Describing the prevalence and management of adverse effects from antipsychotics as “a neglected area” of study, a team of researchers from the UK has published a systematic review in the Journal of Psychopharmacology. They aimed to identify the prevalence of, and management strategies for nine categories of adverse effects, including sedation, weight gain, metabolic syndrome, sexual dysfunction and cardiovascular effects.
The researchers reviewed 53 studies, and catalogued the rates of side effects identified in them. They found that “antipsychotic polypharmacy was associated with increased frequency of adverse effects.” They also found that longer duration of treatment was associated with more severe adverse effects.
“The most frequently reported or observed antipsychotic side effects identified were sexual dysfunction, metabolic problems and weight gain,” the researchers wrote. They found that up to 59% of male patients reported sexual dysfunction, compared to 25–50% of women.
The researchers also found that clinicians were generally not monitoring side effects nor developing management strategies for them very effectively. “Five of the seven studies which addressed baseline testing and follow-up monitoring revealed disappointing levels as low as 0% compliance with monitoring, despite guideline recommendations,” the authors wrote.
“Antipsychotic adverse effects are diverse and frequently experienced, but are not often systematically assessed,” they concluded. “There is a need for further scientific study concerning the management of these side effects.”
(Abstract) “First do no harm.” A systematic review of the prevalence and management of antipsychotic adverse effects. (Young, Su Ling et al. Journal of Psychopharmacology. Published online before print December 16, 2014. doi: 10.1177/0269881114562090)