Comparative study of extrapyramidal side effects, sexual dysfunctions and hyperprolactinaemia using typical and atypical antipsychotic medications among patients with schizophrenia in Maiduguri.

Abstract

Background: Extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia are major side effects with the
use of antipsychotic medications that impede treatment adherence leading to relapse, increased cost of care and
rehospitalization among patients with schizophrenia on antipsychotic medications. The study aims to compare the
prevalence of extra-pyramidal side effects (EPSE), sexual dysfunctions (SD) and hyperprolactinaemia (HPRL) among
patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is
to determine if any associations exist between extra-pyramidal side effects, sexual dysfunctions and
hyperprolactinaemia.
Methodology: A cross-sectional hospital-based survey involving 209 patients with schizophrenia were interviewed with
structured instruments for the assessment of sexual dysfunction, EPSE and the estimation of serum prolactin was done
using Enzyme-linked Immunosorbent Assay. Frequencies and Chi-square analysis were used to compare differences in
EPSE, SD & HPRL.
Result: The study revealed non-statistically significant differences as a group between typical and atypical antipsychotic
medication in terms of extra-pyramidal side effects, sexual dysfunction and hyperprolactinaemia. However, a significant
association was observed when individual drugs were compared with haloperidol causing the highest frequency of
hyperprolactinaemia (χ2 = 14.9, P = 0.011). A significant relationship between sexual dysfunction and
hyperprolactinaemia, sexual dysfunction and extra-pyramidal side effects as well as extra-pyramidal and
hyperprolactinaemia was found when individual items for sexual functionin were used.
Conclusion: The significant relationships between sexual dysfunction only in the domains of sexual desire and arousal
with hyperprolactinaemia and extrapyramidal side effects as well as hyperprolactinaemia with extrapyramidal side
effects point to a common anti-dopaminergic activity of antipsychotics via different pathways. Prospective studies
among a larger sample of patients with schizophrenia are needed to unfold these relationships.