Perbandingan Efektivitas Regimen Terapi Antipsikotik Pasien Schizophrenia di RSJ Dr. Ernaldi Bahar Palembang

https://doi.org/10.22146/farmaseutik.v17i2.58508

Saharuddin Saharuddin(1), Zullies Ikawati(2*), Cecep Sugeng Kristanto(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Fakultas Farmasi, Universitas Gadjah Mada
(3) Departemen Ilmu Kedokteran Jiwa, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada/ RSUP Dr. Sardjito, Yogyakarta
(*) Corresponding Author

Abstract


Penatalaksanaan schizophrenia menawarkan berbagai macam metode baik dengan terapi nonfarmakologi maupun  farmakologi. Terapi farmakologi dengan antipsikotik merupakan terapi pokok dalam  penatalaksanaan schizophrenia. Namun, efektivitas antara regimen antipsikotik masih menjadi perdebatan, sehingga penting untuk mengetahui efektivitas  suatu regimen terapi pengobatan schizophrenia. Penelitian ini bertujuan untuk mengetahui perbandingan efektivitas regimen terapi antipsikotik pada pasien schizophrenia di RSJ dr. Ernaldi Bahar Palembang. Rancangan   penelitian ini adalah Cohort Prospective pre – post test menggunakan alat bantu kuesioner penelitian The Positive and Negative  Syndrome Scale (PANSS). Data diambil di Poliklinik Rawat Jalan RSJ dr. Ernaldi Bahar Palembang periode bulan Maret – April 2020. Uji chi-square digunakan untuk mengetahui perbandingan efektivitas regiman terapi antipsikotik. Sebanyak 451 pasien yang terdiagnosa schizophrenia ditelusuri pengobatannya dan diperoleh 35 jenis pola peresepan antipsikotik pada semua pasien. Dipilih tiga (3) regimen antipsikotik yang terbanyak digunakan untuk dianalisis efektivitasnya yaitu monoterapi risperidone (n=59), kombinasi risperidone dengan klorpomazine (n=59) dan kombinasi risperidone dengan clozapine (n=59). Hasil penelitian ini menemukan tidak adanya perbedaan efektivitas yang bermakna berdasarkan penurunan skala PANSS antara regimen terapi antipsikotik pada pasien schizophrenia di RSJ dr. Ernaldi Bahar Palembang dengan nilai signifikan p>0,05 (p=0,173).


Keywords


Schizophrenia; efektivitas; regimen antipsikotik

Full Text:

