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Wang J, Li M, Zhang J, Gao Q, Ding Z, Sun J. Paliperidone alleviates MK-801-induced damage to prefrontal cortical neurons via the PP2A/PTEN pathway. J Affect Disord 2022; 317:265-277. [PMID: 36031001 DOI: 10.1016/j.jad.2022.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The putative mechanisms underlying the efficacy of the US Food and Drug Administration-approved antipsychotic drug paliperidone for the treatment of schizophrenia deserve additional investigation, which is the aim of the present animal study. METHODS The behavioral activities of mice were recorded in the open field test and light-dark box test. The effects of paliperidone on MK-801-induced neuronal damage in the prefrontal cortex were tested by flow cytometry, TUNEL staining assays, and ROS staining assays. The neuroprotective effects of paliperidone on neural dendrites and synapses were evaluated using Golgi staining and Sholl analysis. An adenovirus vector containing a Ca2+ indicator was used to monitor the calcium ion concentration in the prefrontal cortex. The expression levels of protein phosphatase 2A (PP2A) and phosphatase and tensin homolog (PTEN) were investigated using Western blotting. RESULTS The data showed that MK-801 caused stereotyped behavior in mice and induced synaptic damage and dendritic spine impairment compared with the control, whereas paliperidone ameliorated these changes. Moreover, paliperidone reversed MK-801-induced decreases in PP2A and PTEN levels in prefrontal cortical neurons. Furthermore, in primary cultured cortical neurons and HT-22 cells, paliperidone inhibited cell apoptosis caused by MK-801. In particular, pretreatment with the PP2A inhibitor LB-100 significantly restrained the protective effects of paliperidone on MK-801-treated neurons and on locomotor activity and stereotypical behavior of mice. LIMITATIONS Whether other proteins are involved in this pathway and how the pathway works have not been revealed. CONCLUSION Our data show that paliperidone alleviates neuronal damage induced by MK-801 via the PP2A/PTEN pathway.
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Affiliation(s)
- Jiaxu Wang
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Meng Li
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Jing Zhang
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Qing Gao
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Zhaoxi Ding
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Jinhao Sun
- Department of Anatomy and Neurobiology, School of Medicine, Shandong University, Jinan, Shandong 250012, China.
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Wesołowska A, Jastrzębska-Więsek M, Cios A, Partyka A. The preclinical discovery and development of paliperidone for the treatment of schizophrenia. Expert Opin Drug Discov 2019; 15:279-292. [DOI: 10.1080/17460441.2020.1682994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Anna Wesołowska
- Jagiellonian University Medical College, Department of Clinical Pharmacy, Kraków, Poland
| | | | - Agnieszka Cios
- Jagiellonian University Medical College, Department of Clinical Pharmacy, Kraków, Poland
| | - Anna Partyka
- Jagiellonian University Medical College, Department of Clinical Pharmacy, Kraków, Poland
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A Flexible-Dose Study of Paliperidone ER in Patients With Nonacute Schizophrenia Previously Treated Unsuccessfully With Oral Olanzapine. J Psychiatr Pract 2016; 22:9-21. [PMID: 26813484 PMCID: PMC4770270 DOI: 10.1097/pra.0000000000000117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The goal of this study was to explore the tolerability, safety, and treatment response of switching from oral olanzapine to paliperidone extended release (ER). METHODS Adult patients with nonacute schizophrenia who had been treated unsuccessfully with oral olanzapine were switched to flexible doses of paliperidone ER (3 to 12 mg/d). The primary efficacy outcome was a ≥ 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores from baseline to endpoint for patients who switched medications because of lack of efficacy with olanzapine and noninferiority versus previous olanzapine treatment (mean endpoint change in PANSS total scores vs. baseline of ≤ 5 points) for patients who switched for reasons other than lack of efficacy. Safety and tolerability were assessed by monitoring adverse events, extrapyramidal symptoms, and weight change. RESULTS Of 396 patients, 65.2% were men, mean age was 40.0 ± 12.0 years, and 75.5% had paranoid schizophrenia. Among the patients whose main reason for switching was lack of efficacy, an improvement in the PANSS total score of ≥ 20% occurred in 57.4% of patients. Noninferiority was confirmed for each subgroup of patients whose main reason for switching was something other than lack of efficacy. Paliperidone ER was generally well tolerated. Extrapyramidal symptoms as measured by total Extrapyramidal Symptom Rating Scale scores showed statistically significant and clinically relevant improvements at endpoint, the average weight decreased by 0.8 ± 5.2 kg at endpoint, and a clinically relevant weight gain of ≥ 7% occurred in 8.0% of patients. CONCLUSION Paliperidone ER flexibly-dosed over 6 months was well tolerated and associated with a meaningful clinical response in patients with nonacute schizophrenia who had previously been unsuccessfully treated with oral olanzapine.
