Effect of risperidone on plasma catecholamine metabolites and brain‐derived neurotrophic factor in patients with bipolar disorders

Abstract

A combination treatment with a mood stabilizer and an antipsychotic drug is often used in as many as 90% of subjects with acute mania. Recently, augmentation therapy with atypical antipsychotics has been investigated in both the acute and long-term treatment of bipolar disorder with or without psychosis. In the present study, the authors investigated the efficacy of risperidone treatment for both acute manic and depressive episodes in bipolar disorder. Eighteen patients (M/F: 8/10, age: 34 +/- 15 yr) who met the DSM-IV criteria for bipolar I disorder (12 cases of manic episodes, 6 cases of depressive episodes) with risperidone treatment were evaluated regarding their clinical improvement using the Young Mania rating Scale (YMRS) and the Hamilton rating Scale for Depression (Ham-D). Plasma concentrations of HVA and MHPG were analyzed by HPLC-ECD and plasma brain-derived neurotrophic factor (BDNF) levels were detected by sandwich ELISA. The mean scores of the YMRS were 22, 18, 12, 8, and 5 at time points before and 1, 2, 3, and 4 weeks after the risperidone administration, respectively. The mean scores of the Ham-D were 24, 25, 21, 21, and 19 at time points before and 1, 2, 3, and 4 weeks after the risperidone administration, respectively. The plasma levels of HVA and 3-methoxy-4-hydroxyphenylglycol (MHPG) were observed to have decreased 4 weeks after risperidone administration in manic patients. The levels did not change in depressive patients. The plasma levels of BDNF were decreased in depressive patients compared with manic patients or healthy controls. However, the administration of risperidone did not alter plasma BDNF levels.

Serum Protein Levels of Brain-Derived Neurotrophic Factor and Tropomyosin-Related Kinase B in Bipolar Disorder: Effects of Mood Stabilizers

“…Our results showed that serum BDNF protein levels increased after a 4-week treatment with mood stabilizers, but this did not reach statistical significance. This finding was compatible with one previous report [19] , but not with the results of other studies [22,25] . One study showed that serum BDNF levels were lower in patients treated with antipsychotics and/ or lithium, whereas patients on valproate and/or antidepressants have higher serum BDNF levels [24] .…”

“…This finding corresponds with the results of some previous reports [22,[24][25] , but not all [8,19,21,23] . Many studies have reported decreased blood BDNF protein levels in bipolar mania [8,19,21,23] .…”

Is Brain-derived Neurotrophic Factor a Possible Mechanism Underlying Risperidone Sensitization in Adolescent Rats?

“…Decreased BDNF levels in cortical areas and hippocampus in patients with schizophrenia has also been reported [52], consistent with findings from various animal models [8,12,50]. Human studies on the medication effects often report no significant effects of medications on the peripheral and central BNDF proteins, including risperidone [9,51,53]. However, animal work suggests that antipsychotics such as haloperidol, clozapine and high dose of risperidone (eg.…”

Addition of risperidone to sertraline improves sertraline‐resistant refractory depression without influencing plasma concentrations of sertraline and desmethylsertraline

“…Furthermore, our previous findings human psychopharmacology Hum. Psychopharmacol Clin Exp 2008;23: 707-713 indicate that the effects of risperidone on the noradrenergic system as well as on the serotonergic system might be related to its efficacy in treating negative symptoms of schizophrenia (Yoshimura et al, 2000a(Yoshimura et al, , 2000b and mood disorder (Yoshimura et al, 2006). Taken together, the above results show that the effects of risperidone on three monoaminergic systems (dopamine, serotonin, noradrenaline) are associated with its clinical efficacy for schizophrenia and mood disorder.…”