The Impact of Medication Adverse Effects on Quality of Life in Schizophrenia

Posted on August 15, 2018

Short author bio

Christoph Correll, MD, is professor of Psychiatry at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York, and Medical Director of the Recognition and Prevention (RAP) program at the Zucker Hillside Hospital in New York.

He completed his medical studies in Berlin and Scotland and his research, and clinical work focuses on the identification, characterisation and treatment of adults and youths with severe psychiatric disorders, with a further focus on psychopharmacology and the risk-benefit evaluation of psychotropic medications.

Professor Correll has authored or co-authored over 450 journal articles, has received over 30 national and international research awards and fellowships for his work and is listed by Thomson Reuters as one of “the most influential scientific minds” and “top 1% cited scientists in the area of psychiatry.”

Author Quotes

Adverse effects are not just a nuisance variable, they can decrease quality of life. That’s important because, again, this is what matters to our patients to continue treatment or see a value, and most of you said [earlier] that quality of life is what you want so don’t give patients medication that causes a lot of sedation, weight gain, or EPS.

 

What kills people is the metabolic effect. Weight gain is a nuisance and may make people psychiatrically more ill because of inflammation, but we don’t want lipid and glucose abnormalities.

Summary

Prof Correll introduces this section of his presentation with a discussion of adverse effects and how they can decrease a patient’s quality of life. He gives an interesting account of which side effects are perceived by both schizophrenia patients and their relatives to have the biggest impact on a decreased quality of life, pondering the question of how many physicians ask their patients about which side effects they are willing to tolerate.

 

 

He discusses how different drugs compare with placebo in a network meta-analysis and according to the risk of weight gain.

 

He goes on to present meta-analysis data that reveal how lurasidone out-performs a range of antipsychotics on weight gain analysis and emphasises the importance of the metabolic effect. In particular, he stresses how one single dose of clozapine or olanzapine can shift the oral glucose tolerance test to that of diabetogenic.

 

Prof Correll also compares data from a recent study comparing lurasidone, quetiapine, olanzapine, and placebo at baseline and week 6 and reveals how each intervention affects the metabolic syndrome status of patients.

 

Take Home Bullet Points

  • In patients who relapse, quality of life is decreased by one-third
  • It is vital to measure metabolic outcome and not just consider weight gain when prescribing
  • Always keep the body in mind – the longer the treatment, the greater the effect

Quiz:

References:

  1. McIntyre RS. Understanding needs, interactions, treatment, and expectations among individuals affected by bipolar disorder or schizophrenia: the UNITE global survey. J Clin Psychiatry. 2009;70 Suppl 3:5-11.
  2. Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013 Sep 14;382(9896):951-62. Erratum in: Lancet. 2013 Sep 14;382(9896):940.
  3. De Hert M, Detraux J, van Winkel R, Yu W, Correll CU. Metabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat Rev Endocrinol. 2011 Oct 18;8(2):114-26.

 

 

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