Blood pressure and heart rate in aripiprazole once – monthly and paliperidone 1 and 3-month long-acting preparations

Yıl 2023, , 157 - 161, 31.05.2023

Gokce Elif Sarıdogan Mehmet Zafer Goren

https://doi.org/10.5472/marumj.1302445

Öz

Objective: This study aims to evaluate the blood pressure and heart rates of the patients treated with aripiprazole once-monthly,
paliperidone 1-month, and paliperidone 3-month long-acting injections.
Patients and Methods: This study was a non-invasive observational study. Subjects using the same long-acting injection preparation
for at least four months without skipped injections were assigned to 3 groups according to their treatments. They were screened
starting from routine injection day and monthly for four months. Heart rate, systolic blood pressure, and diastolic blood pressure were
recorded for each subject.
Results: Systolic and diastolic blood pressure among the three treatment groups demonstrated no statistical significance. The heart rate
of the paliperidone 3-month group was significantly higher than the aripiprazole once-monthly group. However, the mean heart rate
was within the physiological limits. Thus, a clinical significance can hardly be attributed.
Conclusion: Aripiprazole once-monthly, paliperidone 1-month, and paliperidone 3-month long-acting injections are non-inferior
regarding heart rate, systolic and diastolic blood pressure during the maintenance treatment.

Anahtar Kelimeler

Long-acting antipsychotic, Hypertension tachycardia, Schizophrenia, Maintenance treatment