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Helldin L, Peuskens J, Vauth R, Sacchetti E, Bij de Weg H, Herken H, Lahaye M, Schreiner A. Treatment response, safety, and tolerability of paliperidone extended release treatment in patients recently diagnosed with schizophrenia. Ther Adv Psychopharmacol 2015; 5:194-207. [PMID: 26301075 PMCID: PMC4535044 DOI: 10.1177/2045125315584870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study was designed to explore the efficacy and tolerability of oral paliperidone extended release (ER) in a sample of patients who were switched to flexible doses within the crucial first 5 years after receiving a diagnosis of schizophrenia. METHODS Patients were recruited from 23 countries. Adults with nonacute but symptomatic schizophrenia, previously unsuccessfully treated with other oral antipsychotics, were transitioned to paliperidone ER (3-12 mg/day) and prospectively treated for up to 6 months. The primary efficacy outcome for patients switching for the main reason of lack of efficacy with their previous antipsychotic was at least 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores. For patients switching for other main reasons, such as lack of tolerability, compliance or 'other', the primary outcome was non-inferiority in efficacy compared with the previous oral antipsychotic. RESULTS For patients switching for the main reason of lack of efficacy, 63.1% achieved an improvement of at least 20% in PANSS total scores from baseline to endpoint. For each reason for switching other than lack of efficacy, efficacy maintenance after switching to paliperidone ER was confirmed. Statistically significant improvement in patient functioning from baseline to endpoint, as assessed by the Personal and Social Performance scale, was observed (p < 0.0001). Treatment satisfaction with prior antipsychotic treatment at baseline was rated 'good' to 'very good' by 16.8% of patients, and at endpoint by 66.0% of patients treated with paliperidone ER. Paliperidone ER was generally well tolerated, with frequently reported treatment-emergent adverse events being insomnia, anxiety and somnolence. CONCLUSIONS Flexibly dosed paliperidone ER was associated with clinically relevant symptomatic and functional improvement in recently diagnosed patients with non-acute schizophrenia previously unsuccessfully treated with other oral antipsychotics.
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Affiliation(s)
- Lars Helldin
- Department of Psychiatry, NU-Health Care Hospital, 46185 Trollhättan, Sweden
| | - Joseph Peuskens
- University Psychiatric Centre KU Leuven, Campus Kortenberg, Kortenberg, Belgium
| | - Roland Vauth
- Center for Mental Health, Department of Psychiatry and Psychotherapy, University Hospital of Psychiatry Basel, University of Basel, Switzerland
| | - Emilio Sacchetti
- Department of Clinical and Experimental Sciences, Neuroscience Section, Brescia University School of Medicine, Brescia University and Brescia Spedali Civili, Brescia, Italy
| | - Haye Bij de Weg
- Division 'Meervoudige Zorg', GGZ Friesland, Leeuwarden, The Netherlands
| | - Hasan Herken
- School of Medicine, Pamukkale University, Denizli, Turkey
| | - Marjolein Lahaye
- Medical Affairs EMEA, Janssen-Cilag BV, Tilburg, The Netherlands
| | - Andreas Schreiner
- Medical & Scientific Affairs EMEA, Janssen-Cilag GmbH, Neuss, Germany
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Pandya CD, Hoda MN, Kutiyanawalla A, Buckley PF, Pillai A. Differential effects upon brain and serum BDNF levels in rats as response to continuous and intermittent administration strategies of two second generation antipsychotics. Schizophr Res 2013; 151:287-8. [PMID: 24135222 DOI: 10.1016/j.schres.2013.09.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Chirayu D Pandya
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA
