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3 results

  • Monitoring of extrapyramidal side effects in patients on antipsychotic treatment: a completed audit cycle

  • MI Butler, J Chandrakanth
  • Journal:
    Irish Journal of Psychological Medicine / Volume 33 / Issue 3 / September 2016
    Published online by Cambridge University Press:
    03 August 2015, pp. 165-169
    Print publication:
    September 2016
  • Background

    Movement disorders are a common problem in those receiving antipsychotic medication. Clinical guidelines recommend that these side-effects are monitored regularly throughout treatment. However, due to a lack of training, clinician confidence levels in assessment are often low and regular monitoring may be neglected.

    Aims

    To audit current practice in our services regarding monitoring of extrapyramidal side effects (EPSE) and improve monitoring through education of clinicians.

    Method

    The clinical records of patients receiving antipsychotic treatment, seen in the outpatient clinic over a 2-week period, were reviewed. Data were collected on whether or not EPSE had been assessed. A re-audit was undertaken following a teaching session.

    Results

    Documentation regarding EPSE was present in only 14% of patient records. Following a teaching session, the overall level of documentation of EPSE rose to 42%, with rates of assessment dramatically improving in non-consultant hospital doctors.

    Conclusion

    In our practice, clinicians are generally poor to assess and record EPSE. However, rates of assessment improved significantly following a teaching session, especially in NCHDs.

  • Chapter 16 - Implications for research design and study implementation

  • Edited by T. Scott Stroup, Columbia University, New York, Jeffrey A. Lieberman, Columbia University, New York
  • Book:
    Antipsychotic Trials in Schizophrenia
    Published online:
    03 May 2010
    Print publication:
    01 April 2010, pp 281-287

  • Summary

    This chapter summarizes the features of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial that are relevant to interpretation of extrapyramidal side effects (EPS) findings. CATIE was designed to address the overall effectiveness of second-generation antipsychotic (SGA) versus a mid-potency first-generation antipsychotic drugs (FGA), perphenazine, based on treatment discontinuation. Using measures of dystonia, Parkinsonism, akathisia, and tardive dyskinesia (TD), the analysis of incidence rates and continuous measures from CATIE shows no substantial or statistically significant differences between modest doses of the intermediate potency FGA perphenazine and four SGAs in patients with chronic schizophrenia requiring maintenance antipsychotic treatment. The conclusion that must be drawn from the CATIE study is that there were no significant differences in primary outcome measures of acute EPS and TD overall, while at the same time perphenazine was shown to be not different in overall effectiveness compared with olanzapine, risperidone, quetiapine, and ziprasidone.