ABSTRACT
Antipsychotic medications have been used to treat a variety of behavioral and psychiatric disturbances in persons with mental retardation. Given the well-documented side effects of traditional antipsychotics, newer "atypical" antipsychotics have been well received in this population due to initial reports of a more favorable side effect profile. We compared the side effect profiles of both the typical and atypical antipsychotics using a comprehensive instrument, the Matson Evaluation of Drug Side Effects (MEDS) scale. Participants taking atypical antipsychotics did not differ in overall side effects from a matched control group taking no psychotropic medication, and both groups showed significantly fewer overall side effects than participants taking typical antipsychotics. Subscales designed to measure involuntary movements (e.g., akathisia, tardive dyskinesia) detected differences between participants taking either atypical or typical antipsychotics with respect to akathisia only. Implications of these findings and directions for future research are discussed.
Subject(s)
Akathisia, Drug-Induced/diagnosis , Antipsychotic Agents/adverse effects , Health Status , Mental Disorders/complications , Mental Disorders/drug therapy , Female , Humans , Male , Middle AgedABSTRACT
1. A review of the medical records in a state psychiatric hospital was conducted to evaluate the clinical efficacy of the atypical antipsychotic, clozapine. 2. Using the Brief Psychiatric Rating Scale (BPRS), four groups of schizophrenic inpatients (n = 59) were operationally defined: Nonresponders (< 20% decrease from pre-drug baseline); Short-term Pharmacological Responders (20% decline, but not sustained); Long-term Pharmacological Responders (maintained a 20% decline) and Clinical Responders (maintained a 20% decline and achieved a BPRS < or = 36; the criterion of Kane et al. 1988). 3. There were 7 NRs, 13 STPRs, 21 LTPRs and 18 CRs 4. The STPR, LTPR and CR groups improved significantly within the first month of treatment and reached a 20% decrease in BPRS by 3 months. CRs required 5 months to attain a BPRS < or = 36. These criteria were reached at the same average doses (about 300-400 mg/day). 5. The proportion of CRs (30%) in this retrospective, naturalistic study, is remarkably close to the results of the definitive study by Kane et al. 1988. These results are also consistent with many of the controlled research studies of clozapine in hospitalized, treatment refractory psychiatric patients.
