Switching antipsychotics to aripiprazole or blonanserin and plasma monoamine metabolites levels in patients with schizophrenia

Hum Psychopharmacol. 2014 Mar;29(2):199-202. doi: 10.1002/hup.2386. Epub 2014 Jan 8.

Abstract

Objective: Blonanserin is a novel atypical antipsychotic drug that has efficacy equal to risperidone. We investigated the effects of aripiprazole and blonanserin on clinical symptoms and plasma levels of homovanillic acid (pHVA) and 3-methoxy-4hydroxyphenylglycol in the switching strategy of schizophrenia.

Methods: Twenty two Japanese patients with schizophrenia were enrolled into this open study. The antipsychotics of all patients were switched to aripiprazole or blonanserin for the improvement of clinical symptoms or side effects. Plasma monoamine metabolites levels were analyzed with high-performance liquid chromatography.

Results: There were no significant effects for time (p = 0.346) or time × group interaction (p = 0.27) on the changes of positive and negative syndrome scale (PANSS) total score, although blonanserin decreased PANSS scores. We observed negative correlation between pHVA at baseline and the change in PANSS total score (rs = -0.450, p = 0.046). We also found positive correlation between the changes in pHVA and the changes in PANSS total (rs = 0.536, p = 0.015) and positive (rs = 0.572, p = 0.008) scores.

Conclusions: There were no differences between blonanserin and aripiprazole in the improvement of clinical symptoms. Our results suggest that pHVA may be useful indicator for the switching strategy to aripiprazole or blonanserin in schizophrenia.

Keywords: aripiprazole; blonanserin; homovanillic acid; schizophrenia; switching strategy.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole
  • Chromatography, High Pressure Liquid
  • Female
  • Homovanillic Acid / blood*
  • Humans
  • Japan
  • Male
  • Methoxyhydroxyphenylglycol / blood
  • Middle Aged
  • Piperazines / adverse effects
  • Piperazines / therapeutic use*
  • Piperidines / adverse effects
  • Piperidines / therapeutic use*
  • Psychiatric Status Rating Scales
  • Quinolones / adverse effects
  • Quinolones / therapeutic use*
  • Schizophrenia / blood*
  • Schizophrenia / drug therapy*
  • Time Factors
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Piperazines
  • Piperidines
  • Quinolones
  • Methoxyhydroxyphenylglycol
  • Aripiprazole
  • blonanserin
  • Homovanillic Acid