Antipsychotic side effects profile and associated factors among Inpatients with First Episode Psychosis at Butabika Hospital, Uganda

Abstract

Background: Psychotic disorders are severe forms of mental illness and have been reported as the 4th leading cause of morbidity worldwide. Antipsychotic medications early at the first episode of psychosis are the cornerstone of treatment for psychosis related disorders. In Uganda, close to 90% of patients with conditions diagnosed with any psychotic disorder are treated with first-generation antipsychotic drugs (e.g. chlorpromazine, haloperidol, trifluoperazine, and depot fluphenazine). However, the side effect profile of antipsychotic medications among patients with first episode psychosis in Ugandan patients has not been described. Objectives: To determine the prevalence, profile and factors associated with acute side effects of commonly used antipsychotic medications among in-patients with first episode psychosis at Butabika Mental Hospital. Methods: This was a cross-sectional study in Butabika hospital. Ethical approval was obtained from the relevant ethical bodies. All participants provided written informed consent. In-patients receiving antipsychotics for the first time were consecutively sampled until the sample size of 385 was attained. The Sociodemographic questionnaire was used to collect the demographics characteristics. The Glasgow antipsychotic side-effect scale was used to assess for acute side effects. Data was entered into EPI DATA and analyzed using STATA. Logistic regression analysis was performed to determine associations. Results: The prevalence of acute side effects was 71%. Females participants were more likely to develop moderate [OR 1.71 (1.04, 2.83); p-value 0.036] and severe [OR 4.47 (2.13, 9.39); p-value <0.001] side effects than males. Participants taking chlorpromazine were more likely than those taking haloperidol [OR 0.2 (0.1, 0.39), p-value <0.001], olanzapine [OR 0.04 (0.01, 0.19), p-value <0.001] and risperidone [OR 0.17 (0.06, 0.51), p-value 0.002] to present with acute side effects. Conclusion: The prevalence of acute side effects among participants with first episode psychosis is high and is associated with female gender, medication type, and dose. Minimum optimal doses should be used especially and female gender.