriptions in full hospitalizations were not re-evaluated every trimester (up to 85 months of delay). This study made it possible to decrease the number of anticholinergic prescriptions. The use of anticholinergics is in conformity with guidelines (situations with a risk of adverse effects). On the other hand, the proportion of anticholinergics is above the expected rate (20%). The re-evaluation procedure for certain prescriptions is insufficient. More work must be performed with prescribers on these subjects.

Schizophrenia and type 2 diabetes mellitus.

Schizophrenia is associated with increased risk for type 2 diabetes mellitus, resulting in elevated cardiovascular risk and limited life expectancy, translated into a weighted average of 14.5 years of potential life lost and an overall weighted average life expectancy of 64.7 years. The exact prevalence of type 2 diabetes among people with schizophrenia varies across studies and ranges 2-5fold higher than in the general population, whereas the aetiology is complex and multifactorial. Besides common diabetogenic factors, applied similarly in the general population, such as obesity, hyperlipidemia, smoking, hypertension, poor diet and limited physical activity, the co-occurrence of schizophrenia and diabetes is also attributed to unique conditions. Specifically, excessive sedentary lifestyle, social determinants, adverse effects of antipsychotic drugs and limited access to medical care are considered aggravating factors for diabetes onset and low quality of diabetes management. Schizophrenia itself is further proposed as causal factor for diabetes, given the observed higher prevalence of diabetes in young patients, newly diagnosed with schizophrenia and unexposed to antipsychotics. Furthermore, studies support genetic predisposition to diabetes among people with schizophrenia, suggesting shared genetic risk and disclosing a number of overlapped risk loci. Therefore, special attention should be paid in preventing diabetes in people with schizophrenia, through intervention in all possible modifiable risk factors. Implementation of careful antipsychotic prescription, provision of adequate motivation for balanced diet and physical activity and facilitating access to primary health care, could serve in reducing diabetes prevalence. On the other hand, increasing calls are made for early diagnosis of diabetes, application of the appropriate anti-diabetic therapy and strict inspection of therapy adherence, to limit the excess mortality due to cardiovascular events in people with schizophrenia. Moreover, population health programs could help counseling and preventing diabetes risk, additionally to early screening and diagnosis set, aiming to reduce disparities in populations. Finally, mental health-care providers might greatly promote offered health services to patients with schizophrenia, through a holistic individualized approach, considering additionally the physical health of the patients and working closely, preventively and therapeutically, in collaboration with the physicians and diabetologists.

Effect of Vitamin B6 Versus Propranolol on Antipsychotic-Induced Akathisia: A pilot Comparative Double-blind Study.

Akathisia is a common adverse effect of antipsychotic drugs and is characterized by subjective feelings of restlessness. First-line treatment usually consists of propranolol, a beta adrenergic antagonist. However, propranolol does not seem to be efficacious in up to 70% of patients. This study was aimed to evaluate the effect of vitamin B6 versus propranolol on antipsychotic-induced akathisia (AIA). This study was a comparative, double-blind, randomized trial. In the present study, 66 adult patients with antipsychotic-induced akathisia were enrolled and randomized into three groups, and received vitamin B6 300 mg/12 h or 600 mg/12 h or propranolol 20 mg/12 h. The diagnosis of AIA was made by clinical examination and its severity was assessed by the Barnes Akathisia Rating Scale. Fifty one patients completed 5 days of the trial. The results showed that there was no significant difference in BARS score among the different groups which means that vitamin B6 attenuated the AIA similar to propranolol. However, there wasn't any significant difference between high or low dose of vitamin B6. In conclusion, the results of this trial suggest that vitamin B6 may be beneficial for ameliorating of antipsychotic-induced akathisia.

