Plasma levels of homovanillic acid and the response to risperidone in first episode untreated acute schizophrenia

Abstract

We have previously reported that risperidone might improve negative symptoms in schizophrenia by influencing noradrenergic neurons. In the present study, we focused on the clinical efficacy and mechanisms of risperidone towards positive symptoms in the acute phase of schizophrenia. Thirty-four patients meeting DSM-IV criteria for schizophrenia and treated with risperidone alone were evaluated regarding their clinical improvement using the Positive and Negative Syndrome Scale (PANSS) before and 2 weeks after risperidone administration, and blood samples were also drawn at the same times. Plasma concentrations of homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylglycol were analysed by high-performance liquid chromatography with electrochemical detection. Plasma HVA levels in the responders to the risperidone treatment (more than 50% improvement in scores of positive symptoms in PANSS) were higher than those of non-responders before risperidone administration. Furthermore, there was a negative trend between changes in plasma HVA levels and improvement of total scores for positive symptoms in PANSS. These results suggest that higher levels of plasma HVA before risperidone administration might be a predictor of a good response to risperidone treatment, and the influence of risperidone on dopaminergic activity might be associated with its efficacy in treating symptoms of schizophrenia in the acute phase.

Relationship between Plasma Homovanillic Acid and Outcome in Patients with Psychosis Spectrum Disorders

“…In contrast, data from the present study suggest that ΔpHVA may have a predictive value for responsiveness and possibly outcome in individual patients, as has also been suggested by others [31]. …”

Addition of risperidone to sertraline improves sertraline‐resistant refractory depression without influencing plasma concentrations of sertraline and desmethylsertraline

“…In vitro and in vivo studies have demonstrated that risperidone is a mixed serotonin (5-HT 2 ) and dopamine (D 2 ) receptor antagonist Leysen et al, 1988). We have reported that risperidone is effective for treating the acute phase of schizophrenia with few extrapyramidal side effects (Yoshimura et al, 2003. Furthermore, we have reported that risperidone is also effective in treating negative symptoms of chronic schizophrenic patients (Yoshimura et al, 2000a).…”

To the question of pathophysiological fundamentals of endocrine system functioning in patients with a first psychotic episode

“…Этому предположению соответствуют дан-ные о значительном (почти двукратное) повышении ак-тивности тромбоцитарной моноаминоксидазы (МАО) у больных с первым эпизодом шизофрении, что свидетель-ствует о нарушении баланса дофамина и серотонина в ЦНС [11,24]. Основные психопатологические проявления у боль-ных шизофренией, в частности с ППЭ, связаны с наруше-ниями моноаминового баланса в префронтальной коре головного мозга [25].…”