Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and/or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study

Kim, Yongmin; Wang, Sheng Min; Kwak, Kyung Phil; Yoon, Ho Kyoung; Pae, Chi Un; Kim, Jung Jin; Bahk, Won Myong

doi:10.9758/cpn.2016.14.4.371

Cited by 10 publications

(11 citation statements)

References 39 publications

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“…It remains uncertain whether the particular antipsychotic medications involved in a switch are relevant to the response, even though studies have hinted that a switch to amisulpride or quetiapine, or from risperidone to olanzapine (compared with olanzapine to risperidone), may achieve some clinical benefit (Hashimoto et al, 2015; Hatta et al, 2018; Kim et al, 2016). However, the antipsychotic formulation may have an influence; while switching from an oral antipsychotic to a depot/LAI may be beneficial (Schreiner et al, 2017), poorer outcomes have been reported for patients switching from a depot/LAI antipsychotic to oral antipsychotic medication (Barnes et al, 2013; Mustafa, 2017; Voss et al, 2015), which presumably partly reflects the opportunities for covert non-adherence with the latter as well as possibly the pharmacokinetic differences between oral and depot/LAI preparations.…”

Section: Maintaining Responsementioning

confidence: 99%

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

2019

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These updated guidelines from the British Association for Psychopharmacology replace the original version published in 2011. They address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting was held in 2017, involving experts in schizophrenia and its treatment.They were asked to review key areas and consider the strength of the evidence on the risk-benefit balance of pharmacological interventions and the clinical implications, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. The guidelines cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. It is hoped that the practice recommendations presented will support clinical decision making for practitioners, serve as a source of information for patients and carers, and inform quality improvement.

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Section: Maintaining Responsementioning

confidence: 99%

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

2019

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“…The results from this analysis support findings showing that switching to amisulpride is effective and safe in Western 20 , 22 and also Korean and Chinese patients. 23 , 24 In particular, the Korean study showed that patients switching to amisulpride from various antipsychotics, including 38% from olanzapine and 5.4% from risperidone, achieved a clinical benefit in terms of effectiveness and tolerability, with over half of patients experiencing an improvement in symptoms as indicated by improved CGI-CB score. 23 However, making a more detailed comparison between this analysis and a previous Korean study is difficult as effectiveness was evaluated using different end points in the two studies.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…While several previous studies have evaluated switching between second-generation antipsychotics, clinical data for Asian patients with schizophrenia who switch to amisulpride from other atypical antipsychotics are scarce, particularly for Chinese patients. 23 , 24 The Phase IV ESCAPE study showed that amisulpride is effective and relatively well tolerated in Chinese patients with schizophrenia and found no difference in the effectiveness or safety profile of amisulpride for patients who switched to amisulpride vs treatment-naïve patients. 25 As risperidone and olanzapine are among the most commonly prescribed antipsychotics in China, this subgroup analysis of the ESCAPE study was conducted to compare the effectiveness and safety of amisulpride for Chinese patients with schizophrenia who switched from treatment with either risperidone or olanzapine.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness and safety of amisulpride in Chinese patients with schizophrenia who switch from risperidone or olanzapine: a subgroup analysis of the ESCAPE study

Liang

2017

NDT

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IntroductionSecond-generation antipsychotics show significant interpatient variability in treatment response and side-effect profiles, and the majority of patients with schizophrenia require multiple treatment changes. This subgroup analysis of the ESCAPE study evaluated the efficacy and safety of amisulpride in Chinese patients with schizophrenia who switched from risperidone or olanzapine.MethodsESCAPE was a prospective, open-label, multicenter, single-arm Phase IV study in which Chinese patients with an ICD-10 diagnosis of schizophrenia received amisulpride for 8 weeks. This analysis included 109 patients who switched to amisulpride from risperidone (n=68) or olanzapine (n=41) and 59 treatment-naïve patients for reference. The primary effectiveness outcome was a ≥50% decrease in Positive and Negative Syndrome Scale (PANSS) Total score from Baseline to Week 8. The study was registered at ClinicalTrials.gov (NCT01795183).ResultsOf the patients who switched from risperidone and olanzapine, 77.9% and 56.1% achieved ≥50% reduction in PANSS Total score from Baseline to Week 8 and 57.4% and 46.3% achieved ≥20% reduction in PANSS score from Baseline to Week 2, respectively; these end points were achieved by 66.1% and 61.0% of treatment-naïve patients, respectively. No unexpected adverse events (AEs) were reported. Of the most common AEs, extrapyramidal side effects occurred in 32.4% and 14.6%, blood prolactin increase in 32.4% and 39.0%, and ≥7% increase in body weight in 4.4% and 12% of patients switching from risperidone and olanzapine, respectively.ConclusionThe results of this subgroup analysis suggest that switching to amisulpride from risperidone and olanzapine is effective and generally well tolerated in Chinese patients with schizophrenia.

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“…Moreover, blonanserin is generally well tolerated with low risk of causing cardiovascular or metabolic side effects or hyperprolactinemia,8) and it showed a lower rate of discontinuation due to intolerance compared with other AAPs, including quetiapine, aripiprazole, risperidone, and olanzapine 15). Schizophrenia is associated with an increased risk of metabolic disorders, which can negatively influence mortality and morbidity,16) and these adverse events (AEs) are among the most important reasons for switching from one antipsychotic to another17,18); consequently, blonanserin may be an alternative option for patients who need to switch antipsychotic drugs due to insufficient efficacy or intolerability.…”

Section: Introductionmentioning

confidence: 99%

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

Woo

Yoon

Jeon

et al. 2019

Clin Psychopharmacol Neurosci

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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/m 2 , 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.

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Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and/or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study

Cited by 10 publications

References 39 publications

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology

The effectiveness and safety of amisulpride in Chinese patients with schizophrenia who switch from risperidone or olanzapine: a subgroup analysis of the ESCAPE study

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

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