Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan; Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2022 Mar 8;113:110470. doi: 10.1016/j.pnpbp.2021.110470. Epub 2021 Nov 3.
Blonanserin is a second-generation antipsychotic for the treatment of schizophrenia. Blonanserin has two different routes of administration: oral tablets/powder and transdermal patches. The aim of this study was to investigate as a post-hoc analysis of an original study whether switching from blonanserin tablets/powders to transdermal patches would reduce extrapyramidal symptoms (EPS) and/or the dose of antiparkinsonian drugs for the stabilization of blood pharmacokinetics in patients with schizophrenia. Patients with schizophrenia (n = 155) were enrolled in either cohort 1 or 2. In cohort 1 (n = 97), patients received 40-80 mg/day blonanserin transdermal patches for one year after taking 8-16 mg/day blonanserin tablets for 6 weeks, and the dose of patches was determined based on the dose of the tablets. In cohort 2 (n = 58), all patients started with 40 mg/day blonanserin patches and then received 40-80 mg/day for a year after taking blonanserin tablets/powders. Changes from the start of transdermal patch treatment in EPS and the dose of antiparkinsonian drugs at 3, 6, and 12 months were assessed using the Drug-Induced EPS Scale (DIEPSS) and biperiden equivalents of total antiparkinsonian drugs (BPD-eq), respectively. Among 155 patients, only four patients in cohort 1 discontinued owing to EPS during a patch period. Significant improvements from the start of patch treatment in the DIEPSS total score at any point were observed (mean change±SD): -0.44 ± 1.50 (p = 0.013), -0.07 ± 1.78 (p = 0.73), and - 0.14 ± 1.37 (p = 0.44) in cohort 1 and - 0.16 ± 1.32 (p = 0.40), -0.74 ± 1.92 (p = 0.020), and - 0.81 ± 2.22 (p = 0.047) in cohort 2 at 3, 6, and 12 months, respectively. In contrast, there were no significant changes from the start of patch treatment in BPD-eq at any month (p > 0.05). Transdermal patches of blonanserin are a more effective route of administration to diminish EPS than oral tablets/powder.
布南色林是一种用于治疗精神分裂症的第二代抗精神病药物。布南色林有两种不同的给药途径：口服片剂/粉末和透皮贴片。本研究旨在作为原始研究的事后分析，探讨从布南色林片剂/粉末转换为透皮贴片是否会减少精神分裂症患者的锥体外系症状（EPS）和/或抗帕金森病药物的剂量，以稳定血药动力学。155 名精神分裂症患者被纳入队列 1 或 2 之一。在队列 1（n=97）中，患者在接受 6 周 8-16 毫克/天布南色林片剂治疗后，接受 40-80 毫克/天布南色林透皮贴片治疗一年，并且根据片剂的剂量确定贴片的剂量。在队列 2（n=58）中，所有患者均开始使用 40 毫克/天布南色林贴片，然后在服用布南色林片剂/粉末一年后接受 40-80 毫克/天。使用药物诱导的锥体外系症状量表（DIEPSS）和抗帕金森病药物的比哌啶等效物（BPD-eq）分别评估从透皮贴剂治疗开始时 EPS 和抗帕金森病药物剂量的变化。在 155 名患者中，只有队列 1 的 4 名患者在贴片期间因 EPS 而停药。在任何时间点，从贴片治疗开始，DIEPSS 总分均有显著改善（平均变化±SD）：队列 1 中分别为-0.44±1.50（p=0.013）、-0.07±1.78（p=0.73）和-0.14±1.37（p=0.44），队列 2 中分别为-0.16±1.32（p=0.40）、-0.74±1.92（p=0.020）和-0.81±2.22（p=0.047）。相比之下，在任何一个月，从贴片治疗开始，BPD-eq 均无显著变化（p>0.05）。与口服片剂/粉末相比，布南色林透皮贴片是一种更有效的给药途径，可减少 EPS。
