본문 바로가기
KERD
논문KCI 등재

Switching Antipsychotics to Blonanserin in Patients with Schizophrenia: An Open-label, Prospective, Multicenter Study

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Objective: This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. Methods: A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. Results: Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. Conclusion: The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.

Abstract

Objective: This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. Methods: A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. Results: Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. Conclusion: The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.

참고문헌 (40)

  1. Heilbronner U, "The longitudinal course of schizophrenia across the lifespan : clinical, cognitive, and neurobiological aspects", Harv Rev Psychiatry, 24, pp.118~128 (2016)
  2. Adarsh Tripathi, "Cognitive Deficits in Schizophrenia: Understanding the Biological Correlates and Remediation Strategies", Clinical Psychopharmacology and Neuroscience, 16(1), pp.7~17 (2018), 대한정신약물학회[DOI]
  3. Kirkpatrick B, "The NIMH-MATRICS consensus statement on negative symptoms", Schizophr Bull, 32, pp.214~219 (2006)
  4. De Hert M, "Remission criteria for schizophrenia : evaluation in a large naturalistic cohort", Schizophr Res, 92, pp.68~73 (2007)
  5. Remington G, "Guidelines for the pharmacotherapy of schizophrenia in adults", Can J Psychiatry, 62, pp.604~616 (2017)
  6. National Collaborating Centre for Mental Health, "Psychosis and schizophrenia in adults: treatment and management" (2014), National Institute for Health and Care Excellence (UK)
  7. Miyamoto S, "Treatments for schizophrenia : a critical review of pharmacology and mechanisms of action of antipsychotic drugs", Mol Psychiatry, 10, pp.79~104 (2005)
  8. Tenjin T, "Profile of blonanserin for the treatment of schizophrenia", Neuropsychiatr Dis Treat, 9, pp.587~594 (2013)
  9. Miura S, "Clinical evaluation of blonanserin for schizophrenia : a randomized controlled study comparing blonanserin with risperidone", Jpn J Clin Psychopharmacol, 11, pp.297~314 (2008)
  10. Yang J, "Efficacy and tolerability of blonanserin in the patients with schizophrenia : a randomized, double-blind, risperidonecompared trial", Clin Neuropharmacol, 33, pp.169~175 (2010)
  11. Garcia E, "The efficacy and safety of blonanserin compared with haloperidol in acute-phase schizophrenia : a randomized, double-blind, placebo-controlled, multicentre study", CNS Drugs, 23, pp.615~625 (2009)
  12. Murasaki M, "Clinical evaluation of blonanserin for schizophrenia : a double-blind trial comparing blonanserin with haloperidol", Jpn J Clin Psychopharmacol, 10, pp.2059~2079 (2007)
  13. 우영섭, "Blonanserin Augmentation of Atypical Antipsychotics in Patients with Schizophrenia-Who Benefits from Blonanserin Augmentation?: An Open-Label, Prospective, Multicenter Study", PSYCHIATRY INVESTIGATION, 13(4), pp.458~467 (2016), 대한신경정신의학회[DOI]
  14. Kishi T, "Blonanserin for schizophrenia : systematic review and meta-analysis of double-blind, randomized, controlled trials", J Psychiatr Res, 47, pp.149~154 (2013)
  15. Takaki M, "Efficacy and tolerability of blonanserin in 48 patients with intractable schizophrenia", Acta Neuropsychiatr, 24, pp.380~383 (2012)
  16. Andrade C, "Cardiometabolic risks in schizophrenia and directions for intervention, 1 : magnitude and moderators of the problem", J Clin Psychiatry, 77, pp.e844~ (2016)[DOI]
  17. Weiden PJ, "The art and science of switching antipsychotic medications, part 2", J Clin Psychiatry, 68, pp.e02~ (2007)
  18. 김용민, "Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and", or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study, 2016, pp.14(4), 371~377[DOI]
  19. Naber D, "A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables", Int Clin Psychopharmacol, 10(Suppl 3), pp.133~138 (1995)
  20. Hogan TP, "A self-report scale predictive of drug compliance in schizophrenics : reliability and discriminative validity", Psychol Med, 13, pp.177~183 (1983)
  21. Gardner DM, "International consensus study of antipsychotic dosing", Am J Psychiatry, 167, pp.686~693 (2010)
  22. Kishi T, "Early prediction of blonanserin response in Japanese patients with schizophrenia", Neuropsychiatr Dis Treat, 10, pp.1861~1866 (2014)
  23. Takahashi H, "Switching to olanzapine after unsuccessful treatment with risperidone during the first episode of schizophrenia : an openlabel trial", J Clin Psychiatry, 67, pp.1577~1582 (2006)
  24. Takahashi H, "Switching to risperidone after unsuccessful treatment of olanzapine in the first-episode schizophrenia : an open trial", Prog Neuropsychopharmacol Biol Psychiatry, 30, pp.1067~1072 (2006)
  25. Suzuki T, "How effective is it to sequentially switch among olanzapine, quetiapine and risperidone?--a randomized, open-label study of algorithm-based antipsychotic treatment to patients with symptomatic schizophrenia in the real- world clinical setting", Psychopharmacology (Berl), 195, pp.285~295 (2007)
  26. Deeks ED, "Blonanserin : a review of its use in the management of schizophrenia", CNS Drugs, 24, pp.65~84 (2010)
  27. Cerovecki A, "Withdrawal symptoms and rebound syndromes associated with switching and discontinuing atypical antipsychotics : theoretical background and practical recommendations", CNS Drugs, 27, pp.545~572 (2013)
  28. Ganguli R, "Assessment of strategies for switching patients from olanzapine to risperidone : a randomized, open-label, rater-blinded study", BMC Med, 6, pp.17~ (2008)
  29. FLB 457 in schizophrenia, "J Clin Psychopharmacol", 2013, 162~169
  30. Kapur S, "Relationship between dopamine D(2)occupancy, clinical response, and side effects : a double-blind PET study of first-episode schizophrenia", Am J Psychiatry, 157, pp.514~520 (2000)
  31. Uchida H, "Monthly administration of long-acting injectable risperidone and striatal dopamine D2 receptor occupancy for the management of schizophrenia", J Clin Psychiatry, 69, pp.1281~1286 (2008)
  32. Kishi T, "Cardiometabolic risks of blonanserin and perospirone in the management of schizophrenia : a systematic review and meta-analysis of randomized controlled trials", PLoS One, 9, pp.e88049~ (2014)
  33. Kishi T, "Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia : a network meta-analysis in a Japanese population", Neuropsychiatr Dis Treat, 13, pp.1281~1302 (2017)
  34. Masakazu Hatano, "Assessment of the Latent Adverse Events of Antipsychotic Treatment Using a Subjective Questionnaire in Japanese Patients with Schizophrenia", Clinical Psychopharmacology and Neuroscience, 15(2), pp.132~137 (2017), 대한정신약물학회[DOI]
  35. Ajmal A, "Psychotropic-induced hyperprolactinemia : a clinical review", Psychosomatics, 55, pp.29~36 (2014)
  36. Kawabe K, "Blonanserin, a novel antipsychotic, is suitable for treating schizophrenia associated with hyperprolactinemia : a case series", Clin Neuropharmacol, 36, pp.239~241 (2013)
  37. Kishi T, "Efficacy, tolerability, and safety of blonanserin in schizophrenia : an updated and extended systematic review and meta-analysis of randomized controlled trials", Pharmacopsychiatry, 52, pp.52~62 (2019)
  38. Arakawa R, "Positron emission tomography measurement of dopamine D(2)receptor occupancy in the pituitary and cerebral cortex : relation to antipsychotic-induced hyperprolactinemia", J Clin Psychiatry, 71, pp.1131~1137 (2010)
  39. Inoue T, "Blonanserin, a novel atypical antipsychotic agent not actively transported as substrate by P-glycoprotein", Prog Neuropsychopharmacol Biol Psychiatry, 39, pp.156~162 (2012)
  40. Murru A, "Antipsychotic switching in schizoaffective disorder : a systematic review", World J Biol Psychiatry, 17, pp.495~513 (2016)

