A comparative study among the anticholinergic adverse effects of some phenothiazine drugs used in the treatment of schizophrenic patients.

Abstract

The aim of this study was the comparison among the Anticholinergic adverse effects of four drugs related to three different classes of phenothiazines, used in the treatment of schizophrenic patients; in order to detect the drugs of most and least potent adverse effects. It was a follow up case series study, carried out at the psychiatric department of Ibn-Sena Teaching General Hospital, Mosul city, during the period from the 1st of August 2009 to the 1st of January 2011. The study was conducted on sixty recently diagnosed schizophrenic patients (thirty seven males and twenty three females). Comprising four groups each of fifteen patients. Each group was treated for the first time with different mono phenothiazine drug. The phenothiazine drugs used were: 1-Chlorpromazine (aliphatic class), 2-Thioridazine (piperidine class), 3-Trifluoperazine and 4-Fluphenazine (piperazine class of phenothiazine drugs). The anicholinergic adverse effects were assessed among the patients before commencement of treatment and thereafter, every month for a period of six months of treatment. The results of this study revealed that the incidence of the anticholinergic adverse effects among the groups of patients on chlorpromazine and thioridazine therapy was the highest in comparison with the groups of patients on trifluoperazine and fluphenazine therapy, and that the difference between the first two groups and the second two groups was statistically highly significant. No significant difference was seen between the groups of patients on chlorpromazine and thioridazine therapy in relation to the incidence of the mentioned adverse effects. Also no significant difference was seen between the groups of patients on Trifluoperazine and fluphenazine therapy in general, except for the parameter of blurred vision; where the incidence of this case upon the last group was absent. This study revealed that the drugs chlorpromazine (aliphatic class) and thioridazine (piperidine class) have more potent anticholinergic adverse effects than the piperazine class related phenothiazines (trifluoperazine and fluphenazine).