Combination Therapy with Blonanserin and Other Antipsychotics May Alleviate Psychotic Symptoms in Patients with Dopamine Supersensitivity Psychosis

摘要

Antipsychotic polypharmacy has remained a common treatment strategy in the management of schizophrenia patients, despite insufficient evidence for its safety and effectiveness". We investigated the consecutive cases of patients treated successfully with blonanserin and other antipsychotics as an add-on therapy by the retrospective follow-up study from April 2015 to March 2016. Inclusion criteria in this study contain three items; (1) Blonanserin 12-24 mg/day (within optimal dose rage) was prescribed continuously more than six months. (2) Other anti-psychotic drugs were used together with blonanserin as an add-on therapy. (3) The period with Brief Psychiatric Rating Scale scores less than 50 continued more than three months by the combination therapy with blonanserin and other antipsychotics, which indicated psychotic improvement and stability. The results were shown in table 1. The study included 3 men and 3 women patients with a mean age of 51.2 years old. The mean duration of illness period was 31.3 years. An average dose of blonanserin was 21.3 mg/day, and total antipsychotic dose was 1187.4 mg/day as chlorpromazine equivalent. Add-on antipsychotics included zotepine, olanzapine, risperidone, and quetiapine, which were classified into serotonin dopamine antagonist (SDA) or multi-acting receptor targeted antipsychotic (MARTA). Four patients (66.6%) had experienced frequent recurrences before combination therapy with blonanserin and other antipsychotics, and three patients (50%) had tar-dive dyskinesia.