Adverse Event Sindroma Metabolik Kombinasi Terapi Risperidon dan Klozapin pada Pasien Skizofrenia di Rumah Sakit Jiwa Magelan
Abstract
Kombinasi risperidon dan klozapin pada pasien skizofrenia dapat menyebabkan adverse drug event peningkatan body mass index (BMI), tekanan darah sistolik, dan tekanan darah diastolik seiring lamanya terapi. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara durasi kombinasi terapi risperidon dan klozapin dengan peningkatan BMI, tekanan darah sistolik, dan tekanan darah diastolik pada pasien skizofrenia. Metode yang digunakan adalah studi kohort retrospektif periode Februari–Mei 2019 pada 59 pasien skizofrenia rawat inap di Rumah Sakit Jiwa Magelang. Subjek dibagi ke dalam 2 kelompok durasi terapi <8 minggu (48 pasien) dan ≥8 minggu (11 pasien). Pengukuran BMI, tekanan darah sistolik, dan tekanan darah diastolik dilakukan pada hari pertama rawat inap dan saat konsultasi rawat jalan yang disesuaikan dengan cut-off point NCEP-ATP III modifikasi BMI populasi Asia Tenggara. Kuesioner terstruktur digunakan untuk mengukur kalori intake dan aktivitas fisik yang diperoleh dari catatan medis pasien. Hasil uji bivariat menunjukkan hubungan bermakna secara klinik antara BMI saat pertama rawat inap dan saat rawat jalan pada kelompok durasi terapi ≥8 minggu, 22,41±2,98 kg/m2 vs 25,2±6,80 kg/m2 (p=0,023, –2,75 (–5,12–(–0,39)), namun tidak ada hubungan bermakna pada tekanan darah sistolik 117±11,73 mmHg vs 118±15,42 mmHg (p=0,797, 95%CI –1,07 (–9,41–7,26) dan tekanan darah diastolik 76±7,86 mmHg vs 73±8,48 mmHg (p=0,192, 95%CI 3,52 (–1,81–8,86) antara kedua kelompok. Faktor usia, jenis kelamin, status merokok, dosis, komedikasi, intake kalori, dan aktivitas fisik tidak menunjukkan hubungan bermakna dengan peningkatan BMI, tekanan darah sistolik, dan tekanan darah diastolik.
Kata kunci: Kombinasi terapi risperidon dan klozapin, metabolik, skizofrenia
Adverse Events of Risperidone and Clozapine Combination Therapy on Schizophrenic Patients at Magelang Mental Hospital
Abstract
The adverse drug effect of risperidone and clozapine combination therapy possibly increases the BMI, systolic and diastolic blood pressures of mental victims. This study aimed at determining the relationship between the duration of risperidone and clozapine combination therapy and increase in body mass index (BMI), systolic and diastolic blood pressures of schizophrenic patients. The correlation was obtained using the cohort retrospective method on 59 schizophrenic inpatients at Magelang Mental Hospital from February–May 2019. Participants were grouped into 2 categories, termed <8 and ≥8 weeks with 48 and 11 persons, respectively. Subsequently, patients’ BMI, systolic and diastolic blood pressures were measured during the first day of hospitalization and outpatient consultations, based on NCEP-ATP III cut off-point with the modification of Southeast Asian population’s BMI. Structured questionnaires were used to evaluate calory intake and physical activity as well as generate respondents’ medical records. The bivariate analysis results showed a significant relationship between BMI increase at initial hospitalization and during outpatient consultation on group ≥8 weeks therapy, 22.41±2.98 kg/m2 vs 25.2±6.80 kg/m2 (p=0.023, –2.75 (–5.12–(–0.39)). However, there is no major correlation occurred in systolic 117±11.73 mmHg vs 118±15.42 mmHg (p=0.797, 95%CI –1.07 (–9.41–7.26)) and diastolic blood pressures 76±7.86 mmHg vs 73±8.48 mmHg (p=0.192, 95% CI 3.52 (–1.81–8.86)) for both groups. Furthermore, age, gender, smoking status, dosage, co-medication, calory intake and physical activity indicated no substantial variations, in terms of the increase in BMI, systolic and diastolic blood pressures among two categories.
Keywords: Metabolic syndrome, risperidone and clozapine combination therapy, schizophrenia
Keywords
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DOI: https://doi.org/10.15416/ijcp.2021.10.3.159
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