Assessment of Extrapyramidal Symptoms and Hyperprolactinemia with Risperidone in Schizophrenic patients and Evaluation of their Management
To check the occurrence of Extrapyramidal Symptoms (EPS) and Hyperprolactinemia (HP) in SchizophrenicÃ‚Â patients receiving Risperidone drug and to check the efficacy of the drugs used for the management of these sideÃ‚Â effects. The study assumes significance in light of reported data that anticholinergic drugs are not very effectiveÃ‚Â in relieving side effects and that they may impair efficacy of antipsychotic drugs to relieve positive symptoms. 30Ã‚Â Schizophrenic patients receiving Risperidone drug were assessed for EPS & HP using Simpson Angus RatingÃ‚Â Scale (SAS), Barnes Akathisia Rating Scale (BARS), Abnormal Involuntary Movement Scale (AIMS) & estimatingÃ‚Â prolactin level in blood. The EPS and HP side effects were treated with Trihexiphenidyl, propranolol or diazepam
and cabergoline respectively and efficacy was studied for resolving the symptoms. The study revealed thatÃ‚Â 54.83% of patients on Risperidone showed EPS; majority of these patients (48.38%) developed ParkinsonismÃ‚Â and rest (6.45%) developed Akathisia. Besides, 6.45% of the patients developed HP manifested as amenorrheaÃ‚Â and menstrual irregularities. Trihexiphenidyl brought about resolution of most (88%) patients with ParkinsonismÃ‚Â and partial resolution in remaining patients where tremors & rigidity persisted. propranolol and diazepam brought
about the resolution of Akathisia. Cabergoline brought about satisfactory resolution of HP & associated symptomsÃ‚Â in all the cases. About 65% of the patients receiving risperidone drug exhibited perceptible side effects. EPS, particularlyÃ‚Â Parkinsonism was found to be the major adverse effect. All the side effects were adequately resolved byÃ‚Â the conventional drugs even at lower levels of the recommended dose improving the compliance of the treatment.