Extrapyramidal side effects in first-episode schizophrenia treated with flupenthixol decanoate

South African Journal of Psychiatry

 
 
Field Value
 
Title Extrapyramidal side effects in first-episode schizophrenia treated with flupenthixol decanoate
 
Creator Joubert, Francois-Pierre Chiliza, Bonginkosi Emsley, Robin Asmal, Laila
 
Subject Psychiatry; Pharmacology flupenthixol; Parkinsonism; dystonia; akathisia; tardive dyskinesia
Description Background: Concern for the development of extrapyramidal side effects (EPSEs) represents a barrier to the routine use of long-acting injectable (LAI) antipsychotic medication in patients with first-episode schizophrenia (FES). Flupenthixol decanoate is a first-generation antipsychotic, which is readily available in the public healthcare system in South Africa.Aim: The aim of this study was to describe the nature, occurrence and severity of EPSEs and their impact on patients with FES over 12 months of treatment with flupenthixol decanoate (fluanxol depot).Setting: The study was based in Cape Town, South Africa, and patients with FES were recruited from inpatient services at Stikland and Tygerberg Hospitals and surrounding psychiatric clinics. This was a sub-study of a larger study, which examined several outcomes in patients with FES treated with the lowest effective dose of flupenthixol decanoate.Methods: The Extrapyramidal Symptom Rating Scale (ESRS) was used to assess both subjective experience and objective measures of EPSEs in a cohort of patients with FES (N = 130). The relationship between demographic and clinical risk factors for individual subsets of EPSEs was also determined.Results: In the context of an overall good 12-month tolerability, EPSEs peaked at month 3. Patients with akathisia were more likely to have greater symptoms of depression, and Parkinsonism was predicted by higher Positive and Negative Syndrome Scale scores (independent of medication dosage). Black and white patients showed higher total ESRS and higher subjective ESRS scores, compared with patients of mixed ancestry, and white patients scored higher on Parkinsonism ratings.Conclusion: Flupenthixol decanoate is well tolerated in patients with FES. Certain clinical features of schizophrenia may be related to EPSEs. Ethnicity is a socio-cultural construct, and hence the differential risk of EPSEs should be interpreted according to ethnicity. Variations in the environment, diet, substance use and genetics may all affect the pharmacokinetics and pharmacodynamics of psychotropic drugs and warrant further investigation.
 
Publisher AOSIS
 
Contributor New Africa Partnership Developments (NEPAD) through the Department of Science and Technology, South Africa
Date 2021-01-11
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — descriptive
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajpsychiatry.v27i0.1568
 
Source South African Journal of Psychiatry; Vol 27 (2021); 7 pages 2078-6786 1608-9685
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajp.org.za/index.php/sajp/article/view/1568/1883 https://sajp.org.za/index.php/sajp/article/view/1568/1882 https://sajp.org.za/index.php/sajp/article/view/1568/1884 https://sajp.org.za/index.php/sajp/article/view/1568/1881
 
Coverage South Africa; Western Cape; Cape Town 2007-2011 age; gender; schizophrenia
Rights Copyright (c) 2021 Francois-Pierre Joubert, Bonginkosi Chiliza, Robin Emsley, Laila Asmal https://creativecommons.org/licenses/by/4.0
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