Predictors of extrapyramidal side effects among patients taking antipsychotic medication at Mekelle psychiatry units, Northern Ethiopia, 2023: unmatched case-control study.

Background: Schizophrenia is one of the most disruptive of neuropsychiatric disorders, affecting around 1% of the world's population. Antipsychotic medications have been the backbone of schizophrenia treatment for the past 50 years. Extrapyramidal side effects of antipsychotic medication are a major problem which is associated with various factors. However, there is a dearth of evidence about the predicting factors for extrapyramidal side effects.

Objective: To determine the predictors of extrapyramidal side effects among all patients taking antipsychotic medication at Mekelle Psychiatry units, Northern Ethiopia, 2023.

Methodology: A Case-control study design was employed with a total of 201 study subjects (67cases and 134 controls). A systematic random sampling technique was employed to select the required study subjects. Extrapyramidal Side Effects were measured by the Simpson-Angus Scale, Abnormal Involuntary Movement Scale (AIMS), and the Barnes Akathisia Rating Scale (BARS) scale. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 22. Bivariate and multiple logistic regression analyses were performed to determine between the independent and dependent variables. The significant independent predictor was declared at a 95% confidence interval and P-value of less than 0.05.

Result: Among the study subjects the modifiable factors significantly associated with EPS were; being female (AOR = 0.140, 95% CI: 0.042-0.465, p = 0.001),being single (AOR = 3.084, 95% CI: 0.569-16.727, p = 0.006), perceived stigma (AOR = 0.165, 95% CI: 0.038-0.708, p = 0.015), having mental illness history (AOR = 6.316, 95% CI: 2.026-19.692), p = 0.001), combination first generation antipsychotic drugs (AOR = 0.095,95% CI: 0.010-0.877, p = 0.038), Khat chewing practice/ behavior (AOR = 4.033, 95% CI: 1.120-14.531, p = 0.033) and history of alcohol use and currently drink alcohol (AOR = 6.213, 95% CI: 1.375-28.079, p = 0.018).

Conclusion And Recommendation: Our study revealed, being female, single, stigma, combination first-generation antipsychotic drug, having mental illness history, Khat chewing practice/ behavior and Alcohol intake in the last 3 months were significant factors of Extrapyramidal Side Effects. Psychiatric professionals should be assessing the predictors of Extrapyramidal Side Effects especially, combination of first-generation antipsychotic drugs, substance use with antipsychotic drugs and management comorbid diagnosis routinely is strongly recommended.