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Gong W, Ma R, Mei D, Jing P, Dong X, Li B, Yang Y, Du L, Mei XG, Hu FQ. A novel subcutaneous infusion delivery system based on osmotic pump:in vitroandin vivoevaluation. Drug Deliv 2013; 21:1-7. [DOI: 10.3109/10717544.2013.838718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmauss M, Jukić V, Siracusano A, Bidzan L, Badescu GM, Maciulis V, Lahaye M, Hoeben D, Tessier C, Schreiner A. Flexible dosing with paliperidone ER in the treatment of patients with acutely exacerbated schizophrenia: results from a single-arm, open-label study. Curr Med Res Opin 2012; 28:1395-404. [PMID: 22746355 DOI: 10.1185/03007995.2012.708327] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To extend findings from fixed-dose, double-blind, placebo-controlled clinical trials in selected patient populations by using flexibly-dosed oral paliperidone extended-release (ER) in a more naturalistic setting. METHODS Adults hospitalized with an acute exacerbation of schizophrenia were prospectively treated with open-label flexibly-dosed paliperidone ER 3-12 mg/day for 6 weeks. RESULTS Overall, 294 patients were treated. The primary endpoint, defined as ≥30% improvement in Positive and Negative Syndrome Scale total scores from baseline to endpoint, was achieved by 66.3% of patients. The percentage of patients rated as at least 'markedly ill' in Clinical Global Impression of Severity scale decreased from baseline (74.1%) to endpoint (20.0%). Patient functioning, assessed by the Personal and Social Performance scale, improved significantly from 50.0 ± 14.3 at baseline to 63.6 ± 14.9 at endpoint (p < 0.0001). Concomitant benzodiazepines were newly initiated in 191 patients (65.0%), and new concomitant medications other than benzodiazepines were started after baseline for 133 patients (45.2%), most frequently paracetamol, zolpidem, and zopiclone. No unexpected adverse events were identified. CONCLUSIONS These data support findings in more selected patient populations treated with fixed-dose paliperidone ER. Flexibly-dosed paliperidone ER administered in a naturalistic hospital setting to a more representative patient population experiencing an acute episode of schizophrenia, was associated with clinically meaningful treatment response. Strength of conclusions is limited by the open-label design and lack of a comparator group. Furthermore, some of the improvements observed may in part be associated with increased attention provided to patients and concomitant use of psychotropic medications, such as benzodiazepines, during this study.
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Cavallaro R, Bosia M, Guglielmino C, Smeraldi E. 9-OH risperidone response in risperidone poor responders: An open study of drug response concordance. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.npbr.2012.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ruiu S, Casu MA, Casu G, Piras S, Marchese G. Effects of controlled-release formulations of atypical antipsychotics on functioning and quality of life of schizophrenic individuals. Expert Opin Pharmacother 2012; 13:1631-43. [PMID: 22594805 DOI: 10.1517/14656566.2012.690397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Controlled-release formulations of atypical antipsychotics have recently been introduced into clinical practice. Clinical studies have indicated that these new therapies induce meaningful improvements in the functioning and quality of life of schizophrenic individuals. AREAS COVERED The present analysis makes an attempt to address the clinical relevance of these studies and their contribution to the understanding of the mechanisms of action of these new drugs. A Medline search was done using the keywords 'antipsychotic', 'plasma level', 'quality of life' and 'functioning'. EXPERT OPINION After reviewing the literature, it seems that symptom control and side effects may play a role in modulating the functioning and quality of life of schizophrenic individuals treated with controlled-release formulations of atypical antipsychotics. The analysis also highlights that these new drugs may possess peculiarities and similarities in regulating patient functioning. However, the low number of clinical analyses that have focused on these aspects of antipsychotic therapy limits the interpretation of the results. Additional comparative clinical trials are needed to evaluate how the pharmacokinetic/pharmacodynamic properties of antipsychotic drugs may modulate the functioning and quality of life of schizophrenic individuals, as well as to establish whether new clinical benefits may come from the use of these drugs in schizophrenia therapy.
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Affiliation(s)
- Stefania Ruiu
- CNR, Institute of Translational Pharmacology, Sect. Cagliari, Technological Park of Sardinia POLARIS, Loc. Piscinamanna, Building 5, I-09010 Pula, Cagliari, Italy
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