Cross-sectional examination of extrapyramidal side effects in a specialist palliative care inpatient unit

O'Brien, Hannah; Kiely, Fiona; Barry, Aileen; Meaney, Sarah

doi:10.1136/bmjspcare-2018-001504

Cited by 2 publications

(1 citation statement)

References 8 publications

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“… 30 This trend may result from consideration for a synergistic effect of antipsychotics in the treatment of MDD, 31 but the combined pharmacotherapy also increases the risk of side effects caused by psychotropic medications. 32 Drug–drug interactions and clinical considerations should be adequately integrated to construct a co-administration of medical therapy. 33 , 34 For the reason above, the antipsychotics (except for quetiapine) and mood stabilizers are inconsistent with the CANMAT guideline.…”

Section: Discussionmentioning

confidence: 99%

Clinical Guideline (CANMAT 2016) Discordance of Medications for Patients with Major Depressive Disorder in China

Zhu¹,

Wu²,

Zhao³

et al. 2023

NDT

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Objective This survey aims to explore the current medical treatment of major depressive disorder (MDD) in China and match its degree with Canadian Network for Mood and Anxiety Treatments (CANMAT). Methods A total of 3275 patients were recruited from 16 mental health centers and 16 general hospitals in China. Descriptive statistics presented the total number and percentage of drugs, as well as all kinds of treatments. Results Selective serotonin reuptake inhibitors (SSRIs) accounted for the largest proportion (57.2%), followed by serotonin-noradrenaline reuptake inhibitors (SNRIs) (22.8%) and mirtazapine (7.0%) in the first therapy, while that of SNRIs (53.9%) followed by SSRIs (39.2%) and mirtazapine (9.8%) in the follow-up therapy. An average of 1.85 medications was administered to each MDD patient. Conclusion SSRIs were the first choice in the first therapy, while the proportion of those drugs decreased during the follow-up therapy and were replaced by SNRIs. Plenty of combined pharmacotherapies were directly selected as the first trial of patients, which was inconsistent with guideline recommendations.

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Section: Discussionmentioning

confidence: 99%

Clinical Guideline (CANMAT 2016) Discordance of Medications for Patients with Major Depressive Disorder in China

Zhu¹,

Wu²,

Zhao³

et al. 2023

NDT

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Case Series of Akathisia in Palliative Medicine: Patient Perspective and Efficacy of Procyclidine in Diagnosis and Management

Murphy,

Maher,

Kennedy

et al. 2024

Am J Hosp Palliat Care

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Aims Akathisia is a disturbing, reversible but under-diagnosed extrapyramidal side effect of medications used in palliative medicine. We assessed patients’ subjective experience of akathisia and response to procyclidine, an anticholinergic used to treat extrapyramidal effects. We also aimed to discuss future areas of research and alternatives to akathisia-causing medications. Methods Suitable patients were retrospectively identified by palliative medicine physicians in a tertiary hospital and a chart review was undertaken. Information gathered included the account of their experience of akathisia, use of inciting medications, treatment, and outcome. Results 20 patients were identified, 12 females, 8 males. Mean number of days on the inciting drug(s) to onset of akathisia symptoms was 18.1. Mean number of days from commencing inciting drug(s) to diagnosis was 20.9. Patients’ descriptions revealed similarities including feeling “locked in” and a need to constantly move. One patient described a “glass coffin” enclosing her. 16 patients had full response to treatment with procyclidine, 3 had partial response requiring up-titration of dosing, response was not documented in 1. Conclusions Akathisia is an elusive symptom that can have dramatic reversibility when treated. Lack of recognition causes unnecessary patient suffering. Procyclidine appears to aid diagnosis and be an effective treatment. Protocols to reduce incidence and guide diagnosis and management are proposed. Further studies are required, in which subjective outcome measures are used and medications to treat akathisia are studied. Recognition remains challenging, causing significant distress for palliative patients, for whom quality of life is paramount.

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Cross-sectional examination of extrapyramidal side effects in a specialist palliative care inpatient unit

Cited by 2 publications

References 8 publications

Clinical Guideline (CANMAT 2016) Discordance of Medications for Patients with Major Depressive Disorder in China

Clinical Guideline (CANMAT 2016) Discordance of Medications for Patients with Major Depressive Disorder in China

Case Series of Akathisia in Palliative Medicine: Patient Perspective and Efficacy of Procyclidine in Diagnosis and Management

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