Psychotic Disorders, Definition, Sign and Symptoms, Antipsychotic Drugs, Mechanism of Action, Pharmacokinetics & Pharmacodynamics with Side Effects & Adverse Drug Reactions: Updated Systematic Review Article
Psychotic Disorders, Definition, Sign and Symptoms, Antipsychotic Drugs, Mechanism of Action, Pharmacokinetics & Pharmacodynamics with Adverse Drug Reaction: Updated Review Article
Psychosis is a mental disorder characterized by a disconnection from reality. Psychosis is a group of disorder characterized by thought disorder, abnormal behaviour, defective cognition, delusion and hallucination. Adverse drug reaction is defined as any undesired or unintended effects of drugs treatment. According to the World Health Organization (WHO)- “adverse drug reaction (ADRs) has been defined one which is noxious and unintended, and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease, or modification of physiological function”. Adverse drug reactions are the most important causes of the mortality and morbidity. Antipsychotics are the most effective drugs which are used in the psychiatry in the maintenance therapy of mania, psychoses and schizophrenia. The antipsychotics drugs are chemically disparate but have the common property of alleviating the symptoms of organic as well as functional psychosis. But they also have a capacity to cause a wide range of potential adverse drug reactions that can lead to non-compliance that can impair quality of life, may cause the extra pyramidal symptoms which can lead to discontinuation of therapy and in extreme cases it may be fatal. Knowledge of assessment of ADRs due to different antipsychotics is necessary. It helps to choose to safe treatment and reduce the risk of occurrence of ADRs by the clinicians. ADR are often poorly identified and reported in day to day medical practice. As we collect more and more information about ADRs, we need an active surveillance system regarding identification and reporting of ADRs with antipsychotic drugs. On many review articles are read & ward round participation experiences we find that antipsychotic drugs can have shown a various kind of ADRs. Psychiatrist and clinical pharmacist are need to be made aware of these potentially fatal adverse effects associated with antipsychotic drugs via conduction of patients counseling regarding (drugs, disease, doses & side effects), quality-based seminars, published medical literature, conferences, learning programs and health care camps.
Keywords: Antipsychotic Drugs, WHO, Adverse Drug Reactions, Pharmacovigilance, Psychiatrist.
2. Radua J,Cravaro VR, Ioannidis J.P.A. What causes psychosis? An umbreela review of risk and protective factors.Workld Psychiatry. 2018; 17: 49-66.
3. Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics. CNS Drugs. 2007 Nov 1; 21(11): 911-36.
4. Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Kirshner MA, Bies RR, Kapur S, Gharabawi G. A model of anticholinergic activity of atypical antipsychotic medications. Schizophrenia research. 2006 Dec 1; 88(1): 63-72.
5. Wallace M. Real progress-the patient's perspective. International clinical psychopharmacology. 2001 Jan 1; 16: S21-4.
6. Ghadirian AM, Chouinard G, Annable L. Sexual dysfunction and plasma prolactin levels in neuroleptic-treated schizophrenic outpatients. Journal of Nervous and Mental Disease. 1982 Aug.
7. Hamer S, Haddad PM. Adverse effects of antipsychotics as outcome measures. The British Journal of Psychiatry. 2007 Aug 1; 191(50): s64-70.
8. Meyer JM. Effects of atypical antipsychotics on weight and serum lipid levels. The Journal of clinical psychiatry. 2001; 62: 27-34
9. Haupt DW, Newcomer JW. Hyperglycemia and antipsychotic medications. Journal of Clinical Psychiatry. 2001 Jan 14; 62(27): 15-26.
10. Sussman N. Review of atypical antipsychotics and weight gain. The Journal of clinical psychiatry. 2001.
11. Iuppa CA, Nelson LA, Elliott E, Sommi RW. Adverse drug reactions: a retrospective review of hospitalized patients at a state psychiatric hospital. Hospital pharmacy. 2013 Nov; 48(11): 931-5.
12. Baldessarine, RJ. et al., 2006. Pharmacotherapy of psychosis and Mania. In Goodman and Gillman’s: The Pharmacological basis of therapeutics (eds).Brunton LL, Lazo JS, Parker KL, New York, Mc GrawHill. Chapter 18: pp477-478.
