Affiliation:
1. Moscow Scientific Research Institute of Psychiatry – branch of the V. Serbsky National Medical Research Centre of Psychiatry and Narcology
2. Central Military Clinical Hospital named after A.A. Vishnevsky
3. Zvenigorod Psychoneurological Boarding School
4. “La Salute” Personal Medicine Clinic
Abstract
Introduction. Although scientific literature demonstrates a relationship between prolactin levels, the efficacy of aripiprazole therapy, and negative symptoms in patients with schizophrenia, many questions regarding these problems remain controversial.Objective to study dynamics of clinical and hormonal parameters in patients with chronic schizophrenia during aripiprazole therapy.Materials and methods: 60 patients with schizophrenia were studied: 42 male (70%) and 18 female (30%), aged 20 to 65 years (mean age 52.84±17.40 years) on inpatient aripiprazole treatment with the mean daily dosage of 15.33±4.52 mg. Comparative analysis of prolactin parameters was carried out taking into account the following factors: effectiveness of therapy, age, duration of the disease, severity of negative symptoms (according to the PANSS scores). Responders included patients with a reduction in total PANSS score of 20% and more.Results: the effectiveness of aripiprazole monotherapy after switching from previous antipsychotic treatment in patients with chronic schizophrenia was noted in 71.7% of patients. The effectiveness of therapy does not depend on the background values of the hormone: at high rates, prolactin levels decrease, and at low rates, they increase. Meanwhile, a certain pattern was revealed between the dynamics of scores of the negative PANSS scale and the level of prolactin: responders with high background levels showed the decrease of prolactin levels given the decline of the PANSS scores, and in responders with low values, the hormone levels increased. In non-responders, low background scores of the negative scale and their slight changes during therapy were accompanied by an increase in prolactin levels. The data obtained in relation to non-responder patients who showed negative correlations between the levels of prolactin, age, dosage of the drug and the duration of the disease require a more careful attitude to the appointment of aripiprazole due to the likelihood of a decrease in their prolactin levels to abnormally low values.
Publisher
V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology
Reference42 articles.
1. Vanyushina EA, Poplavskaya OV, Chernaya NA. Diagnostic difficulties and possible ways to correct maladaptation resulting from simple schizophrenia. Farmaciya i farmakologiya. 2015;5:29–30. (in Russ.).
2. Gorobets LN. Issues of tolerability and safety of aripiprazole therapy. Sovremennaya terapiya psihicheskih rasstrojstv. 2013;1:24-30. (in Russ.)
3. Gorobets LN, Dorovskikh IV, Bulanov VS, Litvinov AV, Gamdullaev SK., Pavlova TA. Features of prolactin secretion in patients with chronic schizophrenia. Social'naya i klinicheskaya psihiatriya. 2022;32(1):5-12. (in Russ.).
4. Dorovskih IV, SHajdegger YuM, Pavlova TA, Tankova OI. New strategies for the correction of undesirable neuroendocrine phenomena of psychopharmacotherapy. Effektivnaya farmakoterapiya. 2020;16(14):12–20. https://doi.org/10.33978/2307-3586-2020-16-14-12-20). (in Russ.).
5. Kut'ko II, Panchenko OA, Achkauskas GS, Linev AN. Modern treatment of psychotic schizophrenia. Differentiated biological therapy of endogenous procedural psychoses. Novosti v medicine i farmacii. 2013;16(647):48-49. (in Russ.).