Effectiveness analysis of antipsychotics in schizophrenia using psychometric scales: an observational study

Authors

  • Ratna Agrawal Department of Pharmacology, Late Baliram Kashyap Memorial Government Medical College, Dimrapal, Jagdalpur, Chhattisgarh, India
  • Bhabagrahi Rath Department of Pharmacology, V.S.S. Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
  • Rajni Kant Shukla Department of Psychiatry, V.S.S. Institute of Medical Sciences and Research, Burla, Sambalpur, Odisha, India
  • Sabita Mohapatra Department of Pharmacology, SCB Medical College and Hospital, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20200181

Keywords:

Antipsychotics, CGI-I scale, CGI-S scale, Schizophrenia

Abstract

Background: Schizophrenia is a commonest and one of the well known psychiatric disorders. Life expectancy of a patient with schizophrenia may be 20 to 30 years shorter than the general population. Long term antipsychotic therapy is usually required for the management of schizophrenia. It is not currently possible to predict which antipsychotic may be optimal for a given patient because there are still many debates about effectiveness and efficacy of atypical drugs over first generation antipsychotics. So, our aim is to assess the effectiveness of various antipsychotics by using various psychometric scales, which will be helpful to bring out better treatment options for schizophrenia patients.

Methods: This was an observational questionnaire based study, conducted on patients of inpatient and outpatient Department of Psychiatry and Department of Pharmacology at VIMSAR, Burla, for a period of 24 months (September 2015 to August 2017). Patients of schizophrenia aged 18 years or above were subjected to clinical global impression – severity scale (CGI-S) and clinical global impression – improvement scale (CGI-I) questionnaire after taking informed consent. Then scores were calculated using non parametric test with Graph pad Prism version 6.0.

Results: Out of the 90 cases, majority (60) of patients belonged to the middle (25 to 45 yrs) age group followed by 20 younger (<25 yrs) age group and rest 10 were elderly (>45 yrs) patients. Both scales showed significant improvement with atypical antipsychotics as compared to first generation antipsychotics.

Conclusions: Based on these findings, we can conclude that atypical antipsychotics are more effective than first generation antipsychotics. But further studies are needed to assist clinicians in making optimum treatment decisions.

Metrics

Metrics Loading ...

Author Biography

Ratna Agrawal, Department of Pharmacology, Late Baliram Kashyap Memorial Government Medical College, Dimrapal, Jagdalpur, Chhattisgarh, India

Assistant Professor
Department of Pharmacology
Late Baliram Kashyap Memorial Government Medical College, Dimrapal, Jagdalpur, Chhattisgarh, India.

References

Perälä J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsä E, Pirkola S, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007;64:19-28.

Barch DM, Bustillo J, Gaebel W. Logic and justification for dimensional assessment of symptoms and related clinical phenomena in psychosis: relevance to DSM–5. Schizophr Res. 2013;150(1):15-20.

Kane JM. Strategies for improving compliance in treatment of schizophrenia by using a long – acting formulation of an antipsychotic: clinical studies. J Clin Psychiatry. 2003;64(16):34-40.

Tondan R. Bridging the Efficacy – Effectiveness Gap in the Antipsychotic Treatment of Schizophrenia: Back to the Basics. J Clin Psychiatry. 2014;75(11):1321-2.

Tandon R. Antipsychotics in the treatment of schizophrenia: an overview. J Clin Psychiatry. 2011;72(1):4-8.

Tandon R, Nasrallah HA, Keshvana MS. Schizophrenia, “just the facts” 5: treatment and prevention: past, present and future. Schizopher Res. 2010;122(1-3):1-23.

Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment- resistant schizophrenic: a double blind comparison of chlorpromazine. Arch Gen Psychiatry. 1988;45(9):789-96.

McEvoy JP, Lieberman JA, Stroup TS. CATIE investigators. Effectiveness of clozapine versus olanzapine, quetiaepine and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry. 2006;163(4):600-10.

Guy W. Clinical global impressions. ECDEU Assessment Manual of Psychopharmacology Revised 1976. US Department of Health, Education, and Welfare; Rockville, MD; 1976: 217-222.

Cortesi PA, Mencacci C, Luigi F, Pirfo E, Berto P, Sturkenboom CJM, et al. Compliance, persistence, costs and quality of life in young patients treated with antipsychotic drugs: results from the COMETA study. BMC Psychiatry. 2013;13:244-471.

Grebb JA, Caroly SP, Sussman N, editors. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/ Clinical psychiatry, 10th Edition. Lippincott Williams & Wilkins; 2007: 469.

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. England: American Psychiatric Association; 2013. Available at: https://www.psychiatry.org/psychiatrists/practice/dsm. Accessed on 3 October 2019.

Johnson S, Sathyaseelan M, Charles H, Jeyaseelan V, Jacob KS. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5- year cohort study. BMC Psychiatry. 2012;12:159.

Suresh KK, Kumar CN, Thirthalli J, Bijjal S, Venktesh BK. Work functioning of schizophrenia patients in a rural south Indian community: Status at 4- year follow up. Soc. Psychiatry Psychiatric Epidemiol. 2012;47:1865-71.

Kua J, Wong KE, Kua EH, Tsoi WF. A 20- year follow- up study on schizophrenia in Singapore. Acta Psychiatr Scand. 2003;108:118-25.

Liberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins Do et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Eng J Med. 2005;353:1209-23.

Ravanic DB, Dejanovic SMD, Janjic V, Jovic SD, Milovanovic DR, Jakovljevic V et al. Effectiveness of clozapine, haloperidol and chlorpromazine in schizophrenia during a five- year period. Arq Neuropsiquiatr. 2009;67(2):195-202.

McCue RE, Waheed R, Charles R. Comparative effectiveness of second generation antipsychotics and haloperidol in acute schizophrenia. Br J Psychiatry. 2006;185:243-5.

Macfadden W, DeSouza C, Crivera C, Kozma CM, Dirani RD, Mao L. Assessment of effectiveness measures in patients with schizophrenia initiated on risperidone long- acting therapy: The SOURSE study results. BMC Psychiatry. 2011;11:167.

Downloads

Published

2020-01-24

How to Cite

Agrawal, R., Rath, B., Shukla, R. K., & Mohapatra, S. (2020). Effectiveness analysis of antipsychotics in schizophrenia using psychometric scales: an observational study. International Journal of Basic & Clinical Pharmacology, 9(2), 305–309. https://doi.org/10.18203/2319-2003.ijbcp20200181

Issue

Section

Original Research Articles