13. Howes OD, Murray RM. Schizophrenia: an integrated sociodevelopmental-cognitive model. The Lancet. 2014 May 10; 383(9929): 1677-87.
14. Divac N, Prostran M, Jakovcevski I, Cerovac N. Second-generation antipsychotics and extrapyramidal adverse effects. BioMed research international. 2014; 2014
15. Kuroki T, Nagao N, Nakahara T. Neuropharmacology of second-generation antipsychotic drugs: a validity of the serotonin–dopamine hypothesis. Progress in brain research. 2008 Jan 1; 172: 199-212.
16. Agid O, Mamo D, Ginovart N, Vitcu I, Wilson AA, Zipursky RB, Kapur S. Striatal Vs Extrastriatal Dopamine D 2 Receptors in Antipsychotic Response—A Double-Blind PET Study in Schizophrenia. Neuropsychopharmacology. 2007 Jun; 32(6): 1209.
17. Hedges D, Jeppson K, Whitehead P. Antipsychotic medication and seizures: a review. Drugs Today (Barc). 2003 Jul 1; 39(7): 551-7.
18. Potter WZ, Hollister LE. In: Katzung BG. Basic and Clinical Pharmacology. 9th ed. New York, NY: The McGraw-Hill; 2004: 462-481.
19. Casey DE. Implications of the CATIE trial on treatment: extrapyramidal symptoms. CNS spectrums. 2006 Jan; 11(S7): 25-31.
20. Ljungdahl A, Hanrieder J, Fälth M, Bergquist J, Andersson M. Imaging mass spectrometry reveals elevated nigral levels of dynorphin neuropeptides in L-DOPAinduced dyskinesia in rat model of Parkinson's disease. PloS one. 2011 Sep 30; 6(9): e25653.
21. Thornton E, Tran TT, Vink R. A substance P mediated pathway contributes to 6hydroxydopamine induced cell death. Neuroscience letters. 2010 Aug 30; 481(1): 64-7.
22. Casey DE. Pathophysiology of antipsychotic drug-induced movement disorders. The Journal of clinical psychiatry. 2004; 65: 25-8.
23. Shirzadi AA, Ghaemi SN. Side effects of atypical antipsychotics: extrapyramidal symptoms and the metabolic syndrome. Harvard review of psychiatry. 2006 Jan 1; 14(3): 152-64.
24. Tarsy D. Neuroleptic‐induced extrapyramidal reactions: classification, description, and diagnosis. Clin Neuropharmacol 1983;6(Suppl. 1):S9‐26.
25. Aguilar EJ, Keshavan MS, Martinez‐Quiles MD et al. Predictors of acute dystonia in first‐episode psychotic patients. Am J Psychiatry 1994; 151:1819‐21.
26. M. Poznic Jesic, A. Jesic, J. Babovic Filipovic et al., ―Extrapyramidal syndromes caused by antipsychotics,‖Medicinski Pregled, 2012; 65: 521–26.
27. Cohen BM, Keck PE, Satlin A, Cole JO. Prevalence and severity of akathisia in patients on clozapine. Biological Psychiatry. 1991 Jun 15; 29(12): 1215-9.
28. Van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ 1999; 319:623‐6.
29. Seemuller F, Lewitzka U, Bauer M. The relationship of akathisia with treatment emergent suicidality among patients with first‐episode schizophrenia treated with haloperidol or risperidone. Pharmacopsychiatry 2012; 45:292‐6.
30. Ballenger JC. Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics. Year Book of Psychiatry & Applied Mental Health. 2009 Jan 1; 2009: 264-5.
31. Poyurovsky M. Acute antipsychotic‐induced akathisia revisited. Br J Psychiatry 2010; 196:89‐91.
32. Poyurovsky M, Pashinian A, Weizman R et al. Low‐dose mirtazapine: a new option in the treatment of antipsychotic‐induced akathisia. A randomized, double‐blind, placebo‐ and propranolol‐controlled trial. Biol Psychiatry 2006; 59:1071‐7.