Kaynakça

• [1] Simeone JC, Ward AJ, Rotella P, Collins J, Windisch R. An evaluation of variation in published estimates of schizophrenia prevalence from 1990-2013: A systematic literature review. BMC Psychiatry 2015; 15:193. doi: 10.1186/ s12888.015.0578-7
• [2] Taylor DM, Barnes TR, Young AH. The Maudsley Prescribing Guidelines in Psychiatry. 13th ed. Hoboken, NJ: Wiley- Blackwell. 2020.
• [3] Valsecchi P, Barlati S, Garozzo A, et al. Paliperidone palmitate in short – and long-term treatment of schizophrenia. Riv Psichiatr 2019; 54:235-48. doi: 10.1708/3281.32542
• [4] Potkin SG, Preda A. Aripiprazole once-monthly longacting injectable for the treatment of schizophrenia. Expert Opin Pharmacother 2016; 17:395-407. doi: 10.1517/14656.566.2015.1114100
• [5] Kane JM, Sanchez R, Perry PP, et al. Aripiprazole intramuscular depot as maintenance treatment in patients with schizophrenia: A 52-week, multicenter, randomized, double-blind, placebocontrolled study. J Clin Psychiatry 2012; 73:617-24. doi: 10.4088/JCP.11m07530
• [6] Fleischhacker WW, Sanchez R, Perry PP, et al. Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study. Br J Psychiatry 2014; 205:135-44. doi: 10.1192/bjp.bp.113.134213
• [7] Burris KD, Molski TF, Xu C, et al. Aripiprazole, a novel antipsychotic, is a high-affinity partial agonist at human dopamine D2 receptors. J Pharmacol Exp Ther 2002; 302:381- 9. doi: 10.1124/jpet.102.033175
• [8] Bishara D. Once-monthly paliperidone injection for the treatment of schizophrenia. Neuropsychiatr Dis Treat 2010; 6:561-72. doi: 10.2147/NDT.S8505
• [9] Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353:1209-23. doi: 10.1056/NEJMoa051688
• [10] Edinoff AN, Doppalapudi PK, Orellana C, et al. Paliperidone 3-month ınjection for treatment of schizophrenia: a narrative review. Front Psychiatry 2021; 12:699748. doi: 10.3389/ fpsyt.2021.699748
• [11] Ravenstijn P, Remmerie B, Savitz A, et al. Pharmacokinetics, safety, and tolerability of paliperidone palmitate 3-month formulation in patients with schizophrenia: A phase-1, singledose, randomized, open-label study. J Clin Pharmacol 2016; 56:330-9. doi:10.1002/jcph.597
• [12] Naber D, Hansen K, Forray C, et al. Qualify: a randomized headto- head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res 2015; 168:498-504. doi: 10.1016/j.schres.2015.07.007
• [13] Haddad PM, Tiihonen J, Haukka J, Taylor M, Patel MX, Korhonen P. The place of observational studies in assessing the effectiveness of depot antipsychotics. Schizophr Res 2011; 131:260–1. doi: 10.1016/j.schres.2011.05.022
• [14] Levine M, Ruha AM. Overdose of atypical antipsychotics: clinical presentation, mechanisms of toxicity and management. CNS Drugs 2012; 26:601-11. doi: 10.2165/11631.640.000000000-00000
• [15] Fisher J, Taori G, Braitberg G, Graudins A. Methylene blue used in the treatment of refractory shock resulting from drug poisoning. Clin Toxicol (Phila) 2014; 52:63-65. doi: 10.3109/15563.650.2013.870343
• [16] Buckley NA, Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug Saf 2000; 23:215-28. doi: 10.2165/00002.018.200023030-00004
• [17] Shah S, Joshi D. Tolerability and efficacy of paliperidone ER compared to olanzapine in the treatment of schizophrenia: A randomized, double-blind, multicentric trial. Ind Psychiatry J 2011; 20:25-31. doi: 10.4103/0972-6748.98411
• [18] Parks KA, Parks CG, Yost JP, Bennett JI, Onwuameze OE. Acute blood pressure changes associated with antipsychotic administration to psychiatric ınpatients. Prim Care Companion CNS Disord 2018; 20:18m02299. doi: 10.4088/ PCC.18m02299
• [19] Garcia-Portilla MP, Llorca PM, Maina G, et al. Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia. Ther Adv Psychopharmacol 2020; 25;10:204.512.5320926347. doi: 10.1177/204.512.5320926347
• [20] Uzun AD, Sapmaz ŞY, Öztürk M, Kandemir H. hypertension ınduced by aripiprazole use in an autistic child patient. Clin Psychopharmacol Neurosci 2019; 17:556-8. doi: 10.9758/ cpn.2019.17.4.556
• [21] Kato T, Mizoguchi Y, Monji A, et al. Inhibitory effects of aripiprazole on interferon-γ-induced microglial activation via intracellular Ca2+ regulation in vitro. J Neurochem 2008; 106:815-825. doi: 10.1111/j.1471-4159.2008.05435.x
• [22] Borras L, Constant EL, Eytan A, Huguelet P. Hypertension and aripiprazole. Am J Psychiatry 2005; 162:2392. doi: 10.1176/ appi.ajp.162.12.2392
• [23] Yasui-Furukori N, Fujii A. Worsened hypertension control induced by aripiprazole. Neuropsychiatr Dis Treat 2013; 9:505-7. doi: 10.2147/NDT.S43950.
• [24] Paton C, Duffett R, Harrington M, Lelliott P, Okocha C, Sensky T. Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients. J. Psychopharmacol 2003; 17:223-9. doi: 10.1177/026.988.1103017002012
• [25] Leung JY, Barr AM, Procyshyn RM, Honer WG, Pang CC. Cardiovascular side-effects of antipsychotic drugs: The role of the autonomic nervous system. Pharmacol Ther 2012; 135:113-22. doi: 10.1016/j.pharmthera.2012.04.003
• [26] Orlins Z, Barnett B. Tachycardia during treatment with risperidone and paliperidone palmitate in a patient without previous cardiovascular disease. Case Rep Psychiatr 2021; 2021:9954991. doi: 10.1155/2021/9954991
• [27] Tagne Nouemssi AB. Risperidone-associated sinus tachycardia potentiated bypaliperidone palmitate in a patient with no prior cardiovascular disease: role of risperidone-related autonomic instability. BML Case Rep 2018;2018: bcr201.722.1771. doi: 10.1136/bcr-2017- 221771
• [28] Grubisha MJ, Brennan JL, Douaihy A. Isolated sinus tachycardia following reinitiation of risperidone in a patient with suspected autonomic hypersensitivity, Journal of pharmacology & pharmacotherapeutics, 2015;6: 42-44. doi: 10.4103/0976-500X.149147
• [29] Oner T, Akdeniz C, Adaletli H. Multifocal atrial tachycardia caused by risperidone. Int J Cardiol 2016; 203:855-7. doi: 10.1016/j.ijcard.2015.10.234
• [30] Borek HA and Charlton NP. Accidental pediatric paliperidone ingestion resulting in delayed profound tachycardia. J Emerg Med 2019; 57:109-11. doi: 10.1016/j.jemermed.2019.06.049
• [31] Davidson M, Emsley R, Kramer M, et al. Efficacy, safety and early response of paliperidone extended-release tablets (paliperidone ER): results of a 6-week, randomized, placebocontrolled study. Schizophrenia Research 2007; 93:117-30. doi: 10.1016/j.schres.2007.03.003
• [32] Polcwiartek C, Sneider B, Graff C, et al. The cardiac safety of aripiprazole treatment in patients at high risk for torsade: a systematic review with a meta-analytic approach. Psychopharmacology (Berl) 2015; 232:3297-308. doi: 10.1007/ s00213.015.4024-9
• [33] Torgovnick J, Sethi NK, Arsura E. Aripiprazole-induced orthostatic hypotension and cardiac arrhythmia. Psychiatry Clin Neurosci 2008; 62:485. doi: 10.1111/j.1440- 1819.2008.01833.x
• [34] Shao Q, Quan W, Jia X, Chen J, Ma S, Zhang X. Severe arrhythmia induced by orally disintegrating aripiprazole tablets (Bosiqing(®)): a case report. Neuropsychiatr Dis Treat 2015;9::3019-21. doi: 10.2147/NDT.S91771
• [35] Alves BB, Oliveira GP, Moreira Neto MG, Fiorilli RB, Cestário EDES. Use of atypical antipsychotics and risk of hypertension: A case report and review literature. SAGE Open Med Case Rep 2019; 7:2050313X19841825. doi: 10.1177/2050313X19841825