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Zhuo C, Xu Y, Wang H, Fang T, Chen J, Zhou C, Li Q, Liu J, Xu S, Yao C, Yang W, Yang A, Li B, Chen Y, Tian H, Lin C. Safety and Efficacy of High-Dose Vitamin B6 as an Adjunctive Treatment for Antipsychotic-Induced Hyperprolactinemia in Male Patients With Treatment-Resistant Schizophrenia. Front Psychiatry 2021; 12:681418. [PMID: 34512411 PMCID: PMC8426548 DOI: 10.3389/fpsyt.2021.681418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022] Open
Abstract
This study aimed to investigate the safety and efficacy of high-dose vitamin B6 (vB6) as an adjunct treatment for antipsychotic-induced hyperprolactinemia (AIHP) in male patients with treatment-resistant schizophrenia (TRS). In this randomized double-blinded controlled study, patients were randomized (1:1) into a control group given aripiprazole (ARI; 10 mg/day; n = 100) or an intervention group given vB6 (300 mg/12 h for 16 weeks; n = 100). Prolactin levels, psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], cognitive function [MATRICS Consensus Cognitive Battery (MCCB)], liver function, kidney function, growth hormone level, micronutrient levels, blood lipids, and adverse secondary effects (ASEs)[Treatment Emergent Symptom Scale (TESS) and Barnes-Akathisia scale] were monitored. After a 16-week treatment period, the vB6 group showed a 68.1% reduction in serum prolactin levels (from 95.52 ± 6.30 μg/L to 30.43 ± 18.65 μg/L) while the ARI group showed only a 37.4% reduction (from 89.07 ± 3.59 μg/L to 55.78 ± 7.39 μg/L). During weeks 1-4, both treatments reduced prolactin similarly. Subsequently, the ARI effect plateaued, while the vB6 effect remained robust. The vB6 group showed better alleviation of psychotic symptoms and cognitive impairment. No serious ASEs were observed; ASEs were more frequent in the ARI group. AIHP reduction efficacy of vB6 was associated with baseline prolactin and triglyceride levels, total vB6 dosage, and education level. In conclusion, compared with the ARI group, TRS patients given vB6 showed better attenuation of AIHP, lower ASE scores, and greater improvements in clinical symptoms and cognitive impairments. These results support further consideration of vB6 as a putative treatment for AIHP. Trial Registration: ChiCTR1800014755.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Mental Disorder Therapy Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Tao Fang
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Jiayue Chen
- Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Jie Liu
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Shuli Xu
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Cong Yao
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Weiliang Yang
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Anqu Yang
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Bo Li
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Yuhui Chen
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Hongjun Tian
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
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