본문 바로가기
KERD
논문KCI 등재

Paliperidone으로 교체한 조현병 환자에서 8주 후 Metabolic Parameter와 Positive and Negative Syndrome Scale (PANSS) 점수의 변화

Changes in the Metabolic Parameters and Positive and Negative Syndrome Scale (PANSS) Scores of Patients with Schizophrenia 8 Weeks after Switching to Paliperidone

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objectives:The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. Methods:Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). Results:The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. Conclusions:Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.

Abstract

Objectives:The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. Methods:Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). Results:The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. Conclusions:Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.

참고문헌 (33)

  1. Son HI, "The effect of atypical antipsychotics on weight", Dongguk Journal of Med, 11, pp.135~144 (2004)
  2. 이종범, "2세대 항정신병 약물의 대사증후군", 생물치료정신의학, 13(2), pp.138~146 (2007), 대한생물치료정신의학회
  3. Marino J, "Paliperidone extended-release for the treatment of schizophrenia", Pharmacotherapy, 28, pp.1283~1298 (2008)
  4. Kane J, "Treatment of schizophrenia with paliperidone extended-release tablets: a 6-week placebo-controlled trial", Schizophr Res, 90, pp.147~161 (2007)
  5. Davidson M, "Efficacy, safety and early response of paliperidone extended-release tablets (paliperidone ER): results of a 6-week, randomized, placebo-controlled study", Schizophr Res, 93, pp.117~130 (2007)
  6. Marder SR, "Efficacy and safety of paliperidone extended-release tablets: results of a 6-week, randomized, placebo-controlled study", Biol Psychiatry, 62, pp.1363~1370 (2007)
  7. Cho HS, "Pharmacological Actions of Antipsychotics, In Clinical Neuropsychopharmacology", pp.115~133 (2009), ML Communications
  8. Kay SR, "The positive and negative syndrome scale (PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
  9. Marangell LB, "Psychopharmacology and Electroconvulsive Therapy, In Textbook of clinical psychiatry. Vol II", pp.1047~1150 (2003), American Psychiatric Publishing
  10. Canuso CM, "Paliperidone extended-release tablets in schizophrenia patients previously treated with risperidone", Int Clin Psychopharmacol, 23, pp.209~215 (2008)
  11. Samaha AN, "“Breakthrough” dopamine supersensitivity during ongoing antipsychotic treatment leads to treatment failure over time", J Neurosci, 27, pp.2979~2986 (2007)
  12. Choi YK, "Effects of repeated risperidone exposure on serotonin receptor subtypes in developing rats", Eur Neuropsychopharmacol, 20, pp.187~194 (2010)
  13. Silvestri S, "Increased dopamine D2 receptor binding after longterm treatment with antipsychotics in humans: a clinical PET study", Psychopharmacology (Berl), 152, pp.174~180 (2000)
  14. Nasrallah HA, "Atypical antipsychotic-induced metabolic side effects: insights from receptor-binding profiles", Mol Psychiatry, 13, pp.27~35 (2008)
  15. Kim SF, "From the Cover: Antipsychotic drug-induced weight gain mediated by histamine H1 receptor-linked activation of hypothalamic AMP-kinase", Proc Natl Acad Sci U S A, 104, pp.3456~3459 (2007)
  16. Masaki T, "Targeted disruption of histamine H1-receptor attenuates regulatory effects of leptin on feeding, adiposity, and UCP family in mice", Diabetes, 50, pp.385~391 (2001)
  17. Minokoshi Y, "AMP-kinase regulates food intake by responding to hormonal and nutrient signals in the hypothalamus", Nature, 428, pp.569~574 (2004)
  18. Wetterling T, "Bodyweight gain with atypical antipsychotics. A comparative review", Drug Saf, 24, pp.59~73 (2001)
  19. Reynolds GP, "Association of antipsychotic drug-induced weight gain with a 5-HT2C receptor gene polymorphism", Lancet, 359, pp.2086~2087 (2002)
  20. Templeman LA, "Polymorphisms of the 5-HT2C receptor and leptin genes are associated with antipsychotic drug-induced weight gain in Caucasian subjects with a firstepisode psychosis", Pharmacogenet Genomics, 15, pp.195~200 (2005)
  21. Arulmozhi DK, "Antipsychotic induced metabolic abnormalities: an interaction study with various PPAR modulators in mice", Life Sci, 79, pp.1865~1872 (2006)
  22. Matsui-Sakata A, "Receptor occupancy-based analysis of the contributions of various receptors to antipsychoticsinduced weight gain and diabetes mellitus", Drug Metab Pharmacokinet, 20, pp.368~378 (2005)
  23. Silvestre JS, "Research on adverse drug events. I. Muscarinic M3 receptor binding affinity could predict the risk of antipsychotics to induce type 2 diabetes", Methods Find Exp Clin Pharmacol, 27, pp.289~304 (2005)
  24. Mertens C, "Long-term treatment of chronic schizophrenic patients with risperidone, In Risperidone: Major Progress in Antipsychotic Treatment", pp.44~48 (1991), Oxford Clinical Communication
  25. Lee MS, "Efficacy and safety profile of risperidone in schizophrenia: long-term follow-up study", J Korean Neuropsychiatr Assoc, 38, pp.116~127 (1999)
  26. Melkersson K, "Adverse metabolic effects associated with atypical antipsychotics: literature review and clinical implications", Drugs, 64, pp.701~723 (2004)
  27. Graham KA, "Effect of olanzapine on body composition and energy expenditure in adults with first-episode psychosis", Am J Psychiatry, 162, pp.118~123 (2005)
  28. 김양래, "Olanzapine을 투여 받은 정신분열병 환자의 체중, 체질량지수, 렙틴, 인슐린, 공복시 혈당의 변화", 신경정신의학, 40(6), pp.1240~1246 (2001), 대한신경정신의학회
  29. McEvoy JP, "Efficacy and tolerability of olanzapine, quetiapine, and risperidone in the treatment of early psychosis: a randomized, doubleblind 52-week comparison", Am J Psychiatry, 164, pp.1050~1060 (2007)
  30. Turkoz I, "Direct and indirect effects of paliperidone extended-release tablets on negative symptoms of schizophrenia", Neuropsychiatr Dis Treat, 4, pp.949~958 (2008)
  31. Dirks B, "Effects of paliperidone ER in patients with schizophrenia previously treated with olanzapine", Proceeding of the International Congress on Schizophrenia Research (2007)
  32. de Leon J, "The pharmacokinetics of paliperidone versus risperidone", Psychosomatics, 51, pp.80~88 (2010)
  33. Vermeir M, "Absorption, metabolism, and excretion of paliperidone, a new monoaminergic antagonist, in humans", Drug Metab Dispos, 36, pp.769~779 (2008)

