Perbandingan Regimen Terapi Antipsikotik Berbasis Risperidon Terhadap Sindrom Ekstrapiramidal, Fungsi Kognitif, dan Gangguan Metabolik Pada Pasien Schizophrenia

https://doi.org/10.22146/farmaseutik.v1i1.60346

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

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

Abstract


Target kerja setiap regimen antipsikotik menimbulkan efek samping berbeda baik digunakan secara tunggal maupun kombinasi. Risperidon tunggal, kombinasi risperidon-klorpromazin dan risperidon-klozapin merupakan 3 besar regimen terapi antipsikotik terbanyak yang digunakan di Instalasi rawat jalan RS Ernaldi Bahar Palembang. Penelitian ini bertujuan untuk mengetahui pengaruh 3 regimen terapi antipsikotik berbasis risperidon terhadap kejadian sindrom ekstrapiramidal (EPS), fungsi kognitif, serta gangguan metabolik. Rancangan penelitian Cohort Prospective pre-post test menggunakan alat bantu kuesioner Extrapyramidal Symptom Rating Scale (ESRS) untuk mengetahui kejadian EPS, Mini Mental State Examination (MMSE) untuk mengetahui perubahan fungsi kognitif serta mengukur Body Mass Index (BMI), kolesterol total, tekanan darah, dan gula darah sewaktu (GDS) untuk mengetahui adanya gangguan metabolik. Pengambilan data dilakukan pada pasien rawat jalan periode Maret–April 2020. Diperoleh sebanyak 361 subyek penelitian, namun akibat pandemi covid-19 maka hanya 180 yang memenuhi kelengkapan data untuk dianalisa dan terdistribusi merata ke dalam 3 regimen terapi antipsikotik yang diteliti. Analisis demografi responden dilakukan secara deskriptif. Uji Kruskal Wallis digunakan untuk mengetahui perbandingan regimen terapi antipsikotik berbasis risperidon terhadap kejadian EPS, sedangkan untuk melihat perburukan fungsi kognitif dan gangguan metabolik digunakan Uji Chi-square. Hasil penelitian menunjukkan terdapat perbedaan yang signifikan munculnya kejadian parkinson (p=0,000) dan distonia (p=0,027). Penggunaan obat antikolinergik yang tidak adekuat merupakan faktor pengganggu yang ikut mempengaruhi secara signifikan terhadap kejadian parkinson (p=0,048). Serta tidak terdapat perbedaan yang signifikan dalam perburukan fungsi kognitif (p=0,465), BMI (p=0,610), kolesterol total (p=0,167), tekanan darah (p=0,327) dan GDS (p=0,218) antar 3 regimen terapi antipsikotik berbasis risperidon.

Keywords


Schizophrenia; efek samping; regimen antipsikotik

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References

Balitbangkes, R., 2013. Riskesdas 2013. Kementerian Kesehatan RI, Jakarta.

Balitbangkes, R., 2018. Hasil Utama Riskesdas 2018.

Bruijnzeel, D., Suryadevara, U., dan Tandon, R., 2014. Antipsychotic treatment of schizophrenia: An update. Asian Journal of Psychiatry, 11: 3–7.

Carrière, I., Fourrier-Reglat, A., Dartigues, J.-F., Rouaud, O., Pasquier, F., Ritchie, K., dkk., 2009. Drugs With Anticholinergic Properties, Cognitive Decline, and Dementia in an Elderly General Population: The 3-City Study. Archives of Internal Medicine, 169: 1317.

Clifton, P.M. dan Nestel, P.J., 1992. Influence of gender, body mass index, and age on response of plasma lipids to dietary fat plus cholesterol. Arteriosclerosis and Thrombosis: A Journal of Vascular Biology, 12: 955–962.

Correll, C.U., Frederickson, A.M., Kane, J.M., dan Manu, P., 2007. Does Antipsychotic Polypharmacy Increase the Risk for Metabolic Syndrome? Schizophrenia Research, 89: 91–100.

Crismon, M.L., Argo, T.R., dan Bucley, P.F. (Editor), 2008. Schizophrenia, dalam: Pharmacotherapy: A Pathophysiologic Approach. McGraw-Hill Medical, New York, hal. 1099–1122.

De Hert, M., Wampers, M., van Winkel, R., dan Peuskens, J., 2007. Anticholinergic use in hospitalised schizophrenic patients in Belgium. Psychiatry Research, 152: 165–172.

Ezeme, M.S., Uwakwe, R., Ndukuba, A.C., Igwe, M.N., Odinka, P.C., Amadi, K., dkk., 2017. Socio-demographic correlates of treatment response among patients with schizophrenia in a tertiary hospital in South-East Nigeria. African Health Sciences, 16: 1036.

