We searched for every paper that reported on sedation in the context of antipsychotic use in psychosis AND identified any impact on functioning and wellbeing resulting from sedation...out of ~3300 papers only 11 met these criteria. NONE had collected data to explore this relationship specifically.
The majority of studies reflected qualitative or content-analysis approaches (n=8), which limits interpretation and generalisability in many ways. Many studies also were likely to be non-representative in population recruited (e.g. analysing websites or patient forums for medication comments).
New paper out from myself, Kate Robbins and Jo Hodgekins exploring what is known about how sedation from antipsychotics impacts on patients...Short answer, not nearly enough! Longer answer below... www.sciencedirect.com/science/arti...
Overall, while these medications are helpful (and often necessary) for managing symptoms for many patients, it is surprising that so little is known about the impacts - knowing more will improve clinical management and hopefully enable informed choices for patients.
On the other hand, excessive sleep being used as a strategy to avoid anxiety or challenging situations would be expected to worsen mental health over time, increase isolation, and probably affect social recovery. So - while identified as a positive in the studies this is not straightforward(!)
In all studies reporting on multiple medication side effects (n=7), sedation was identified in all of them as either the most common (n=5) or in the top three (n=2). Also noteworthy was the lack of definition of sedation, and inconsistent measurement - nearly every study had a different approach...
Sarah Reeve
Sarah Reeve
Important research on clinical perceptions of sedation in psychosis - please take part and circulate if you can! 🙏
Nevertheless, a negative impact of sedation on day-to-day functioning was consistently reported across all studies across qualitative and content-analysis based studies, and in the few studies which used validated measures. Sedation was also reported to negatively affect motivation of patients.
With respect to wellbeing, a negative impact was also supported (lowered self-esteem, self-efficacy, quality of life, and increased anhedonia). Some positive effects of sedation were noted on improving sleep and therefore symptoms like hallucinations, and on allowing escape more generally...
There are also many domains not explored to date - for example, the effect of sedation on depression or mood, paranoia, hallucinations, or on important features like employment, relationship status or social functioning. I'm hoping to do more work in this area, so reach out if you are interested!