관련 논문AI추천

조현병 환자에서 항정신약물이 대사지표에 미치는 영향 조사 - 1년 추적연구박은경, 윤해주, 이종일, 임선진, 정선화대한조현병학회 · 대한조현병학회지2015 · 제18권 제2호조현병 환자에서 비전형항정신병약물 사용시 대사지표에 미치는 영향 조사 : 3년 추적연구박은경, 배하현, 윤해주, 이종일대한조현병학회 · 대한조현병학회지2017 · 제20권 제1호리스페리돈(Risperidone)을 투약 중인 정신분열병 환자에서 지프라시돈(Ziprasidone)으로 교체 투약 시 보이는 임상적 및 대사적 이득에 대한 전향적 개방 연구구본훈, 송진옥, 이광헌, 이승재, 이종훈, 정성원대한생물치료정신의학회 · 생물치료정신의학2009 · 제15권 제1호한국인 정신분열병 환자에서 비정형 항정신병 약물의 치료반응과 체중증가의 관련성에 대한 연구이민수, 이재병, 이화영, 함병주대한생물정신의학회 · 생물정신의학2011 · 제18권 제4호만성적 정신분열병 또는 분열정동장애를 가진 입원환자에서 Aripiprazole과 Haloperidol의 치료효과 및 안정성 비교:16주간의 임상적 연구의 결과김정기, 서영익, 장옥진대한생물치료정신의학회 · 생물치료정신의학2009 · 제15권 제2호항정신병약물을 처음으로 사용하는 초발 정신증 환자에서 나타나는 체중 및 대사성 지표의 변화 : 후향적 연구강제욱, 공보금, 김민걸, 김성진, 김우진, 김정은, 김현정, 문정준, 박민경, 심주철, 정도운대한생물치료정신의학회 · 생물치료정신의학2011 · 제17권 제2호

이 간행물의 다른 논문 (5건)