Handayani, D.S., Cahaya, N., dan Srikartika, V.M., 2017. Pengaruh Pemberian Kombinasi Antipsikotik Terhadap Efek Samping Sindrom Ekstrapiramidal Pada Pasien Skizofrenia Di Rumah Sakit Jiwa Sambang Lihum. Farmaka, 15: 86–95.

Holder, S.D. dan Wayhs, A., 2014. Schizofrenia. American Family Physician, 775.

Kochhann, R., Cerveira, M.O., Godinho, C., Camozzato, A., dan Chaves, M.L.F., 2009. Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample. Dementia & Neuropsychologia, 3: 88–93.

Lader, M., 1998. Long-term side-effects of U antipsychotic drug medication. The Royal Society of Medicine Press, 4: 173–177.

Lewine, R., Martin, M., dan Hart, M., 2017. Sex Versus Gender Differences in Schizophrenia: The Case for Normal Personality Differences. Schizophrenia Research, 189: 57–60.

MacKenzie, N.E., Kowalchuk, C., Agarwal, S.M., Costa-Dookhan, K.A., Caravaggio, F., Gerretsen, P., dkk., 2018. Antipsychotics, Metabolic Adverse Effects, and Cognitive Function in Schizophrenia. Frontiers in Psychiatry, 9: 622.

Mayangsari, D.R., 2016. 'Evaluasi Adverse Event dan Penatalaksanaannya Dalam Penggunaan Antipsikotik Pada penderita Skizofrenia di RSJ Prof. Dr. Soerojo Magelang dan RSJD Dr. Amino Gondohutomo Provinsi Jawa Tengah Periode Januari-Juni 2015', , Program Pasca Sarjana, . Universitas Gadjah Mada, Yogyakarta.

Mendelson, S.D., 2008. Metabolic Syndrome and Psychiatric Illness: Interactions, Pathophysiology, Assessment and Treatment, 1st ed. ed. Elsevier/Academic Press, Amsterdam ; Boston.

Munikanan, T., Midin, M., Daud, T.I.M., Rahim, R.A., Bakar, A.K.A., Jaafar, N.R.N., dkk., 2017. Association of social support and quality of life among people with schizophrenia receiving community psychiatric service: A cross-sectional study. Comprehensive Psychiatry, 75: 94–102.

Pallava, A., Chadda, R.K., Sood, M., dan Lakshmy, R., 2012. Metabolic syndrome in schizophrenia: A comparative study of antipsychotic-free/naïve and antipsychotic-treated patients from India. Nordic Journal of Psychiatry, 66: 215–221.

Patel, K.R., Cherian, J., Gohil, K., dan Atkinson, D., 2014. Schizophrenia: Overview and Treatment Options. P&T, 39: 638–645.

PDSKJI, 2011. Konsensus Penatalaksanaan Gangguan Skizofrenia. PDSKJI, Jakarta.

Šagud, M., Vuksan, B., dan Rojni, M., 2018. Smoking in Schizophrenia: An Updated Review. Psychiatria Danubina, 30: 216–223.

Saharuddin, 2020. Perbandingan Efektivitas Regimen Terapi Antipsikotik Pasien Schizophrenia di RSJ dr. Ernaldi Bahar Palembang. Majalah Farmaseutik, .

Schatz, S.N. dan Weber, R.J., 2015. Adverse Drug Reactions.

Skrede, S., Steen, V.M., dan Fernø, J., 2013. Antipsychotic-induced increase in lipid biosynthesis: activation through inhibition? Journal of Lipid Research, 54: 307–309.

Stahl, S.M., 2017. Prescriber’s Guide, Sixth. ed. Cambridge University Press, United Kingdom.

Stramecki, F., Kotowicz, K.D., Piotrowski, P., Frydecka, D., Rymaszewska, J., Beszłej, J.A., dkk., 2018. Assessment of the Association Between Cigarette Smoking and Cognitive Performance in Patients With Schizophrenia-Spectrum Disorders: A Case-Control Study. Frontiers in Psychiatry, 9: 642.

Talreja, B.T., Shah, S., dan Kataria, L., 2013. Cognitive function in schizophrenia and its association with socio-demographics factors. Industrial Psychiatry Journal, 22: 47.

Wijono, R., Nasrun, M.W., dan Damping, C.E., 2013. Gambaran dan Karakteristik Penggunaan Triheksifenidil pada Pasien yang Mendapat Terapi Antipsikotik. J Indon Med Assoc, 63: 14.

Woodward, N.D., Purdon, S.E., Meltzer, H.Y., dan Zald, D.H., 2005. A Meta-Analysis of Neuropsychological Change to Clozapine, Olanzapine, Quetiapine, and Risperidone in Schizophrenia. The International Journal of Neuropsychopharmacology, 8: 457–472.



DOI: https://doi.org/10.22146/farmaseutik.v1i1.60346

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