PDF


References

American Psychiatric Association 2000. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association. 2. American Psychiatric Association 2013. Diagnostic and Statistical Manual of Mental Disorder : DSM-V. In: IKAWATI, Z. (ed.) 2018,Tata Laksana Terapi Penyakit Sistem Syaraf Pusat edisi 1. Karangkajen, Yogyakarta: Bursa Ilmu. 3. Amir & Nurmiati. 2008. RE: Pengenalan Instrument PANSS. 4. Anil, Y. A., Kivircik, A. B., Turgut, T. I., Tümüklü, M., Yazici, M. K., Alptekin, K., Ertuğrul, A., Jayathilake, K., Göğüş, A. & Tunca, Z. 2005. A double-blind controlled study of adjunctive treatment with risperidone in schizophrenic patients partially responsive to clozapine: efficacy and safety. The Journal of clinical psychiatry, 66, 63. 5. Arisyandi, R. R. 2015. Pengaruh Kunjungan Keluarga Terhadap Skor Positive and Negative Symptom Scale (Panss) Pada Pasien Skizofrenia Yang Dirawat Inap Di Rumah Sakit Jiwa Daerah Sungai Bangkong. Tanjungpura University. 6. Baldessarini, R. J., and F. R. Frankenburg 1991. "A novel antipsychotic agent.". N Engl J Med 324.11, 746-754. 7. Blessing, I. O., Iyalomhe, G. B. S., George, E. O., Okojie, F. O. & Solomon, A. O. 2013. Effect of chlorpromazine and haloperidol combination on lipid profile in Nigeria schizophrenic patients. International Journal of Medical and Pharmaceutical Sciences, 3(12), 11-20. 8. Bruijnzeel, D., Suryadevara, U. & Tandon, R. 2014. Antipsychotic treatment of schizophrenia: an update. Asian J Psychiatr, 11, 3-7. 9. Crilly, J. 2007. The history of clozapine and its emergence in the US market: a review and analysis. Hist Psychiatry, 18, 39-60. 10. Crismon, M. L., Argo, T. R. & Buckley, P. F. 2008. Schizophrenia. In: DIPIRO, J. T., TALBERT, R. L., YEE, G. C., MATZKE, G. R., WELLS, B. G. & POSEY, L. M. (eds.) 2008, Pharmacotherapy A Pathophysiologic Approach, 7th Edition,Edition, 1099-1122. New York: McGraw Hill Companies. 11. Damayantie, N., Rusmimpong, R. & Elly, A. 2019. Hubungan Pengetahuan Dan Dukungan Keluarga Dengan Kepatuhan Kontrol Berobat Pasien Skizofrenia Di Poli Jiwa Rsjd Provinsi Jambi Tahun 2018. Jurnal Bahana Kesehatan Masyarakat (Bahana of Journal Public Health), 3, 1-5. 12. Depkes 2004. Pedoman penggolongan dan diagnosis gangguan jiwa di Indonesia. akarta: Departemen Kesehatan. 13. Dipiro, J. T., Talbert, R. L., Yee, G. C., Matzke, G. R., Wells, B. G. & Posey, L. M. 2008. Pharmacotherapy A Pathophysiologic Approach, 7th Edition,Edition,. McGraw Hill Companies: New York. 14. Durand, V. M. & Barlow, D. H. 2006. Intisari psikologi abnormal. Yogyakarta: Pustaka Pelajar. 15. Ezeme, M. S., Uwakwe, R., Ndukuba, A. C., Igwe, M. N., Odinka, P. C., Amadi, K. & Obayi, N. O. 2016. Socio-demographic correlates of treatment response among patients with schizophrenia in a tertiary hospital in South-East Nigeria. Afr Health Sci, 16, 1036-1044. 16. Gibson., Aaron P., Nick C. Patel. & Lauriello, J. 2008. "Antipsychotic combinations blind step or logical? Though unsupported by evidence, using> 1 antipsychotic may make sense for some treatment-resistant patients.". Current Psychiatry 7, 40. 17. Goff, D. C., Henderson, D. C. & Amico, E. 1992. Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. Am J Psychiatry. 18. Gupta, S., Black, D. W. & Smith, D. A. 1994. Risperidone: review of its pharmacology and therapeutic use in schizophrenia. Annals of Clinical Psychiatry, 6, 173-180. 19. Herz, M. I. & Marder, S. R. 2002. Schizophrenia: comprehensive treatment and management. Philadelphia: Lippincott Williams & Wilkins. 20. Hukkanen, J., Jacob III, P., Peng, M., Dempsey, D. & Benowitz, N. L. 2011. Effect of nicotine on cytochrome P450 1A2 activity. British journal of clinical pharmacology, 72, 836. 21. Ikawati, Z. 2018. Tata Laksana Terapi Penyakit Sistem Syaraf Pusat, Pertama,Karangkajen, Yogyakarta, Bursa Ilmu. 22. Irman, V., Patricia, H. & Srimayenti 2018. Faktor-faktor yang berhubungan dengan kepatuhan keluarga dalam mengontrol minum obat pada pasien Skizofrenia. Jurnal Ilmu Kesehatan, Volume 2 No.1. 23. Isuru, A. & Rajasuriya, M. 2019. Tobacco smoking and schizophrenia: re-examining the evidence. BJPsych Advances, 25, 363-372. 24. Kane, J. M., Robinson, D. G., Schooler, N. R., Mueser, K. T., Penn, D. L., Rosenheck, R. A., Addington, J., Brunette, M. F., Correll, C. U. & Estroff, S. E. 2015a. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry, 173, 362-372. 25. Kane, J. M., Schooler, N. R., Patricia Marcy, B., Correll, C. U., Brunette, M. F., Mueser, K. T., Rosenheck, R. A., Addington, J., Estroff, S. E. & Robinson, J. 2015b. Original research the RAISE early treatment program for first-episode psychosis: Background, rationale, and study design. J Clin Psychiatry, 76, 240-6. 