Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2024; 14(4): 523-532
Published online Apr 19, 2024. doi: 10.5498/wjp.v14.i4.523
Relationship between plasma risperidone concentrations and clinical features in chronic schizophrenic patients in China
Jing-Wen Xu, Xiao-Bo Guan, Xue-Ying Wang, Yang Feng, Qi Zhang, Jun-Juan Zhu, Jian-Hua Chen
Jing-Wen Xu, Qi Zhang, Department of Medicine, Shanghai No. 3 Mental Health Center of Civil Administration, Shanghai 200435, China
Xiao-Bo Guan, The Fourth Sick Ward, Shanghai No. 3 Mental Health Center of Civil Administration, Shanghai 200435, China
Xue-Ying Wang, Jun-Juan Zhu, Jian-Hua Chen, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
Yang Feng, The First Sick Ward, Shanghai No. 3 Mental Health Center of Civil Administration, Shanghai 200435, China
Co-first authors: Jing-Wen Xu and Xiao-Bo Guan.
Co-corresponding authors: Jian-Hua Chen and Xue-Ying Wang.
Author contributions: Xu JW, Guan XB, Wang XY, and Chen JY conceived, designed, and refined the study protocol, analyzed the data, and drafted the manuscript; Xu JW, Guan XB, and Feng Y were involved in the data collection; Zhang Q contributed to laboratory analysis and electrocardiogram test; Wang XY and Zhu JJ revised and translated the manuscript. All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. The reasons for designating Xu JW and Guan XB as co-first authors are twofold: First, they made equal contributions to the writing and revision of the manuscript. Second, this study was conducted collaboratively, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. The rationale behind selecting Chen JY and Wang XY as co-corresponding authors lies in their equal contributions to formulating, conceptualizing, and executing the study. In summary, the co-first and co-corresponding authors in this study not only reflect our team's collaborative spirit and equal contributions, but also enhanced the rationality and depth of the research topic.
Supported by Shanghai Civil Administration Bureau, No. 8-2-50.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shanghai No. 3 Mental Health Center of Civil Administration.
Informed consent statement: All study participants or their legal guardian provided their consent to participate after being informed of the study’s purpose.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The data for this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Chen, MD, PhD, Chief Physician, Professor, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, No. 600 Wanping Nan Road, Shanghai 200030, China. jianhua.chen@smhc.org.cn
Received: November 21, 2023
Peer-review started: November 21, 2023
First decision: January 24, 2024
Revised: February 7, 2024
Accepted: March 22, 2024
Article in press: March 22, 2024
Published online: April 19, 2024
Processing time: 147 Days and 15.2 Hours
Abstract
BACKGROUND

Prior studies have noted great variability in the plasma levels of risperidone (RIS). Plasma concentrations of RIS and its active moiety are highly variable and depend on absorption, metabolism, and other predictors of metabolic dysregulation; however, these factors are poorly understood and the association between metabolic change and change in psychopathology is uncertain.

AIM

To ascertain the characteristics of chronic schizophrenic patients treated with RIS, and to assess their relationship with plasma RIS levels.

METHODS

This was a descriptive cross-sectional study of 50 patients with a diagnosis of schizophrenic psychosis treated with RIS in a psychiatric service. The plasma concentrations of RIS and its metabolite 9-hydroxyrisperidone were determined by high performance liquid chromatography. The patients’ demographic and clinical characteristics, and psychopathologies were assessed, and the associations between clinical variables and plasma levels of RIS were explored.

RESULTS

Male patients received higher doses of RIS than female ones, but plasma concentrations of RIS and risperidone + 9-hydroxyrisperidone (active moiety) were higher in female patients. Age and the mean scores of the general psychopathology subscale of the Positive and Negative Syndrome Scale (PANSS) were significantly positively correlated with plasma concentrations of risperidone + 9-hydroxyrisperidone adjusted for weight and dose in all 50 subjects. In male subjects, we found a statistically significant positive correlation between the concentrations of risperidone + 9-hydroxyrisperidone in plasma/(dose × kg) and age, mean PANSS negative subscale scores, mean PANSS general psychopathology subscale scores, and mean PANSS total scores.

CONCLUSION

Long-term use of RIS should be closely monitored in older patients and females to minimize the risk of high concentrations which could induce side effects.

Keywords: Antipsychotics; Risperidone; 9-hydroxyrisperidone; Plasma drug concentration monitoring; Chronic schizophrenia

Core Tip: Prior studies have noted great variability in the plasma levels of risperidone (RIS). Fifty patients confirmed to have schizophrenia were selected for this study. We assessed the patients’ demographic and clinical characteristic, and psychopathologies, and explored the associations and correlations between clinical variables and plasma levels of RIS. The results of this study indicate that the long-term use of RIS should be closely monitored in older patients and females to minimize the risk of high concentrations which could induce side effects.