Ocular side effects among adult patients taking antipsychotic drugs in Mulago National Referral Hospital Psychiatry Clinic.

Abstract

Background: Ocular side effects resulting from the use of antipsychotic drugs represent a significant concern for the safety and long-term treatment adherence of patients with psychosis. These side effects can include blinding conditions such as abnormal pigmentation of cornea and lens, cataracts, glaucoma, and retinopathies. Despite the increasing prevalence of psychosis and widespread use of antipsychotic medications in Uganda, there is a notable lack of studies examining the ocular side effects among patients receiving these medications. Objective: This study aimed to determine the prevalence and patterns of ocular side effects of antipsychotic drug use and associated factors among adult patients in the psychiatry outpatient clinic of Mulago national referral hospital. Methods and materials: This was a hospital based cross sectional study, conducted in Mulago National referral Hospital Psychiatry Out-Patient clinic between 1st March and 1st May 2023. The principal investigator recruited 380 eligible adult patients consecutively and conducted, sociodemographic, medical, psychiatric, and a comprehensive ocular evaluation. Data was collected in a pre-tested questionnaire, entered in epi data, and analyzed using STATA version 14. Descriptive statistics were presented as means and standard deviation (SD), frequencies and proportions. Factors associated were assessed using a logistic regression to obtain odd ratios with their corresponding P-values and 95% confidence intervals. Results: We assessed 380 patients with a median age of 35 years, age range 18 and 84 years, SD +/-14 years. Ocular side effect was found prevalent at 27.63%, the most frequent being; cataracts (35.65%) and dry eye disease (20%). Some of the factors associated with ocular side effects included; older age (p< 0.001, AOR = 11.743, 95% CI: 3.667 – 37.599), having a history of eye disease (p<0.001), drug class type (p<0.001), a higher chlorpromazine dosage (p<0.001), and a higher number of antipsychiatry drugs taken (p=0.073). Conclusion: The prevalence of ocular side effects among patients taking antipsychotics was high at 27.63%, with cataracts, dry eye as the commonest, whereas older age, presence of comorbidity, high chlorpromazine dose, and history of eye disease were some of the factors associated with ocular side effects of antipsychotic drug use.