Evaluation of Subject Response to Antipsychotics - Subjective Aspect and Related Clinical Correlates

  • V Geethaanjali Madurai Medical College, Madurai, Tamil Nadu, India
  • C Jayakrishnaveni Madurai Medical College, Madurai, Tamil Nadu, India
Keywords: Antipsychotic therapy, Insight, Schizophrenia

Abstract

Aim: The aim of this study is to assess the subjective response to antipsychotics in patients with schizophrenia and to assess
the related factors such as psychopathology, side effects, insight, and treatment variables.
Methodology: A total of 60 patients with schizophrenia were randomized to treatment with risperidone (n-30) or haloperidol
(n = 30) daily. Efficacy was assessed by the improvement of psychotic symptoms, measured on the positive and negative
syndrome scale. The safety and tolerability were evaluated with the extrapyramidal symptom rating scale, the UKU side effect
rating scale, and Insight and Treatment Attitude Questionnaire.
Results: Comparing haloperidol group and risperidone group for variables such as sex, age, duration of treatment, literacy level,
and drug-free duration before admission was not statistically significant. Hence, both groups are comparable. Haloperidol group
had the number of dysphoric patients (21), and risperidone group had only 8 patients who had dysphoria (Chi-square P < 0.01).
In psychopathology, subjective response was more dysphoric when paranoid scores were high (significant two-tailed −0.00).
In the final assessment total, psychopathology scores were high if dysphoria is high and if psychopathology scores were low
and the dysphoria is also low (significant two-tailed −0.00). Dysphoria scores are high if insight is low, and dysphoria scores are
low if insight is good. Dysphoria scores increase with increasing side effects and decrease with decreasing insight (significant
two-tailed −0.00).
Conclusion: Subjective response to risperidone is better than haloperidol. If there is the initial dysphoric response, the treatment
response is reduced with low insight and high psychopathology in the dysphoric group.

Author Biographies

V Geethaanjali, Madurai Medical College, Madurai, Tamil Nadu, India

Associate Professor, Department of Psychiatry, 

C Jayakrishnaveni, Madurai Medical College, Madurai, Tamil Nadu, India

Associate Professor, Department of Psychiatry,

References

1. Awad AG, Voruganti LN. New antipsychotics, compliance, quality of
life, and subjective tolerability – are patients better off? Can J Psychiatry
2004;49:297-302.
2. Van Putten T, May PR. Subjective response as a prediction of outcome in
pharmacotherapy. Arch Gen Psychiatry 1978;35:477-80.
3. van Putten T, May PR, Marder SR. Subjective response to thiothixene and
chlorpromazine. Psychopharmacol Bull 1980;16:36-8.
4. Awad AG, Hogan TP. Early treatment events and prediction of response to
neuroleptics in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry
1985;9:585-8.
5. Awad AG, Hogan TP. Drug therapy in schizophrenia–prediction of outcome.
Schizophr Res 1988;1:222.
6. Hwang SS, Jung DC, Ahn YM, Kim SH, Kim YS. The effects
of psychopathology on subjective experience of side effects of
antipsychotics in patients with schizophrenia. Int Clin Psychopharmacol
2010;25:83-90.
7. de Haan L, Lavalaye J, Linszen D, Dingemans PM, Booij J. Subjective
experience and striatal dopamine D(2) receptor occupancy in patients with
schizophrenia stabilized by olanzapine or risperidone. Am J Psychiatry
2000;157:1019-20.
8. Voruganti L, Cortese L, Owyeumi L, Kotteda V, Cernovsky Z, Zirul S,
et al. Switching from conventional to novel antipsychotic drugs: Results of
a prospective naturalistic study. Schizophr Res 2002;57:201-8.
9. Hellewell JS, Kalai AK, Lagham SJ, Awad AG. Patient satisfaction and
acceptability of long term treatment with quetiapine. Int J Psychiatry Clin
Pract 1999:3:105-13.
10. Rossi A, Arduini L, Stratta P, Pallanti S. Subjective experience and
subjective response to neuroleptics in schizophrenia. Compr Psychiatry
2000;41:446-9.
11. Gervin M, Browne S, Garavan J, Roe M, Larkin C, O’Callaghan E,
et al. Dysphoric subjective response to neuroleptics in schizophrenia:
Relationship to extrapyramidal side effects and symptomatology. Eur
Psychiatry 1999;14:405-9.
12. Hogan TP, Awad AG. Subjective response to neuroleptics and outcome in
schizophrenia: A re-examination comparing two measures. Psychol Med
1992;22:347-52.
13. Cabeza IG, Amador MS, López CA, González de Chávez M. Subjective
response to antipsychotics in schizophrenic patients: Clinical implications
and related factors. Schizophr Res 2000;41:349-55.
Published
2018-06-14