Academic journal article Advances in Mental Health

Australian Mental Health Staff Response to Antipsychotic Medication Side Effects - the Perceptions of Consumers

Academic journal article Advances in Mental Health

Australian Mental Health Staff Response to Antipsychotic Medication Side Effects - the Perceptions of Consumers

Article excerpt

Background

Health professionals commonly elect to use antipsychotic medications as the frontline treatment for people experiencing a serious mental health problem. The use of these medications inevitably results in side effects, which may include weight gain, apathy, anxiety, blurred vision, restlessness, headaches, dizziness, diarrhoea, involuntary body movements, and sexual dysfunction (Hartling et al., 2012; Peluso, Lewis, Barnes, & Jones, 2012; Rummel-Kluge et al., 2012). Each of these side effects alone may seriously affect an individual's life, but people frequently experience numerous side effects concurrently, which substantially worsens their impact (Bentall, 2010; Naber, Karow, & Lambert, 2005) and may undermine the recovery process.

Second-generation antipsychotic medications were initially reported to cause fewer or less severe side effects than first generation antipsychotic medications (Leucht, Arbter, Engel, Kissling, & Davis, 2009). Recent systematic views have challenged this view, however, concluding that the side effect profiles between first- and second-generation antipsychotic medications do not differ significantly (Hartling et al., 2012; Peluso et al., 2012; Rummel-Kluge et al., 2012). Importantly, second-generation antipsychotic medication typically results in less sedation when compared with first-generation antipsychotic medication, and mental health consumers commonly report sedation as one of the most disturbing side effects (Leucht, Arbter, et al., 2009).

Limited evidence suggests that health professionals do not facilitate the participation of mental health consumers in discussions about issues that consumers may potentially find embarrassing, regardless of whether these issues may be associated with psychotic symptoms (McCabe, Heath, Burns, & Priebe, 2002) or antipsychotic medication side effects (Rogers, Day, Randall, & Bentall, 2003).When mental health consumers raise such issues, mental health professionals tend to avoid, dismiss, or tentatively address them (McCabe et al., 2002; Rogers et al., 2003). It also appears that mental health consumers are not well informed about antipsychotic medications (Rogers et al., 2003). Overall, this situation is less than satisfactory, as research has shown that a patient-centred approach, particularly one informed by shared decision-making principles, enhances adherence to treatment recommendations, improved patient satisfaction, and improved patient outcomes (Barr & Threlkeld, 2000; Charles, Gafni, & Whelan, 1997; Ende, Kazis, Ash, & Moskowitz, 1989; Halpern, 2003; Levinson, Lesser, & Epstein, 2010).

Qualitative studies, conducted in the United Kingdom (Carrick, Mitchell, Powell, & Lloyd, 2004; Hon, 2012; Kikkert et al., 2006; Seale, Chaplin, Lelliott, & Quirk, 2007), United States (Sajatovic, Jenkins, Cassidy, & Muzina, 2009), and Canada (Vandyk & Baker, 2012), have examined people's experience of antipsychotic medication side effects and reported several common themes. Mental health consumers frequently state that antipsychotic medication impairs their ability to communicate and has a detrimental, embarrassing effect on their appearance, which impacts significantly on social activities (Kikkert et al., 2006; Seale et al., 2007; Vandyk & Baker, 2012). On the other hand, consumers also note that the use of antipsychotic medication results in some benefits. In particular, consumers report that medication controls antipsychotic symptoms (Carrick et al., 2004; Hon, 2012; Sajatovic et al., 2009), improves insight (Carrick et al., 2004; Kikkert et al., 2006), and enables them to lead relatively normal lives.

Mental health consumers' experience of antipsychotic medication side effects has been addressed in several qualitative Australian studies (Happell, Manias, & Roper, 2004; McCann & Clark, 2004; Meehan, Stedman, & Wallace, 2011; Salomon & Hamilton, 2013; Usher, Park, & Foster, 2013). …

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