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Current Drug Safety


ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Positive and Negative Effects of Antipsychotic Medication: An International Online Survey of 832 Recipients

Author(s): John Read* and James Williams

Volume 14, Issue 3, 2019

Page: [173 - 181] Pages: 9

DOI: 10.2174/1574886314666190301152734

Price: $65


Background: Antipsychotic medication is currently the treatment of choice for psychosis, but few studies directly survey the first-hand experience of recipients.

Objective: To ascertain the experiences and opinions of an international sample of users of antipsychotic drugs, regarding positive and negative effects.

Methods: An online direct-to-consumer questionnaire was completed by 832 users of antipsychotics, from 30 countries – predominantly USA, UK and Australia. This is the largest such sample to date.

Results: Over half (56%) thought, the drugs reduced the problems they were prescribed for, but 27% thought they made them worse. Slightly less people found the drugs generally ‘helpful’ (41%) than found them ‘unhelpful’ (43%). While 35% reported that their ‘quality of life’ was ‘improved’, 54% reported that it was made ‘worse’. The average number of adverse effects reported was 11, with an average of five at the ‘severe’ level. Fourteen effects were reported by 57% or more participants, most commonly: ‘Drowsiness, feeling tired, sedation’ (92%), ‘Loss of motivation’ (86%), ‘Slowed thoughts’ (86%), and ‘Emotional numbing’ (85%). Suicidality was reported to be a side effect by 58%. Older people reported particularly poor outcomes and high levels of adverse effects. Duration of treatment was unrelated to positive outcomes but significantly related to negative outcomes. Most respondents (70%) had tried to stop taking the drugs. The most common reasons people wanted to stop were the side effects (64%) and worries about long-term physical health (52%). Most (70%) did not recall being told anything at all about side effects.

Conclusion: Clinical implications are discussed, with a particular focus on the principles of informed consent, and involving patients in decision making about their own lives.

Keywords: Antipsychotic drugs, psychosis, suicidality, sedation, TAE, second generation, maudsley side effects.

