Abstract

ADRS DUE TO ANTIPSYCHOTIC DRUGS: A REVIEW

Prashant Mathur* and Waseem Yahya

Abstract

WHO defines an ADR as ―any response to a drug which is noxious and unintended, and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function‖.[1] The antipsychotic drugs are chemically diverse but have the common property of alleviating the symptoms of organic as well as functional psychosis.[2] Antipsychotics are among the most effective drugs used in psychiatry in the maintenance therapy of schizophrenia, mania, or in acute psychotic reactions.[3] These drugs are also capable of causing a wide range of potential adverse drug reactions that can lead to non-compliance that can impair quality of life, may cause stigma and physical morbidity which may lead to discontinuation of medication and in extreme cases may be fatal.[4] Antipsychotic drugs have a high therapeutic index and are generally safe agents. Adverse effects are extensions of many pharmacological actions of these drugs which include those on the cardiovascular, central, autonomic nervous system and endocrine systems.[4,5-7] The knowledge of how the prevalence and severity of adverse effects vary for different antipsychotics allows the clinicians to choose the safer and effective drug therapy for the patients.[8] Atypical antipsychotics differ from conventional agents as atypical antipsychotics have lower risk of extrapyrimidal side effects and also significantly reduce both positive as well as negative symptoms of shizophrernia.[9] Besides having lower risk of extrapyrimidal side effects, atypical antipsychotic agents present their own spectrum of adverse effects that include hypotension, seizures, weight gain, increased risk of diabetes mellitus and hyperlipidemia.[9-11] These ADRs in hospitalized psychiatric patients are not only common, but they also have high rate of preventability. To identify medications that should be targeted for quality improvement projects and patient education, a healthcare system can use data on frequency, severity, probability and preventability. Targeting high-risk medications that have been identified through analysis may have a significant impact on reducing preventable ADRs.[12]

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