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Inoue Y, Tsuchimori K, Nakamura H. Safety and effectiveness of oral blonanserin for schizophrenia: A review of Japanese post-marketing surveillances. J Pharmacol Sci 2020; 145:42-51. [PMID: 33357778 DOI: 10.1016/j.jphs.2020.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 01/22/2023] Open
Abstract
Schizophrenia significantly limits social functioning with positive and negative symptoms and cognitive dysfunction. Blonanserin (LONASEN®), a novel second-generation antipsychotic approved for treating schizophrenia in Japan in 2008, reportedly shows beneficial effects on cognitive function as well as positive and negative symptoms, with potential for improving social functioning. To understand the safety and effectiveness of blonanserin in the real clinical practice, five Japanese post-marketing surveillances have been conducted and published to date. In this article, we reviewed all the Japanese post-marketing surveillances and discussed the clinical usefulness of blonanserin in patients with schizophrenia having diverse clinical characteristics. Adverse drug reactions, such as akathisia and extrapyramidal symptoms, were common in all surveillances. However, those specific to second-generation antipsychotics, such as weight gain and abnormalities in glycometabolism or lipid metabolism, were rarely observed. In addition, no adverse drug reactions apart from clinical trial results were found. Brief Psychiatric Rating Scale total scores in all surveillances significantly lowered at the last evaluation than at baseline. These results were consistent through 1-year of treatment, suggesting that effectiveness is maintained even after long-term use. In conclusion, blonanserin is considered a beneficial drug in real clinical practice for patients with schizophrenia having diverse characteristics.
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Affiliation(s)
- Yoshifumi Inoue
- Medical Affairs, Sumitomo Dainippon Pharma Co., Ltd., Tokyo, Japan.
| | - Kimiko Tsuchimori
- Corporate Governance Material Review Group, Sumitomo Dainippon Pharma Co., Ltd., Osaka, Japan.
| | - Hiroshi Nakamura
- Medical Affairs, Sumitomo Dainippon Pharma Co., Ltd., Tokyo, Japan.
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Hammoudeh S, Al Lawati H, Ghuloum S, Iram H, Yehya A, Becetti I, Al-Fakhri N, Ghabrash H, Shehata M, Ajmal N, Amro I, Safdar H, Eltorki Y, Al-Amin H. Risk Factors of Metabolic Syndrome Among Patients Receiving Antipsychotics: A Retrospective Study. Community Ment Health J 2020; 56:760-770. [PMID: 31884574 PMCID: PMC7089884 DOI: 10.1007/s10597-019-00537-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 12/23/2019] [Indexed: 01/25/2023]
Abstract
This study aimed to assess the differential effects of first-generation (FGA) and second-generation antipsychotics (SGA) on the prevalence of risk factors for metabolic syndrome among mentally ill patients in Qatar. We also wanted to check if there is proper adherence with the guidelines for prescribing antipsychotics and the monitoring of metabolic effects in this population. We collected the available retrospective data (socio-demographic, psychiatric, anthropometric, and metabolic measures) from the records of 439 patients maintained on antipsychotics. The majority were males, married, employed, having a psychotic disorder, and receiving SGA. Patients on SGA showed more obesity, higher BP, and more elevated triglycerides compared to those on FGA. The prevalence of the abnormal metabolic measures was high in this sample, but those on SGA showed a significantly higher prevalence of abnormal body mass index and BP. Obesity and hypertension were common in patients maintained on antipsychotics, especially those on SGA. Polypharmacy was common, and many metabolic measures were not monitored properly in those maintained on antipsychotics. More prospective studies with guided monitoring of the patients' clinical status and metabolic changes are needed to serve better this population of patients.
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Affiliation(s)
- Samer Hammoudeh
- Research Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hawra Al Lawati
- Medical Education Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Suhaila Ghuloum
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Huma Iram
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Arij Yehya
- Research Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Imen Becetti
- Medical Education Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Nora Al-Fakhri
- Medical Education Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hany Ghabrash
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mena Shehata
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Nighat Ajmal
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Iman Amro
- Research Department, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hira Safdar
- Psychiatry Department, Mental Health Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Yassin Eltorki
- Pharmacy Department, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Hassen Al-Amin
- Psychiatry Department, Weill Cornell Medicine - Qatar, Education city, P.O. Box: 24144, Doha, Qatar.
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Hammoudeh S, Ghuloum S, Mahfoud Z, Yehya A, Abdulhakam A, Al-Mujalli A, Al-Zirie M, Abdel Rahman MO, Godwin A, Younes N, Hani Y, Mook-Kanamori D, Mook-Kanamori M, El Sherbiny R, Al-Amin H. The prevalence of metabolic syndrome in patients receiving antipsychotics in Qatar: a cross sectional comparative study. BMC Psychiatry 2018; 18:81. [PMID: 29587717 PMCID: PMC5870932 DOI: 10.1186/s12888-018-1662-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 03/13/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Metabolic abnormalities are common in patients maintained on antipsychotics. These abnormalities increase the risk of cardiovascular diseases and mortality in this population. The aim of this study is to assess the prevalence of metabolic syndrome (MetS) in subjects maintained on antipsychotics relative to controls in Qatar, and to assess the factors contributing to the development of MetS. METHODS A cross sectional design was used to collect data and fasting blood samples from subjects maintained on antipsychotics for at least six months (n = 112) and from a control group (n = 114). The groups were compared in regard to prevalence of MetS, and multiple regression analysis was used to determine the risk factors in each group. RESULTS The two groups (antipsychotics vs. control) were similar in regard to age (35.73 ± 10.28 vs. 35.73 ± 8.16 years) and gender ratio. The MetS was higher among the subjects on antipsychotics, but this difference did not reach statistical significance. Blood pressure (BP) was significantly higher in the antipsychotics group and BMI was the major risk factor to develop MetS in this group. CONCLUSIONS The prevalence of MetS in both groups is high and mostly attributed to obesity and high BP. Public health interventions are needed to address this major health problem overall. Larger studies are needed to further assess the impact of antipsychotics and mental illness on the development of MetS.
