Prevalence and Correlates of Extrapyramidal Side Effects Among Patients with Schizophrenia Spectrum Disorders on Typical and Atypical Antipsychotics

Abstract

Background: Antipsychotic medication for the treatment of schizophrenia spectrum disorders are associated with adverse effects with extrapyramidal side effects constituting one of the most notable effects associated with poor medication adherence and poor quality of life. Aims: The study aims to compare the prevalence of extrapyramidal side effects (EPSE), among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine the association of extra-pyramidal side effects with socio-clinical variables. Methodology: A cross-sectional hospital-based study with systematic random sampling recruitment of 340 participants and 303 completed the study. Variables with significant association on chi square analysis were subjected to logistic regression analysis. Results: The overall prevalence of extrapyramidal side effects among patients with schizophrenia spectrum disorder on antipsychotic medication was 42.6 %. The prevalence of tardive dyskinesia, parkinsonism and akathisia were 7.9 %, 38.6 and 3.6 %, respectively. The prevalence of extra-pyramidal side effects due to use of typical, atypical and combination drug was 44.4 %, 51.2 % and 34.5 %, respectively with haloperidol (59.4 %) and risperidone (71.4 %) having the greatest effect. Being elderly was associated with tardive dyskinesia, duration of treatment, severity of illness and type of illness with parkinsonism and severity of illness with akathisia. Conclusion: The findings of this study support the high prevalence of extrapyramidal side effects from either using typical and atypical antipsychotic medications. Therefore, Clinicians should discuss on these side effects and proffer possible solutions with their patients prior to commencement of antipsychotic medications in order to promote medication adherence.

The antipsychotic potential of Salix Mucronata on ketamine-induced rats

“…The medication includes antipsychotic drugs which are commonly classified into typical (first generation) and atypical (second generation). Typical antipsychotic drugs attenuate the positive symptoms whilst lacking the ability to improve the negative and cognitive symptoms of schizophrenia ( Luther et al, 2023 , Shettima et al, 2023 ). Atypical antipsychotic drugs exhibit the efficacy in alleviating both the positive and negative symptoms of this disorder ( Sheybani-Arani et al, 2023 ).…”

“…In the mesolimbic pathway, excess production of DA from the ventral tegmental area (VTA) to the limbic areas results in the development of the positive symptoms of schizophrenia ( Patel et al, 2014 ). On the other hand, the negative symptoms of schizophrenia are associated with low levels of DA from the VTA to the cortex in the mesocortical pathway ( Patel et al, 2014 , Shettima et al, 2023 , Velligan and Rao, 2023 ). The blockage of D2 receptor in the mesocortical, nigrostriatal, and tuberoinfundibular pathways has also been reported to aggravate the negative symptoms of schizophrenia ( de Bartolomeis et al, 2023 ).…”