PROSPECTIVE STUDY OF THE SIDE EFFECTS BETWEEN ATYPICAL–ATYPICAL ANTIPSYCHOTIC COMBINATIONS WITH TYPICAL-ATYPICAL ANTIPSYCHOTIC COMBINATIONS ON THE PSYCHOTIC DISORDERS INPATIENTS
Objective: Antipsychotic therapy is the main therapy in psychotic disorders. Antipsychotics use often causes various side effects, such as the orthostatic hypotension, weight gain, and waist circumference. The study objective is to prove these side effects on combination therapy of atypical-atypical and typical-atypical antipsychotics on the psychotic disorders in patients.
Methods: This study method is a prospective cohort applied to psychotic disorders inpatients. This study is composed of 2 different groups(n=16). Data analysis using Risk Relative Ratio for orthostatic hypotension study variables and statistical difference test with 95% confidence level for study variables of weight gain and waist circumference.
Results: The p value showed that there was no significant side effects of orthostatic hypotension (p>0.05). Relative Risk Ratio (RR) value explained that the atypical-atypical antipsychotic combination group had opportunity to cause orthostatic hypotension side effects by 2,000 times greater than the typical-atypical antipsychotic combination group at 0th week observation and 1,667 times greater than the typical-atypical antipsychotic combination group at 1st and 2nd week observations. Atypical-atypical antipsychotic combinations use and typical-atypical antipsychotic combinations use cause insignificant weight gain (p>0.05). Typical-atypical antipsychotic combination use in the 2nd week increases waist circumference greater than atypical-atypical antipsychotic combination use in the 2nd week (p<0.05).
Conclusion: Typical-atypical antipsychotic combinations use and atypical-atypical antipsychotic combination use did not cause significant on orthostatic hypotension and weight gain. Significant test results appear on the waist circumference increasing in the second week of typical-atypical antipsychotic combinations use when compared to atypical-atypical antipsychotic combinations use.
2. R Maslim. Pocket book diagnosis for mental disorders. Brief reference from practical guidelines for diagnosing mental disorders-III and the diagnostic and statistical manual of mental disorders (DSM–5); 2013.
3. Mueser KT, Jeste DV. Clinical handbook of schizophrenia; 2008.
4. Fidiansyah. The Role of the Family Supports Community Mental Health; 2016.
5. Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics differential risk and clinical implications. CNS Drugs 2007;21:911–36.
6. Gardner DM, Baldessarini RJ, Waraich P. Modern antipsychotic drugs: a critical overview; 2005. p. 172.
7. Keks NA. Are atypical antipsychotics advantageous? The case against. Aust Prescr 2004;27:149–51.
8. Lopuszanska U, Makara Studzinska M. Relationship between antipsychotic medication, obesity and cognitive functions. Curr Probl Psychiatry 2017;18:272–8.
9. Honer WG. Clozapine alone versus clozapine and risperidone with refractory schizophrenia. N Engl J Med 2006;354:472–82.
10. The consensus committee of the american autonomic society and the american academy of neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 1996;46:1470.
11. WHO. Physical Status: The Use and Interpretation of Anthropometry: Report of a World Health Organization (WHO) Expert Committee; 1995.
12. International Diabetes Federation. The IDF Consensus Worldwide Definition of the Metabolic Syndrom. IDF; 2006.
13. Labad X, Kulkarni J, Ochoa S, Usall J. Gender differences in schizophrenia and first-episode psychosis: a gender differences in schizophrenia and first-episode psychosis;?2012.
14. MD Yulianty, N Cahaya, VM Srikartika. Study of antipsychotic use and side effects in schizophrenia patients at sambang lihum mental hospital in south kalimantan. J Sains Farm Klin 2017;3:153.
15. Hafner H. Gender differences in schizophrenia. Psychoneuroendocrinology 2003;28:17–54.
16. Low PA, Tomalia VA. Orthostatic hypotension: mechanisms, causes, management. J Clin Neurol 2015;11:220–6.
17. Ricci F, Caterina R De, Fedorowski A. Orthostatic hypotension. J Am Coll Cardiol 2015;66:848–60.
18. Gupta V, Lipsitz LA. Orthostatic hypotension in the elderly: diagnosis and treatment. Am J Med 2007;120:841–7.
19. Krakowski M, Czobor P, Citrome L. Weight gain, metabolic parameters, and the impact of race in aggressive inpatients randomized to double-blind clozapine, olanzapine or haloperidol. Schizophr Res 2009;110:95–102.
20. Dayabandara M. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence. Neuropsychiatr Dis Treat 2017;13:2231–41.
21. Zhang J. Pharmacogenetic associations of antipsychotic drug-related weight gain: a systematic review and meta-analysis. Schizophr Bull 2016;42:1418–37.
22. Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician 2010;81:617–22.
23. Tek C. Antipsychotic-induced weight gain in first-episode psychosis patients: a meta-analysis of differential effects of antipsychotic medications. Early Interv Psychiatry 2016;10:193–202.
24. Vandenberghe F. Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment. J Clin Psychiatry 2015;76:1417–23.
25. Citrome L, McEvoy JP, Saklad SR. A guide to the management of clozapine-related tolerability and safety concerns. Clin Schizophr Relat Psychoses 2016;10:163-77.
26. Henderson DC. Waist circumference is the best anthropometric predictor for insulin resistance in nondiabetic patients with schizophrenia treated with clozapine but not olanzapine. Int J Psychiatry Clin Pract 2009;15:251–61.
27. Mulat E, Mossie A, Negash A, Ibrahim M. Effect of antipsychotic drugs on body composition in patients attending psychiatry clinic, jimma, Ethiopia. J Psychiatry 2017;20:1–7.
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