26. Kaplan, H. I., Sadock, B. J. & Grebb, J. A. 1997. Sinopsis Psikiatri Ilmu Pengetahuan Perilaku Psikiatri Klinis Jilid 2. Edisi Ke-7. Alih Bahasa: Dr. Widjaja Kusuma. Jakarta: Binarupa Aksara. 27. Kaplan, H. I., Sadock, B. J. & Grebb, J. A. 2010. Sinopsis psikiatri jilid 1. Terjemahan Widjaja Kusuma. Jakarta: Binarupa Aksara, 704-43. 28. Katona, Cornelius, Claudia Cooper & Robertson, M. 2012. At a Glance Psikiatri edisi keempat, Jakarta, Erlangga. 29. Kementrian Kesehatan 2018. Hasil Utama Riskesdas. In: RI., B. P. D. P. K. (ed.). Jakarta: Kementrian Kesehatan. 30. Lv, Y., Wolf, A. & Wang, X. 2013. Experienced stigma and self-stigma in Chinese patients with schizophrenia. General hospital psychiatry, 35, 83-88. 31. Marangell, Lauren B. & Martinez., J. M. 2006. Concise guide to psychopharmacology. American Psychiatric Pub. 32. McGrath, J., Saha, S., Chant, D. & Welham, J. 2008. Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiologic reviews, 30, 67-76. 33. Montoya, A., Amparo Valladares., Luis Lizan., Luis San., Rodrigo Escobar. & Silvia Paz. 2011. Validation of the Excited Component of the Positive and Negative Syndrome Scale (PANSSEC) in a naturalistic sample of 278 patients with acute psychosis and agitation in a psychiatric emergency room. Health and Quality of Life Outcomes, 9:18, 1-11. 34. Nucifora, F. C., Jr., Mihaljevic, M., Lee, B. J. & Sawa, A. 2017. Clozapine as a Model for Antipsychotic Development. Neurotherapeutics, 14, 750-761. 35. Nuryati 2017. Bahan Ajar Rekam Medis dan Informasi Kesehatan Farmakologi. In: KESEHATAN, B. P. D. P. S. D. (ed.). Jakarta: Kementerian Kesehatan Republik Indonesia. 36. Ortiz-Orendain, J., Castiello-de Obeso, S., Colunga-Lozano, L. E., Hu, Y., Maayan, N. & Adams, C. E. 2017. Antipsychotic combinations for schizophrenia. Cochrane Database Syst Rev, 6, CD009005. 37. Park, S. G., Bennett, M. E., Couture, S. M. & Blanchard, J. J. 2013. Internalized stigma in schizophrenia: relations with dysfunctional attitudes, symptoms, and quality of life. Psychiatry research, 205, 43-47. 38. Patel, M. 2010. Tobacco dependence and schizophrenia. A Complex Correlation. Journal of Young Investigators, 19, 1-7. 39. Peng, H., Kuang, Y. & Huang, X. 2001. A control study of risperidone in combination with clozapine in treating refractory schizophrenia. J Mod Clin Med Bioeng, 7, 100-102. 40. Preskorn, S. H. 2010. CNS drug development: part I: the early period of CNS drugs. Journal of Psychiatric Practice®, 16, 334-339. 41. Rosen, K. & Garety, P. 2005. Predicting recovery from schizophrenia: a retrospective comparison of characteristics at onset of people with single and multiple episodes. Schizophrenia bulletin, 31, 735-750. 42. Salam, R., Budiman R., Bastaman TK., Yuniar S., Damping C., Kusumawardhani A., Purnamawati YD. & S., W. 1994. Pedoman Definisi PANSS (Positive and Negative Symptoms Scale), Jakarta, FK Universitas Indonesia Bagian Psikiatri. 43. Saperstein, A. M. & Kurtz, M. M. 2013. Current trends in the empirical study of cognitive remediation for schizophrenia. The Canadian Journal of Psychiatry, 58, 311-318. 44. Savioli, W. K. 2009. The Relationship Between Perceived Stress and Smoking: Focusing on Schizophrenia and Comparative Sub-Groups Diagnosed with Mental Illness. 45. Seeman, M. V. 2004a. Gender differences in the prescribing of antipsychotic drugs. American Journal of Psychiatry, 161, 1324-1333. 46. Seeman, P. 2004b. Atypical antipsychotics: mechanism of action. Focus, 47, 27-58. 47. Setiati, E., Sumarni, D. & Suryawati, S. 2017. Dukungan sosial dan ketaatan pengobatan dengan kekambuhan pasien skizofrenia di Purworejo. Berita Kedokteran Masyarakat, 33, 305-310. 48. Shen, W. W. 1999. A history of antipsychotic drug development. Comprehensive psychiatry, 40, 407-414. 49. Wardani, I. Y. & Dewi, F. A. 2018. Kualitas Hidup Pasien Skizofrenia Dipersepsikan Melalui Stigma Diri. Jurnal Keperawatan Indonesia, 21, 17-26. 50. Wells, B. G., DiPiro, J. T., Matzke, G. R. & Posey, L. M. 2012. Pharmacotherapy handbook 8th edition, McGraw-Hill Medical Pub. Division. 51. Xin, X.-f., Du, B.-c. & Zeng, Z.-x. 2001. A controlled clinical study of risperidone and low dose of clozapine in treating schizophrenia. Herald Med, 20, 501-502. 52. Ziedonis, D. M., Kosten, T. R., Glazer, W. M. & Frances, R. J. 1994. Nicotine dependence and schizophrenia. Psychiatric Services, 45, 204-206.



DOI: https://doi.org/10.22146/farmaseutik.v17i2.58508

Article Metrics

Abstract views : 258 | views : 210

Refbacks

  • There are currently no refbacks.


Majalah Farmaseutik Indexed by:

   
 
 
Creative Commons License