관련 논문AI추천

Blonanserin Augmentation of Atypical Antipsychotics in Patients with Schizophrenia-Who Benefits from Blonanserin Augmentation?: An Open-Label, Prospective, Multicenter Study박영민, 박원명, 박주언, 우영섭, 정종현, Do-Hoon Kim, Duk-In Jon, Inki Sohn, Tae Yeon Hwang대한신경정신의학회 · PSYCHIATRY INVESTIGATION2016 · 제13권 제4호Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and/or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study곽경필, 김용민, 김정진, 박원명, 배치운, 왕성민, 윤호경대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2016 · 제14권 제4호Blonanserin-induced Mood Alteration in Schizophrenia and Schizoaffective Disorder: Two Cases김대호, 민아란대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2013 · 제11권 제3호Effect of Aripiprazole on Cognitive Function and Hyperprolactinemia in Patients with Schizophrenia Treated with Risperidone김경미, 김민경, 김영훈, 박성우, 이봉주, 이승주, 이정구대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2013 · 제11권 제2호Amisulpride Augmentation in Schizophrenia Patients with Poor Response to Olanzapine: A 4-week, Randomized, Rater-Blind, Controlled, Pilot Study박원명, Bo-Hyun Yoon, Sheng Min Wang, Sung-Yong Park, Won-Seok Choi, Young Sup Woo대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2022 · 제20권 제3호Effectiveness of Switching to Long-acting Injectable Aripiprazole in Patients with Recent-onset and Chronic Schizophrenia정영철, Anna Jo, Bong Ju Lee, Eun-Jin Cheon, Jae-Min Kim, Seunghee Won, Sung-Wan Kim대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2023 · 제21권 제1호

이 간행물의 다른 논문 (15건)