Identification of antipsychotic side effects in Schizophrenia patients using Naranjo algorithm at Jambi Psychiatric Hospital
DOI:
https://doi.org/10.22437/proca.v1i2.50325Keywords:
Antipsychotic; Inpatient; Naranjo Algorithm; Schizophrenia; Adverse Drug Reaction.Abstract
Background: Schizophrenia is a chronic mental disorder that requires long-term antipsychotic therapy. However, the use of antipsychotics may lead to adverse drug reactions (ADRs) that can affect patients’ quality of life. Objective: This study aimed to identify the types and likelihood of antipsychotic-related side effects among patients with schizophrenia using the Naranjo Algorithm. Methods: A descriptive observational study was conducted in September 2025. Data were collected through structured patient interviews and verified using medical records. The probability of ADRs was assessed using the Naranjo Algorithm, and the data were analyzed descriptively. Results: Among 119 patients with schizophrenia, 12 met the inclusion criteria. These 12 patients experienced a total of 23 ADR events. Based on the Naranjo Algorithm, 4 patients (33.33%) were categorized as probable and 8 (66.67%) as possible. The most common adverse effects were severe sedation (6 cases, 29.09%) and weakness (6 cases, 29.09%), followed by acute dystonia, mouth stiffness, and hypotension (each 8.70%). Less frequent events included hyperglycemia, hypertension, leukocytosis, slurred speech, and hypersalivation (each 4.35%). Conclusion: Most adverse effects showed a possible to probable causal relationship with antipsychotic use. The Naranjo Algorithm proved useful for identifying ADRs and supporting pharmacovigilance activities in psychiatric settings. Enhanced clinical monitoring and patient education are recommended to minimize serious adverse effects.
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[1] Devi F, Robiyanto, Yuswar MA. Studi efek samping dan profil pengobatan pada pasien skizofrenia di instalasi rawat inap rumah sakit jiwa provinsi kalimatan barat. Occup Med (Chic Ill). 2020;53(4):130.
[2] Al Hindi A, Al Balushi S, Al Ruzaiqi S, Al Busafi S, Abdulmonem S, Ali IM, et al. Adverse Drug Reactions Among Hospitalized Psychiatric Patients, Prevalence, Severity, Preventability, and Opportunities for Intervention. Oman Med J. 2024;39(3):e631–e631. doi: 10.5001/omj.2024.75.
[3] Saharuddin, Ikawati Z, Kristanto. Perbandingan Efektivitas Regimen Terapi Antipsikotik Pasien Schizophrenia di RSJ Dr. Ernaldi Bahar Palembang. Maj Farm. 2021;17(2):206–16. https://doi.org/10.22146/farmaseutik.v17i2.58508
[4] Dania H, Faridah IN, Rahmah KF, Abdulah R, Barliana MI, Perwitasari DA. Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta. Indones J Clin Pharm. 2019;8(1). https://doi.org/10.15416/ijcp.2019.8.1.19
[5] Oliva D, Ortega-Sánchez N, Hinojosa S, Pérez-Cisneros M. Literature Review. Mod Metaheuristics Image Process. 2022;7(11):16–35. https://doi.org/10.1201/9781003183501
[6] Meilani D, Sinuraya RK. Pharmacovigilance Dalam Aspek Penanganan Reaksi Obat Yang Tidak Diinginkan. Farmaka. 2018;16(1):103–11. https://doi.org/10.24198/jf.v16i1.17037
[7] Fadhilah H, Salman S, Hilmi IL. Review Artikel: Studi Farmakovigilans terhadap Kejadian Advers Drug Reactions (ADRs). J Pharm Sci. 2023;6(1):199–206. https://doi.org/10.36490/journal-jps.com.v6i1.20
[8] Al Madury S, Padmasari S, Jenderal Achmad Yani Yogyakarta U, Siliwangi J, Barat R, Soerojo Hospital I, et al. Laporan Kasus: Kajian Efek Samping Obat Antipsikotik pada Kejadian Gejala Ekstrapiramidal pada Pasien Skizofrenia. J Pharm [Internet]. 2024;2(2):29–39. https://doi.org/10.30989/jop.v2i2,%20Special%20Edition.1474
[9] Nugrahaningtyas OD, Rahajeng B. Antipsychotic Side Effects Identification Using the Naranjo Algorithm at Hospital X Yogyakarta. Indones J Pharm Sci Technol. 2025;12:42–50. https://doi.org/10.24198/ijpst.v12s1.57955
[10] Rusli R. FARMASI KLINIK. 2021. Jakarta. Indonesia
[11] Gedge L, Lazowski L, Murray D, Jokic R, Milev R. Effects of quetiapine on sleep architecture in patients with unipolar or bipolar depression. Neuropsychiatr Dis Treat. 2010;6:501–8. https://doi.org/10.2147/ndt.s12433
[12] Bharti P, Kumar R, Singh GP. Tardive dystonia with olanzapine: A rare case report. Indian J Psychol Med. 2012;34(2):187–9. https://doi.org/10.4103/0253-7176.101795
[13] Kırşavoğlu B, Odabaşı O. An unexpected side effect related to the use of clozapine: Neutrophilic leukocytosis and brief review of the literature. Psychiatry Res Case Reports. 2023;2(1):100101. https://doi.org/10.1016/j.psycr.2022.100101
[14] Widianto Sudjud R, Yulriyanita B. Sedasi dan Analgesia di Ruang Rawat Intensif. Anesth Crit Car. 2014;32(3):221–33.
[15] Made I, Suardiyasa DO, Dundu AE, Kairupan BHR. Efek samping glaukoma pada penggunaan antipsikotik atipikal. J Kedokt Kom Trop. 2024;12(1):537–42.
[16] Gedam SR, Ghosh S. Distonia akut yang diinduksi oleh quetiapine: laporan kasus. 2015;6:59–61.
[17] Zaporowska-stachowiak I, Oduah KS szymczak CM tiffany. Haloperidol dalam perawatan paliatif: Indikasi dan risiko. Biomedis & Farmakoterapi. 2020;132 https://doi.org/10.1016/j.biopha.2020.110772
[18] Utami VW, Darajati M, Puspitasari CE. Potensi interaksi obat pada pasien skizofrenia di Rumah Sakit Jiwa Mutiara Sukma tahun 2020. Sasambo J Pharm. 2022;3(1):36–42. https://doi.org/10.29303/sjp.v3i1.151
[19] Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45. https://doi.org/10.1038/clpt.1981.154
[20] KEMENKES. Pedoman Pelayanan Kefarmasian Pada Pasien Gangguan Jiwa. 2021. Jakarta: Kemenenterian Kesehatan Republik Indonesia.
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Copyright (c) 2025 Yuliawati, Attiya Istarini, Kamariyah, Yuliana, Uce Lestari, Indah Sri Wulan Sofyan, Sofia Elisa Apriyanti
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