Hutton P, Weinmann S, Bola J, Read J. Antipsychotic drugs.In: Read J, Dillon J, Eds.. Models of madness: Psychological, social and biological approaches to psychosis. 2nd ed. London: Routledge 2013; pp. 105-24.
National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults Quality standard. London: NICE 2015.
American Psychiatric Association Practice guidelines for the treatment of patients with schizophrenia. 2nd ed. Washington, DC: APA 2010.
Leucht S, Arbter D, Engel R, Kissling W, Davis J. How effective are second-generation antipsychotic drugs? Mol Psychiatry 2009; 14: 429-47.
Lepping P, Sambhi R, Whittington R, Lane S, Poole R. Clinical relevance of findings in trials of antipsychotics: Systematic review. Br J Psychiatry 2011; 198: 341-5.
Bola J, Kao D, Soydan H. Antipsychotic medication for early episode schizophrenia. Cochrane Database Syst Rev 2011; 6: CD006374.
Leucht S, Leucht C, Huhn M, et al. Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: Systematic review, bayesian meta-analysis, and meta-regression of efficacy predictors. Am J Psychiatry 2017; 174: 927-42.
Bola J, Lehtinen K, Cullberg J, Ciompi L. Psychosocial treatment, antipsychotic postponement, and low-dose medication strategies in first episode psychosis. Psychosis 2009; 1: 4-18.
Jung E, Wiesjahn M, Wendt H, Bock T, Rief W, Lincoln T. Symptoms, functioning and coping strategies in individuals with schizophrenia spectrum disorders who do not take antipsychotic medication: A comparative interview study. Psychol Med 2016; 46: 2179-88.
Mosher L, Gosden R, Beder S. Drug companies and ‘schizophrenia’: Unbridled capitalism meets madness.In: Read J, Dillon J, Eds.. Models of madness: psychological, social and biological approaches to psychosis. (2nd edition). London: Routledge 2013; pp. 125-40.
Miller D, Caroff S, Davis S, et al. Extrapyramidal side-effects of antipsychotics in a randomised trial. Br J Psychiatry 2008; 193: 279-88.
Longden E, Read J. Assessing and reporting the adverse effects of antipsychotic medication: A systematic review of clinical studies, and prospective, retrospective, and cross-sectional research. Clin Neuropharmacol 2016; 39: 29-39.
Ho B, Andreasen N, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes. Arch Gen Psychiatry 2011; 68: 128-37.
Weinmann S, Read J, Aderhold V. The influence of antipsychotics on mortality in schizophrenia: A systematic review. Schizophr Res 2009; 113: 1-11.
Weinmann S, Aderhold V. Antipsychotic medication, mortality and neurodegeneration. Psychosis 2010; 2: 250-69.
Perkins D. Predictors of noncompliance in patients with schizophrenia. J Clin Psychiatry 2002; 63: 1121-8.
Lieberman J, Stroup T, McEvoy J, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209-23.
Cahling L, Berntsson A, Bröms G, Öhrmalm L. Perceptions and knowledge of antipsychotics among mental health professionals and patients. Br J Psych Bul 2017; 41: 254-9.
Yeisen R, Bjornestad J, Joa I, Johannessen J, Opjordsmoen S. Experiences of antipsychotic use in patients with early psychosis: A two-year follow-up study. BMC Psychiatry 2017; 17: 299.
Larsen-Barr M, Seymour F, Read J, Gibson K. Attempting to stop antipsychotic medication: Success, supports and efforts to cope. Soc Psychiatry Psychiatr Epidemiol 2018; 53: 745-56.
Geyt G, Awenat Y, Tai S, Haddock G. Personal accounts of discontinuing neuroleptic medication for psychosis. Qual Health Res 2016; 26: 1-16.
Salomon C, Hamilton B, Elsom S. Experiencing antipsychotic discontinuation: Results from a survey of Australian consumers. J Psychiatr Ment Health Nurs 2014; 21: 917-23.
Day J, Bentall R, Warner S. Schizophrenic patients’ experiences of neuroleptic medication: A Q-methodological investigation. Acta Psychiatr Scand 1996; 93: 397-402.
Day J, Kinderman P, Bentall R. A comparison of patients’ and prescribers’ beliefs about neuroleptic side-effects: Prevalence, distress and causation. Acta Psychiatr Scand 1998; 97: 93-7.
Floersch J, Townsend L, Longhofer J, et al. Adolescent experience of psychotropic treatment. Transcult Psychiatry 2009; 46: 157-79.
Murphy A, Gardner D, Kisely S, Cooke C, Kutcher S, Hughes J. A qualitative study of antipsychotic medication experiences of youth. J Can Acad Child Adolesc Psychiatry 2015; 24: 61-9.
Morrison P, Meehan T, Stomski N. Living with antipsychotic medication side-effects: The experience of Australian mental health consumers. Int J Ment Health Nurs 2015; 24: 253-61.
Morant N, Azam K, Johnson S, Moncrieff J. The least worst option: User experiences of antipsychotic medication and lack of involvement in medication decisions in a UK community sample. J Ment Health 2017; 27: 322-8.
Gray R, Rofail D, Allen J, Newey T. A survey of patient satisfaction with and subjective experiences of treatment with antipsychotic medication. J Adv Nurs 2005; 52: 31-7.
Ashoorian D, Davidson R, Rock D, Dragovic M, Clifford R. A clinical communication tool for the assessment of psychotropic medication side effects. Psychiatry Res 2015; 230: 643-57.
Wykes T, Evans J, Paton C, et al. What side effects are problematic for patients prescribed antipsychotic medication? The Maudsley Side Effects (MSE) measure for antipsychotic medication. Psychol Med 2017; 47: 2369-78.
Moncrieff J, Cohen D, Mason J. The subjective experience of taking antipsychotic medication: A content analysis of Internet data. Acta Psychiatr Scand 2009; 120: 102-11.
Read J, Cartwright C, Gibson K. Adverse emotional and interpersonal effects reported by 1,829 New Zealanders while taking antidepressants. Psychiatry Res 2014; 216: 67-73.
Read J, Gee A, Diggle J, Butler H. The interpersonal adverse effects reported by 1,008 users of antidepressants; and the incremental impact of polypharmacy. Psychiatry Res 2017; 256: 423-7.
Read J, Williams J. Adverse effects of antidepressants reported by a large international cohort: Emotional blunting, suicidality, and withdrawal effects. Curr Drug Saf 2018; 13: 176-86.
Read J, Cartwright C, Gibson K. How many of 1,829 antidepressant users report withdrawal symptoms or addiction? Int J Ment Health Nurs 2018; 27: 1805-15.
Adewuya A, Ola B, Mosaku S, Fatoye F, Eegunranti A. Attitude towards antipsychotics among outpatients with schizophrenia in Nigeria. Acta Psychiatr Scand 2006; 113: 207-11.
Hoffer A, Rettenbacher M, Edlinger M, Kemmler G, Widschwendter C, Fleischhacker W. Subjective response and attitudes toward antipsychotic drug therapy during the initial treatment period: A prospective follow-up study in patients with schizophrenia. Acta Psychiatr Scand 2007; 116: 354-61.
Mizrahi R, Bagby R, Zipursky R, Kapur S. How antipsychotics work: The patients’ perspective. Prog Neuropsychopharmacol Biol Psychiatry 2005; 29: 859-64.
Healy D. Neuroleptics and psychic indifference: A review. J R Soc Med 1998; 2: 615-9.
Sharma T. Tarang, Guski, L, Freund N, Gøtzsche P. Suicidality and aggression during antidepressant treatment: Systematic review and meta-analyses. Br Med J 2016; 352: i65.
Larsen-Barr M, Seymour F, Read J, Gibson K. Attempting to discontinue antipsychotic medication: Withdrawal methods, relapse and success. Psychiatry Res 2018; 270: 365-74.
Jeste D, Maglione J. Treating older adults with schizophrenia: Challenges and opportunities. Schizophr Bull 2013; 39: 966-8.
Hayhurst K, Drake R, Massie J, Dunn G, Lewis S. Patients’ subjective rating of mental health improvement in a randomised controlled trial. Psychiatry Res 2015; 229: 593-5.
Day J, Wood G, Dewey M, Bentall R. A self-rating scale for measuring neuroleptic side-effects: Validation in a group of schizophrenic patients. Br J Psychiatry 1995; 166: 650-3.
Hagen R, Turkington D, Berge T, Grawe W. CBT for Psychosis: A symptom-based approach. London: Routledge 2010.
Morrison A, Turkington D, Pyle M, et al. Cognitive therapy for people with schizophrenia spectrum disorders not taking antipsychotic drugs: A single-blind randomised controlled trial. Lancet 2014; 383: 1395-403.
Cleary A, Walsh F, Connolly H, et al. Monitoring and documentation of side effects from depot antipsychotic medication: An interdisciplinary audit of practice in a regional mental health service. J Psychiatr Ment Health Nurs 2012; 19: 395-401.
Yusufi B, Mukherjee S, Flanagan R, et al. Prevalence and nature of side effects during clozapine maintenance treatment and the relationship with clozapine dose and plasma concentration. Int Clin Psychopharmacol 2007; 22: 238-43.
Morrison A, Hutton P, Shiers D, Turkington D. Antipsychotics: Is it time to introduce patient choice? Br J Psychiatry 2012; 201: 83-4.

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