Use of atypical antipsychotics in a neuropsychiatric hospital in Nigeria: A clinical audit

Abstract

There appears to be an increase in the use of atypical antipsychotics in the management of severe mental disorders in Nigeria. The metabolic and other side effects associated with their use are becoming major concern to both clinicians and service users. International guidelines required that their use be regulated by results of baseline and follow-up investigations. This audit aimed at determining the extent to which baseline and on going monitoring are carried out among patients attending the out-patients clinic at the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria. A retrospective survey was carried out at the general outpatient clinic of the Neuropsychiatric Hospital Aro, a tertiary specialist institution in Nigeria. A proforma data extraction questionnaire was developed by the authors and used in obtaining information from the case notes of patients on atypical antipsychotics medication attending the out-patients clinic between January and December 2013. A total of 213 case-notes of patients on atypical antipsychotics were reviewed. Over half (55%) of the patients were commenced on atypical medication at their first contact with the hospital. Majority (51%) of the patients were on treatment for schizophrenia. Risperidone was the most prescribed atypical antipsychotics (86.4%). The level of compliance with baseline investigations and follow up investigations were poor. In conclusion, there is urgent need to improve on the level of baseline and on going monitoring of blood parameters among others on patients on atypical antipsychotics. This is more so in view of the likely metabolic and other side effects associated with the use of these medications.