Subjective side effects of antipsychotics and medication adherence in people with schizophrenia

Title. Subjective side effects of antipsychotics and medication adherence in people with schizophrenia.

Aim. This paper is a report of a study conducted to describe the prevalence of antipsychotic medication side effects in individuals with schizophrenia, and to assess if a relationship existed between side effects and medication-taking.

Background. Non-adherence to antipsychotics is common in people with schizophrenia. There is a direct relationship between non-adherence and relapse, but it is unclear if an association exists between side effects and non-adherence.

Method. The Liverpool University Neuroleptic Side-effect Rating Scale was used with a convenience sample of 81 mental health service users with schizophrenia. Participants were recruited from one urban and one rural area in Australia in 2004. Data were analysed using Statistical Package for Social Science and nonparametric statistical methods based on the nature of data.

Findings. Around 20% of participants had missed taking their medication at least once in the week before data collection. About half experienced one or more side effects, but the level of accumulated side effects was not associated with medication omission. Older participants were more likely to experience anticholinergic and allergic side effects than their younger counterparts. Younger women were more likely to experience hormone-related side effects than older women. Overall, medication omission was not statistically significantly correlated with any of the seven Liverpool University Neuroleptic Side-effect Rating Scale subscales.

Conclusion. Greater attention needs to be paid to age- and gender-specific side effects and to monitoring side effects in people prescribed atypical medication antipsychotics. Service users, case managers and prescribers may need additional training to assist them to identify side effects and to take steps to ameliorate or at least minimize their effects.