33. Kulkarni SK, Naidu PS. Pathophysiology and drug therapy of tardive dyskinesia: current concepts and future perspectives. Drugs Today (Barc). 2003 Jan 1; 39(1): 19-49.
34. Crismon ML, Argo TR, Buckley PF. Schizophrenia. In DiPiro JT, Talbert RL, Yee GC, et al, eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill Inc; 2008: 1099-1122.
35. Chouinard G. Effects of risperidone in tardive dyskinesia: an analysis of the Canadian multicenter risperidone study. J Clin Psychopharmacol 1995;15:36S‐44S.
36. Pouclet‐Courtemanche H, Rouaud T, Thobois S et al. Long‐term efficacy and tolerability of bilateral pallidal stimulation to treat tardive dyskinesia. Neurology 2016;86:651‐9.
37. Saleh C, Gonzalez V, Coubes P. Role of deep brain stimulation in the treatment of secondary dystonia‐dyskinesia syndromes. Handb Clin Neurol 2013;116:189‐208.
38. Sobstyl M, Zabek M. Deep brain stimulation for intractable tardive dystonia: literature overview. Neurol Neurochir Pol 2016;50:114‐22.
39. Lieberman, J.A., Tollefson, G., Tohen, M., Green, A.I., Gur, R.E., Kahn, R., McEvoy, J., Perkins, D., Sharma, T., Zipursky, R. and Wei, H., Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. American Journal of Psychiatry, 2003; 160(8): 1396-1404.
40. Thanvi B, Treadwell S. Drug induced parkinsonism: a common cause of parkinsonism in older people. Postgrad Med J 2009 Jun 1;85(1004):322‐6.
41. Caligiuri MP, Lohr JB. Instrumental motor predictors of neuroleptic‐induced parkinsonism in newly medicated schizophrenia patients. J Neuropsychiatry Clin Neurosci 1997;9:562‐7.
42. Hriso E, Kuhn T, Masdeu JC et al. Extrapyramidal symptoms due to dopamine‐blocking agents in patients with AIDS encephalopathy. Am J Psychiatry 1991; 148:1558‐61.
43. Magnus RV. A comparison of biperiden hydrochloride (Akineton) and benzhexol (Artane) in the treatment of drug‐induced Parkinsonism. J Int Med Res 1980; 8:343‐6.
44. Every‐Palmer S, Ellis PM. Clozapine‐induced gastrointestinal hypomotility: a 22‐year bi‐national pharmacovigilance study of serious or fatal ‘slow gut’ reactions, and comparison with international drug safety advice. CNS Drugs 2017; 31:699‐709
45. Chen CY, Lane HY, Lin CH. Effects of antipsychotics on bone mineral density in patients with schizophrenia: gender differences. Clin Psychopharmacol Neurosci 2016; 14:238‐49.
46. Madaan V, Dvir Y, Wilson DR. Child and adolescent schizophrenia: pharmacological approaches. Expert opinion on pharmacotherapy., 2008 Aug 1; 9(12): 2053-68.
47. Masi G, Liboni F. Management of schizophrenia in children and adolescents. Drugs., 2011 Jan 1; 71(2): 179-208.
48. Kwack YS, Ryu JS. Neuroleptic Malignant Syndrome in Children and Adolescents: A Review. Journal of the Korean Academy of Child and Adolescent Psychiatry, 2013; 24(1): 13-20.
49. De Hert M, Hudyana H, Dockx L, Bernagie C, Sweers K, Tack J, Leucht S, Peuskens J: Second-generation antipsychotics and constipation: A Review of the Literature. European Psychiatry, 2011; 26: 34-44.
50. Taylor D, Paton C, Kapur S. The Maudsley prescribing guidelines in psychiatry. John Wiley & Sons; 2015 Feb 23.
51. Tandon R. Antipsychotics in the treatment of schizophrenia: an overview. J Clin Psychiatry. 2011; 72(suppl 1):4-8.
52. Lieberman JA, Stroup TS, McEvoy JP, et al, for the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005; 353:1209-1223.
53. Miyamoto S, Miyake N, Jarskog LF. Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Mol Psychiatry. 2012 May 15 [Epub ahead of print].
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