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Affiliation(s)
- Samer Hammoudeh
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Suhaila Ghuloum
- Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Arij Yehya
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | | | | | | | | | - Angela Godwin
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Noura Younes
- Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Yahya Hani
- Department of Psychiatry, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Dennis Mook-Kanamori
- Department of Physiology and Biophysics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | | | - Reem El Sherbiny
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine - Qatar, Education city, P.O. Box 24144, Doha, Qatar.
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Zhai D, Lang Y, Feng Y, Liu Y, Dong G, Wang X, Cao Y, Cui T, Ni C, Ji Y, Zhang X, Zhao Y, Zhang R. Early onset of cardiometabolic risk factor profiles in drug naïve adolescents and young adults with first-episode schizophrenia. Schizophr Res 2017; 190:60-62. [PMID: 28318836 DOI: 10.1016/j.schres.2017.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE AND METHOD We performed a case-control study, which included antipsychotic-naïve first-episode schizophrenia (FES) of adolescents and young adults and general population controls, to investigate the early-onset cardiometabolic risk factors in FES. RESULTS FES had more frequent lower HDL-C when compared to controls. However, the distribution of BMI and the frequency of hypercholesterolemia, elevated LDL-C, hypertriglyceridemia in FES were not significantly different to controls. CONCLUSIONS The results indicated that abnormal HDL-C might be an early-onset event in drug-naïve FES of adolescents and young adults who are unlikely to have other cardiometabolic risks.
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Affiliation(s)
- Desheng Zhai
- Xinxiang Medical University, The Second Affiliated Hospital, Xinxiang 453002, China; Xinxiang Medical University, School of Public Health, Xinxiang 453003, China
| | - Yan Lang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China
| | - Yihang Feng
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Yijun Liu
- Xinxiang Medical University, School of Public Health, Xinxiang 453003, China
| | - Gaopan Dong
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Xin Wang
- McLean Hospital & Harvard Medical School, USA
| | - Ying Cao
- McLean Hospital & Harvard Medical School, USA
| | - Taizhen Cui
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Chenyang Ni
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Yonggan Ji
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Xiaodan Zhang
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China
| | - Ying Zhao
- Xinxiang Medical University, School of Pharmacy, Xinxiang 453003, China; McLean Hospital & Harvard Medical School, USA.
| | - Ruiling Zhang
- Xinxiang Medical University, The Second Affiliated Hospital, Xinxiang 453002, China.
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Sugawara N, Yasui-Furukori N, Yamazaki M, Shimoda K, Mori T, Sugai T, Suzuki Y, Someya T. Psychiatrists' attitudes toward metabolic adverse events in patients with schizophrenia. PLoS One 2014; 9:e86826. [PMID: 24466260 PMCID: PMC3900677 DOI: 10.1371/journal.pone.0086826] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 12/13/2013] [Indexed: 12/26/2022] Open
Abstract
Background There is growing concern about the metabolic abnormalities in patients with schizophrenia. Aims The aim of this study was to assess the attitudes of psychiatrists toward metabolic adverse events in patients with schizophrenia. Method A brief questionnaire was constructed to cover the following broad areas: the psychiatrists' recognition of the metabolic risk of antipsychotic therapy, pattern of monitoring patients for physical risks, practice pattern for physical risks, and knowledge of metabolic disturbance. In March 2012, the questionnaire was mailed to 8,482 psychiatrists who were working at hospitals belonging to the Japan Psychiatric Hospitals Association. Results The overall response rate was 2,583/8,482 (30.5%). Of the respondents, 85.2% (2,200/2,581) reported that they were concerned about prescribing antipsychotics that have a risk of elevating blood sugar; 47.6% (1,201/2,524) stated that their frequency of monitoring patients under antipsychotic treatment was based on their own experiences; and only 20.6% (5,22/2,534) of respondents answered that the frequency with which they monitored their patients was sufficient to reduce the metabolic risks. Conclusions Psychiatrists practicing in Japan were generally aware and concerned about the metabolic risks for patients being treated with antipsychotics. Although psychiatrists should monitor their patients for metabolic abnormalities to balance these risks, a limited number of psychiatrists answered that the frequency with which they monitored patients to reduce the metabolic risks was sufficient. Promotion of the best practices of pharmacotherapy and monitoring is needed for psychiatrists treating patients with schizophrenia.
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Affiliation(s)
- Norio Sugawara
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- * E-mail:
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
| | | | - Kazutaka Shimoda
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Takao Mori
- Japan Psychiatric Hospitals Association, Tokyo, Japan
| | - Takuro Sugai
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaro Suzuki
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshiyuki Someya
- Japanese Society of Clinical Neuropsychopharmacology, Tokyo, Japan
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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