The Impact of Second-Generation Antipsychotic Medication Side-Effects on Functioning From a Schizophrenia Patient Perspective: a Cross-Sectional, Observational, Patient Centered, Web Survey Study

Background: Second-generation antipsychotics (SGAs) are associated with well-known side effects (SEs). We aimed to gain a patients’ perspective on how specific SEs impact daily functioning, emotional well-being, and overall quality of life (QoL).

Methods: This was a cross-sectional, patient-reported web survey, conducted in the US. Eligible participants were ≥18 years, with schizophrenia stable for >1 month, taking an SGA for 1–12 months, and self-reporting ≥1 SE. The survey included patient socio-demographics, the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF), the Glasgow Antipsychotic Side-Effect Scale, and questions about the impact of SEs on functioning and emotions. Participants used a visual analog scale to record the degree of impact for each reported SE.

Results: There were 180 participants: mean age 35 (range 18–61) years; 58.3% female; 69.4% White. Participants reported the lowest Q-LES-Q-SF scores for satisfaction with one’s ‘economic status’, followed by ‘sexual drive’, ‘work’, ‘mood’, and ‘social relationships’. The most prevalent SEs were ‘difficulty sleeping’, ‘feeling sleepy during the day’, ‘dry mouth’, and ‘restlessness’. Almost half of the participants stated that they had experienced weight gain. SEs reported as having a moderate to severe impact on all aspects of functioning were: feeling ‘drugged or like a zombie’, ‘sleepy during the day’, having ‘difficulties sleeping’, feeling ‘restless’, and ‘gaining weight’.

Conclusion: Patients taking SGAs appear to have many SEs, including activating and sedating SEs, and weight gain. These SEs have considerable negative impact on patient’s daily functioning and QoL, including work, sexual drive, and psychosocial effects.