A Prospective Study on Combination of Olanzapine Orrisperi Done With Fluoxetine and Their Impact on Quality of Life in Psychosis Patients

Main Article Content

Abstract

Objectives: To assess the quality of life, medication adherence and the ADRs in psychosis patients taking a combination of olanzapine with fluoxetine and risperidone with fluoxetine. Methods: A six-month prospective observational cohort study with 100 participants on antipsychotics was conducted at Krishna Rajendra Hospital, Mysuru, in 2023. Data, including quality of life, ADRs, and medication adherence, was collected and assessed using SF-12, Naranjo scale, and MARS-10. Results: The study encompassed 100 participants, with those aged 36-45 (29%) more prone to psychosis. Males (52%) exhibited higher susceptibility than females (48%), and higher literacy levels (65%) increased the risk. Weight range 51-70kg (74%) was common, and most with psychosis were non-alcoholic (93%) and nonsmokers (85%). Regimens improved quality of life and medication adherence. Adverse drug reactions included sleeplessness (13.02%) and weight gain (13.02%), with a total of 307 reported, 201 deemed probable and 106 possible. Conclusion: The study population shows strong adherence, indicating the efficacy and tolerance of the current medication regimen. Findings underscore the need to address both physical and mental health for overall wellbeing. Emphasizing ADR assessment aids physicians in safe treatment selection, necessitating an active surveillance system for identifying and reporting ADRs linked to antipsychotic medicines

References

Singh G., Sharma M., Kumar G.A., Rao N.G., Prasad K., Mathur P., et al. The burden of neurological disorders across the states of India: the Global Burden of Disease Study 1990–2019. The Lancet Global Health. 2021 Aug 1;9(8):e1129–e1144.

Arciniegas D.B. Psychosis. Continuum (Minneap Minn). 2015 Jun;21(3 Behavioral Neurology and Neuropsychiatry):715–736. doi:10.1212/01.CON.0000466662.89908.e7.

Craddock N., O’Donovan M.C., Owen M.J. The genetics of schizophrenia and bipolar disorder: dissecting psychosis. Journal of Medical Genetics. 2005 Mar 1;42(3):193–204.

Morgan V.A., McGrath J.J., Jablensky A., Badcock J.C., Waterreus A., Bush R., et al. Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis. Psychological Medicine. 2014 Jul;44(10):2163–2176.

Muzaffar G. Features of Reactive Psychosis in Schizophrenia. Research Journal of Trauma and Disability Studies. 2023 Jan 24;2(1):44–49.

Insel T.R. Rethinking schizophrenia. Nature. 2010 Nov 11;468(7321):187–193.

World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders.

Wells B.G. Pharmacotherapy Handbook. London and New York; 2009.

Smith D.J., Whitham E.A., Ghaemi S.N. Bipolar disorder. In: Aminoff M.J., Boller F., Swaab D.F., editors. Handbook of Clinical Neurology. 2012;106:251–263.

Grande I., Berk M., Birmaher B., Vieta E. Bipolar disorder. The Lancet. 2016 Apr 9;387(10027):1561–1572.

Vieta E., Salagre E., Grande I., Carvalho A.F., Fernandes B.S., Berk M., Birmaher B., Tohen M., Suppes T. Early intervention in bipolar disorder. American Journal of Psychiatry. 2018 May 1;175(5):411–426.

McNamara R.K., Nandagopal J.J., Strakowski S.M., DelBello M.P. Preventative strategies for early-onset bipolar disorder: towards a clinical staging model. CNS Drugs. 2010 Dec;24:983–996.

Torres F. What is depression [Internet]. American Psychiatric Association. October 2020.

Lépine J.P., Briley M. The increasing burden of depression. Neuropsychiatric Disease and Treatment. 2011 May 31;7(Suppl 1):3–7.

Lam R.W. Depression. Oxford University Press; 2018.

Hálfdánarson Ó., Zoëga H., Aagaard L., Bernardo M., Brandt L., Fusté A.C., et al. International trends in antipsychotic use: a study in 16 countries, 2005–2014. European Neuropsychopharmacology. 2017 Oct 1;27(10):1064–1076.

Fourrier A., Gasquet I., Allicar M.P., Bouhassira M., Lépine J.P., Bégaud B. Patterns of neuroleptic drug prescription: a national cross-sectional survey of a random sample of French psychiatrists. British Journal of Clinical Pharmacology. 2000 Jan;49(1):80–86.

Lahon K., Shetty H.M., Paramel A., Sharma G. Pharmacoepidemiological study of antipsychotics in the psychiatry unit of a tertiary care hospital: a retrospective descriptive analysis. International Journal of Nutrition, Pharmacology, Neurological Diseases. 2012 May 1;2(2):135–141.

Patteet L., Cappelle D., Maudens K.E., Crunelle C.L., Sabbe B., Neels H. Advances in detection of antipsychotics in biological matrices. Clinica Chimica Acta. 2015 Feb 20;441:11–22.

Gareri P., Segura-García C., Manfredi V.G., Bruni A., Ciambrone P., Cerminara G., et al. Use of atypical antipsychotics in the elderly: a clinical review. Clinical Interventions in Aging. 2014 Aug 16:1363–1373.

Stroup T.S., Gray N. Management of common adverse effects of antipsychotic medications. World Psychiatry. 2018 Oct;17(3):341–356.

Song M., Rubin B.S., Ha J.W., Ware R.S., Doan T.N., Harley D. Use of psychotropic medications in adults with intellectual disability: a systematic review and meta-analysis. Australian & New Zealand Journal of Psychiatry. 2023 May;57(5):661–674.

Miller C.H., Mohr F., Umbricht D., Woerner M., Fleischhacker W.W., Lieberman J.A. The prevalence of acute extrapyramidal signs and symptoms in patients treated with clozapine, risperidone, and conventional antipsychotics. Journal of Clinical Psychiatry. 1998 Feb 1;59(2):69–75.

Haddad P.M., Sharma S.G. Adverse effects of atypical antipsychotics: differential risk and clinical implications. CNS Drugs. 2007 Nov;21:911–936.

Divac N., Prostran M., Jakovcevski I., Cerovac N. Second-generation antipsychotics and extrapyramidal adverse effects. BioMed Research International. 2014;2014.