Publication:

Safety and treatment adherence of commonly prescribed typical and atypical antipsychotics in schizophrenic patients in a tertiary care hospital

Background Schizophrenia is a chronic mental disorder characterized by delusions, hallucinations, incoherence and physical agitation. Presently available drugs in the treatment of Schizophrenia are typical and atypical antipsychotics which act on various neurotransmitters like Dopamine, Serotonin and Acetylcholine. Though both classes of drugs are effective in treatment, they differ in tolerability and treatment adherence. Hence present study has been taken to compare safety and treatment adherence of typical and atypical antipsychotics.

Methods It was a comparative study conducted on 90 patients of Schizophrenia for one year. The study subjects were randomly assigned into 3 groups of 30 patients each. Group 1 were treated with Risperidone, group 2 with Olanzapineand and group 3 with Haloperidol. Safety was measured by Abnormal involuntary movement scale, Barnes akathisia scale, Simpson angus scale and pattern of adverse effects in each group. Treatment adherence was measured by number of dropout subjects and pill count.

Results Barnes akathisia scale and Simpson angus scale showed one point improvement in Risperidone and Olanzapine group where as one point worsening in haloperidol group. Abnormal involuntary movement scale showed low scores in haloperidol group. Extra Pyramidal symptoms were more common adverse effect in Haloperidol group where as weight gain in Olanzapine and Risperidone group. Pill count was more in Olanzapine group than Risperidone and Haloperidol group.

Conclusions The adverse effect like extrapyramidal symptoms is more common among haloperidol. Weight gain was common in olanzapine treated patients than Risperidone treated patients but treatment adherence was better in Olanzapine treated patients.