Subjective Experiences of Antipsychotic Treatment: A Comparison of First and Second-generation Medications among Patients with Schizophrenia | Chapter 01 | Innovations in Medicine and Medical Research Vol. 1
Aims:
The patient’s perspective of antipsychotic treatment has been a relatively
neglected area of research. Whether subjective experiences of antipsychotic
treatment are better among patients on second-generation antipsychotics (SGAs),
than those on first-generation antipsychotics (FGAs) has also evoked some
controversy. This study attempted a longitudinal comparison of attitudes toward
treatment, subjective well-being and quality of life (QOL) between patients on
SGAs and FGAs. Socio-demographic and clinical correlates of these subjective
experiences were also examined.
Methodology:
Standardised ratings of insight, psychopathology, side-effects, attitudes,
subjective well-being and QOL were carried out among 40 patients with
schizophrenia on SGAs and 30 on FGAs, over a 6-month period.
Results:
Both groups were similar in the first 3-month period, apart from the slightly
greater severity of illness in the FGA group. Differences in symptom-severity
and side-effects emerged between the groups over the course of follow-up.
Moreover, as the study progressed, differences also became apparent in subjective
experiences; patients on SGAs had significantly better attitudes, subjective
well-being and QOL than those on FGAs. However, differences between individual
SGAs (olanzapine and risperidone) on these indices were minimal. The three
indices of subjective experience were highly correlated with each other. Older
age, being employed, greater insight, lower symptom-severity and the absence of
side-effects demonstrated significant positive associations with different
aspects of subjective experiences.
Conclusions:
Patients on SGAs had a more favourable profile of subjective experiences with
treatment than those on FGAs. These differences seemed to be determined mainly
by differences in symptom-severity and side-effects.
Author(s) Details
Nisha Warikoo
Department of Psychiatry,
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh,
India.
Prof. Subho Chakrabarti
Department of Psychiatry,
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh,
India.
Sandeep Grover
Department of Psychiatry,
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh,
India.
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