Relationship of Depression and Antidopaminergic Side Effects (Extrapyramidal Syndrome and Hyperprolactinemia) of Antipsychotic Maintenance Treatment in Schizophrenia

Abstract

Background. Currently, depression is seen as one of the most common symptoms in patients with schizophrenia, which can be observed at all stages of its course. The study of factors
affecting the development of affective disorders in schizophrenia, including the relationship between postQschizophrenic depression and side effects of antipsychotics, remains topical.
Material and methods. At the stage of remission, 50 patients with paranoid schizophrenia who received antipsychotics at the time of inclusion in the study for at least 2 weeks were
examined. Comparison groups were formed depending on the type of antipsychotic therapy and were comparable in age and duration of the disease. The study was conducted using a clinical
scale score: Abnormal Involuntary Movement Scale (AIMS), Simpson Angus rating scale (SAS), Barnes akathisia rating scale, Calgary depression rating scale (CDSS) and Сlinical global
impression scale (CGI). In all patients, the level of prolactin in the blood serum was determined on an empty stomach.
Results. The presence of depression was verified in 40 % of patients, including 52 % of women and 28 % of men. The depression was represented, mainly, by apatoQadynamic syndrome.
The total severity of the mental state of patients receiving secondQgeneration antipsychotics was less. Patients treated with traditional antipsychotics had more pronounced extrapyramidal
side effects in the form of pathological involuntary movements, akathisia, tremor, muscle rigidity, etc. Clinically defined depression was found in 68 % of patients receiving antipsychotics of
the first generation and 12 % who received therapy with atypical antipsychotics. Side effects of antipsychotic therapy significantly correlated with the severity of depressive symptoms. A
direct parallelism was found between the depression score on the Calgary scale and the level of prolactin in the blood.
Conclusion. Supportive therapy of schizophrenic patients with firstQgeneration antipsychotics, accompanied by side effects, is a risk factor for the development of depression. For the prevention
of postQschizophrenic depression, it is advisable to use secondQgeneration antipsychotics that are safe with regard to the development of EPS and hyperprolactinaemia.