A Retrospective Study of the Adverse Effects of Second Generation Antipsychotics at the Psychiatric Outpatient Clinic in Srinagarind Hospital

Abstract

Objective : To study the rate of adverse drug reactions that occurred in psychiatric patients treated with second generation antipsychoticsat the psychiatry outpatient clinic, Srinagarind
Hospital.
Method : This was a descriptive retrospective study. The purpose was to review the occurrence of adverse drug reactions from second generation antipsychotics recorded in the medical
records of all psychiatric outpatients of Srinagarind hospital during January 2004 to December 2014 (11 years). The occurrences of adverse drug reactions were recorded by Thai Medical Council certified psychiatrists and psychiatric residents who were under supervision by any certified psychiatrists.
Result : Two-hundred and forty-two medical records were reviewed, 118 of which were male (48.8%) and 124 were female (51.2%). Their mean age±SD was 47.5±19.6, median age was
48.0 years old. There were patients with schizophrenia for 48.4% and bipolar disorder for 15.9%. The most frequent adverse drug reaction was weight gain (33.8%) which was caused by olanzapine (54.6%) and clozapine (43.3%). The second most frequent adverse drug reaction was extrapyramidal side effect (EPS; 10.8%), most of which were caused by paliperidone and
ziprasidone (35.7% and 28.6% respectively). The third most frequent adverse drug reaction was sedation (4.8%) which was caused by all second-generation antipsychotics in an equal
rate except not any record was for quetiapine. Metabolic syndrome was found only 2.2%, the cause of which was aripiprazole.
Conclusion : The most frequent adverse drug reaction from second generation antipsychotics in descending order were weight gain, EPS and sedation. Weight gain was mostly from olanzapine; EPS from paliperidone; and sedation from any second-generation antipsychotics.
Metabolic syndrome was found in very few rates.