Premium
Effect of switching to risperidone after unsuccessful treatment with aripiprazole on plasma monoamine metabolites level in the treatment of acute schizophrenia
Author(s) -
Miura Itaru,
Takeuchi Satoshi,
Katsumi Akihiko,
Kanno Keiko,
Watanabe Kenya,
Mashiko Hirobumi,
Niwa ShinIchi
Publication year - 2012
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.2251
Subject(s) - aripiprazole , risperidone , schizophrenia (object oriented programming) , antipsychotic , monoamine neurotransmitter , psychology , medicine , psychiatry , homovanillic acid , pharmacology , serotonin , receptor
Objective In the treatment of acute schizophrenia, risperidone and aripiprazole are both placed the first line antipsychotics. These two antipsychotics have different pharmacological effects. We investigated the effects of risperidone on plasma levels of homovanillic acid (HVA) and 3‐methoxy‐4hydroxyphenylglycol after unsuccessful aripiprazole treatment in acute schizophrenia. Methods Ten Japanese patients with acute schizophrenia were enrolled to this study. Plasma levels of monoamine metabolites were analyzed with high‐performance liquid chromatography with electrochemical detection. Results Risperidone improved the symptoms and 4 of 10 patients were responders. Risperidone showed a tendency to decrease plasma HVA (pHVA) levels in responders ( p = 0.068), but not in non‐responders ( p = 1.0). At baseline, pHVA levels of responders were significantly higher than that of non‐responders ( p = 0.033). A trend for negative correlation was found between pHVA at baseline and the changes in Positive and Negative Syndrome Scale‐Total ( p = 0.061, r = −0.61). Conclusion Our results suggest that high pHVA level before switching may predict good response to the second line antipsychotics after unsuccessful first antipsychotic treatment. If aripiprazole is not effective in acute schizophrenia, switching to risperidone may be effective and reasonable strategy for improving symptoms. Copyright © 2012 John Wiley & Sons, Ltd.