To assess the effectiveness of Self Instructional Module (SIM) on knowledge regarding life style modification among Myocardial Infarction patients admitted in selected hospitals in Vidarbha Region

To assess the effectiveness of Self Instructional Module (SIM) on knowledge regarding life style modification among myocardial infarction patients admitted in selected hospitals in Vidarbha region. The objectives of the study were to assess the knowledge regarding life style modification among myocardial infarction patients, to evaluate the effectiveness of Self Instructional Module on knowledge regarding life style modification among myocardial infarction patients, to associate post-test knowledge regarding life style modification among myocardial infarction patients with selected demographic variables. This study was based on interventional research approach. The population was myocardial infarction patients. The subjects consisted of 60 myocardial infarction patients in selected hospitals of Vidarbha region. The inclusion criteria were: Patients who are: (A) Willing to participate in the study, (B) Available during data collection, (C) Able to read and understand Hindi & Marathi. The exclusion criteria were: (A) Patients who have attended the similar programme, (B) Patients who were medical persons like, doctor, nurse.. The tool was self-structured knowledge questionnaire. The technique adopted was self-reporting. The content validity of the tool was done by 12experts. The reliability of the questionnaire was done by Spearman Brown Coefficient method. The pilot study was conducted in Wardha from 14th Aug. to 20th Aug. 2012 as per laid down criteria 6 subjects were selected from Pawde Nursing Home, Wardha for pilot study from non-probability convenient sampling technique. The data gathering process began from 17th Sept. to 13th Oct 2012. The investigator visited the selected hospitals of Vidarbha region in advance and obtained the necessary permission from the concerned authorities. Based on the objectives and the hypothesis the data were analyzed by using various statistical tests i.e. percentage, mean, and standard deviation, student’ t’ test, One way analysis of variance (ANOVA). The level of significance set for testing the hypothesis was at 0.05. Majority of the subjects: 38.4% were from age group of 35–45 years, 53.3% were male.41.7% of the subject were secondary and graduates, 38.3% of subjects were doing the government job, 53.3% were Hindu. The findings show that in pre test scores, 63.4% of subjects were having average knowledge, 33.3% having poor knowledge and 3.3% subjects having very knowledge. But in post test scores 61.67% of subjects were having good knowledge, 38.33% having excellent knowledge. The findings show that the tabulated ‘t’ value for n-1, i.e.59 degrees of freedom was 2.00. The calculated values were 27.69 respectively for knowledge regarding adverse effects of antipsychotic drugs. The calculated ‘t’ values were much higher than the tabulated values at 5% level of significance which is statistically acceptable level of significance. Hence it is strongly interpreted that the self-instructional module regarding life style modification was effective. Thus, the H1 is accepted. There was no significant association between age, gender, education, occupation and religion. The self-instructional module significantly brought out their improvement in the knowledge regarding life style modification among myocardial infarction patients admitted in selected hospital in Vidarbha region. Analysis of data showed that there was significant difference between pretest and posttest knowledge

Reducing Metabolic Adverse Effects of Antipsychotic Drugs: A New Approach

People with schizophrenia are vulnerable to metabolic disorders. Glucagon-like peptide-1 (GLP-1) receptor agonists, a new class of agents used to treat

Antipsychotic Drugs and Cardiac Arrest in Outpatients

To address concerns about adverse effects of antipsychotic drugs (e.g., NEJM JW Psychiatry Sep 29 2008), these researchers correlated 10 years of

Reducing the use of antipsychotics in dementia care through staff education and family participation

Background: The widespread use of antipsychotic medication to treat the behavioural and psychological symptoms of dementia in residential aged care facilities is a world wide concern. Despite evidence of the numerous adverse effects of antipsychotic drugs, and the efficacy of non-pharmacological approaches, prescription rates are increasing in aged care. Methods: This controlled before and after study aimed to investigate if an education intervention with family participation in dementia care improved the use of antipsychotic drugs. Antipsychotic use was measured by audit of residents’ clinical records. Three similar rural residential aged care facilities (RACF’s) participated in the study. At site 1 and 2 staff undertook training in dementia care using an on-line learning tool and peer reviewed literature on the use of antipsychotic drugs in dementia. Additionally, family members participated in ‘resident life story telling’ at site 2. Site 3 acted as the control. Results: At sites 1 and 2, twenty five staff (25%) volunteered to participate in training. No training was provided at the control site. Across the three sites 47 residents had a clinical diagnosis of dementia with 30 of this group prescribed antipsychotic medication at baseline. At the intervention sites the use of antipsychotic medication reduced from 85% to 69% at site 1 and from 50% to 38% at site 2. At the control site medication use increased from 61% from 69%. Conclusion: Dementia education for staff, especially with family participation in resident life story telling, may reduce antipsychotic medication use in residential aged care. Additionally, positive clinical implications such as reduction in falls were observed. The encouraging findings of this small study support further investigation in a larger sample.