Related Experiment Videos
Self-reported neuroendocrine effects of antipsychotics in women: a pilot study
J M Zito1, J B Sofair, J Jaeger
1Nathan Kline Institute for Psychiatric Research, Orangeburg, NY.
Abstract:
Although neuroendocrine adverse effects (NAEs) of antipsychotic agents in women have been widely reported, it has been generally assumed that either (1) tolerance to these effects develops with chronic use, (2) patients adjust to the effects, or (3) a trial of dopamine-agonist treatment is effective. We have begun to examine the prevalence of chronic adverse effects and their effect on compliance using a pilot study of self-reported NAEs, antipsychotic drugs, and compliance patterns in a naturalistic setting. Twenty chronic psychiatric outpatients who had been continuously prescribed antipsychotic agents for a minimum of six months were interviewed. The major finding is the greater antipsychotic dose exposure among those with self-reported NAEs compared with those without NAEs (781 +/- 606 chlorpromazine-equivalent mg/d vs. 125 +/- 117, p less than 0.001). High-potency agents were prescribed for all of the patients reporting amenorrhea and/or galactorrhea, although the relationship between potency group (high vs. low) and total neuroendocrine effects was not significant. Self-reported compliance was not significantly related to neuroendocrine adverse effects. However, a trend toward the association of self-reported galactorrhea and noncompliance (p = 0.08) is noted. The implications of these findings and a suggested approach for their replication in a more powerful statistical analysis is discussed.
Insights
Antipsychotic medications can cause neuroendocrine adverse effects (NAEs) in women. This study found higher antipsychotic doses in patients experiencing NAEs, suggesting dose reduction may be beneficial.
Area of Science:
- Neuroendocrinology
- Psychopharmacology
- Women's Health
Background:
- Neuroendocrine adverse effects (NAEs) from antipsychotics are common in women.
- Previous assumptions suggested tolerance or successful management of NAEs.
- The impact of chronic NAEs on patient compliance remains under-examined.
Purpose of the Study:
- To investigate the prevalence of chronic NAEs in women on antipsychotic agents.
- To explore the relationship between NAEs, antipsychotic dosage, and patient compliance.
- To assess self-reported NAEs in a naturalistic outpatient setting.
Main Methods:
- Pilot study involving 20 chronic psychiatric outpatients on antipsychotics for ≥6 months.
- Data collected via interviews on self-reported NAEs, antipsychotic drugs, and compliance.
- Analysis compared antipsychotic dose exposure between patients with and without NAEs.
Main Results:
- Patients reporting NAEs had significantly higher antipsychotic dose exposure (781 mg/d vs. 125 mg/d).
- High-potency agents were used in all patients with amenorrhea/galactorrhea.
- No significant relationship found between NAEs and self-reported compliance, though galactorrhea trended with noncompliance.
Conclusions:
- Chronic NAEs are associated with higher antipsychotic dose exposure.
- Further research with larger sample sizes is needed to confirm findings and explore interventions.
- Potential for dose adjustment or alternative treatments to manage NAEs and improve adherence.