Amisulpride Augmentation in Schizophrenia Patients with Poor Response to Olanzapine: A 4-week, Randomized, Rater-Blind, Controlled, Pilot Study
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Objective: The purpose of this study was to compare the efficacy and tolerability of continued olanzapine (OLA) versus amisulpride (AMI) augmentation in schizophrenic patients with poor response to OLA monotherapy. Methods: The present 4-week, randomized, rater-blinded study included 25 patients with schizophrenia who were partially or completely unresponsive to treatment with OLA monotherapy. Eligible subjects were randomly assigned at a 1:1 ratio to continuation of OLA monotherapy (OLA group) or OLA with AMI augmentation (AMI group). Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 1, 2, and 4 weeks. Results: The changes in PANSS total score and PANSS-positive subscale score were significantly different (p < 0.05) between the OLA and AMI groups. The differences between the two groups in PANSS-negative subscale, PANSS-general subscale, Brief Psychiatric Rating Scale, and Clinical Global Impression-Severity (CGI-S) scale scores were not statistically significant. Conclusion: AMI augmentation could be an effective strategy for patients with schizophrenia who show inadequate early response to OLA monotherapy.
Abstract
Objective: The purpose of this study was to compare the efficacy and tolerability of continued olanzapine (OLA) versus amisulpride (AMI) augmentation in schizophrenic patients with poor response to OLA monotherapy. Methods: The present 4-week, randomized, rater-blinded study included 25 patients with schizophrenia who were partially or completely unresponsive to treatment with OLA monotherapy. Eligible subjects were randomly assigned at a 1:1 ratio to continuation of OLA monotherapy (OLA group) or OLA with AMI augmentation (AMI group). Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 1, 2, and 4 weeks. Results: The changes in PANSS total score and PANSS-positive subscale score were significantly different (p < 0.05) between the OLA and AMI groups. The differences between the two groups in PANSS-negative subscale, PANSS-general subscale, Brief Psychiatric Rating Scale, and Clinical Global Impression-Severity (CGI-S) scale scores were not statistically significant. Conclusion: AMI augmentation could be an effective strategy for patients with schizophrenia who show inadequate early response to OLA monotherapy.
참고문헌 (25)
- Moore BA, "Drug information update. Unconventional treatment strategies for schizophrenia: polypharmacy and heroic dosing", BJPsych Bull, 41, pp.164~168 (2017)
- 배치운, "Consideration of Long-Acting Injectable Antipsychotics for Polypharmacy Regimen in the Treatment of Schizophrenia: Put It on the Table or Not?", Clinical Psychopharmacology and Neuroscience, 19(3), pp.434~448 (2021), 대한정신약물학회[DOI]
- Jung Suk Lee, "Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms", Clinical Psychopharmacology and Neuroscience, 18(3), pp.386~394 (2020), 대한정신약물학회[DOI]
- Lin SK, "Antipsychotic polypharmacy : a dirty little secret or a fashion?", Int J Neuropsychopharmacol, 23, pp.125~131 (2020)
- 노대영, "Antipsychotic Prescribing Patterns in First-episode Schizophrenia: A Five-year Comparison", Clinical Psychopharmacology and Neuroscience, 13(3), pp.275~282 (2015), 대한정신약물학회
- Leucht S, "Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia : a multiple-treatments meta-analysis", Lancet, 382, pp.951~962 (2013)
- Leucht S, "Second-generation versus first-generation antipsychotic drugs for schizophrenia : a meta-analysis", Lancet, 373, pp.31~41 (2009)
- Bhana N, "Olanzapine : an updated review of its use in the management of schizophrenia", Drugs, 61, pp.111~161 (2001)
- Aringhieri S, "Molecular targets of atypical antipsychotics : from mechanism of action to clinical differences", Pharmacol Ther, 192, pp.20~41 (2018)
- Callaghan JT, "Olanzapine. Pharmacokinetic and pharmacodynamic profile", Clin Pharmacokinet, 37, pp.177~193 (1999)
- Gibson AP, "Antipsychotic combinations: blind step or logical? T Though unsupported by evidence, using >1 antipsychotic may make sense for some treatment-resistant patients", Curr Psychiatry, 7, pp.41~53 (2008)
- Kahn RS, "Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder : an open randomised clinical trial", Lancet, 371, pp.1085~1097 (2008)
- Rosenzweig P, "A review of the pharmacokinetics, tolerability and pharmacodynamics of amisulpride in healthy volunteers", Hum Psychopharmacol, 17, pp.1~13 (2002)
- Mauri MC, "Clinical pharmacokinetics of atypical antipsychotics : an update", Clin Pharmacokinet, 57, pp.1493~1528 (2018)
- Perrault G, "Psychopharmacological profile of amisulpride : an antipsychotic drug with presynaptic D2", D3 dopamine receptor antagonist activity and limbic selectivity, 1997, pp.280, 73~82
- Zink M, "Combination of amisulpride and olanzapine in treatment-resistant schizophrenic psychoses", Eur Psychiatry, 19, pp.56~58 (2004)
- Molina JD, "Augmentation treatment with amisulpride in schizophrenic patients partially responsive to olanzapine", Pharmacopsychiatry, 44, pp.142~147 (2011)
- Leucht S, "What does the PANSS mean?", Schizophr Res, 79, pp.231~238 (2005)
- Kane JM, "Clozapine in treatment-resistant schizophrenics", Psychopharmacol Bull, 24, pp.62~67 (1988)
- Leucht S, "Definitions of response and remission in schizophrenia : recommendations for their use and their presentation", Acta Psychiatr Scand Suppl, (438), pp.7~14 (2009)
- Seung-Gul Kang, "Clinical Usefulness of Amisulpride Add-on Therapy in Schizophrenia Patients without Treatment Response to Second-generation Antipsychotics", Clinical Psychopharmacology and Neuroscience, 19(1), pp.117~124 (2021), 대한정신약물학회[DOI]
- Mortimer AM, "Symptom rating scales and outcome in schizophrenia", Br J Psychiatry Suppl, 50, pp.s7~s14 (2007)
- Bell M, "The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale. Reliability, comparability, and predictive validity", J Nerv Ment Dis, 180, pp.723~728 (1992)
- Leucht S, "Linking the PANSS, BPRS, and CGI : clinical implications", Neuropsychopharmacology, 31, pp.2318~2325 (2006)
- Goldman LS, "Medical illness in patients with schizophrenia", J Clin Psychiatry, 60(Suppl 21), pp.10~15 (1999)
