Comparative Safety Profile of Single Versus Combination Antipsychotic Therapy by Using Glassgow Antipsychotic Side Effect Scale (Gass)

Authors:

Zikria S¹*, Hamid S¹, Amna A¹, Farooq B¹, Iqra B¹, Murryam K¹, Azqa N¹, Saba A¹, Areefa T¹, Muhammad I¹ and Furqan KH^1,2

DOI: 10.23880/nnoaj-16000115

Volume 2, Issue 2

Abstract

Background: The considerable controversies exist regarding the clinical safety of first and second-generation antipsychotics and their different combinations frequently prescribed for schizophrenia and bi-polar disorders. Objective: The prime intent of the study was to compare the side effect profiles of first and second-generation antipsychotic drugs, either single or combination, in patients with schizophrenia and bipolar disorder. Methods: In this cross-sectional observational study, Glassgow Antipsychotic Side effect Scale (GASS), a validated self-assessment and self-rating scale for determining side effects of antipsychotics, was used for grading purpose. The study was conducted by enrolling a total of 252 patients. Results: Out of 252 patients, 21.83% were using first generation antipsychotics (FGAs), 44.04% were using second generation antipsychotics (SGAs) and 34.13% were using combination of the first and second generation antipsychotics. A total of 57.9% of patients suffered from mild and 42.06% patients experienced moderate side effects after using different antipsychotics. The findings indicated greater risk of side effects of antipsychotics in female gender based on GASS score (Male;18.82, Female; 22.00, p=0.014). On the other hand, demographic factors like age (p=0.185), marital status (p=0.655), education (p=0.128), family history of psychosis (p=0.496) and history of substance (p=0.736) were not significantly associated with overall side effects. However, patients doing exercise experienced fewer side effects as compared to those patients who were having sedentary life style (17.42 vs 20.51,. p=0.006). Mean GASS score was least in case of combination therapy of FGAs and SGAs which showing that antipsychotic drugs were better tolerance when used in combination (FGAs: 20.51, SGAs: 20.05, Combination: 18.12).Conclusion: This study manifested that the differences between antipsychotics were subtle, but precise and distinguishable. These findings depicted the general notion that risk of side effects significantly increased in patients on mono-therapy as compared to those who were using combination of FGA and SGA.

Keywords:

Antipsychotic drugs; Safety; GASS; Monotherapy; Combination Therapy

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