Skip to main content
Top
Published in: CNS Drugs 1/2010

01-01-2010 | Adis Drug Evaluation

Blonanserin

A Review of its Use in the Management of Schizophrenia

Authors: Emma D. Deeks, Gillian M. Keating

Published in: CNS Drugs | Issue 1/2010

Login to get access

Abstract

Oral blonanserin (Lonasen®) is an atypical antipsychotic agent indicated for use in patients with schizophrenia in Japan and Korea. It is effective in the treatment of patients with schizophrenia, providing short- and long-term efficacy against both the positive and negative symptoms of the disorder in several randomized and noncomparative trials. Notably, in two randomized, double-blind trials of 8 weeks’ duration, blonanserin was noninferior to haloperidol or risperidone for primary endpoints, although it appeared to be better than haloperidol in improving negative symptoms. Blonanserin is generally well tolerated and appears to have an acceptable profile in terms of bodyweight gain. Potential tolerability benefits of the drug in short-term trials included fewer extrapyramidal symptoms than haloperidol and fewer reports of prolactin level increases or hyperprolactinaemia than risperidone. Nevertheless, extrapyramidal symptoms and hyperprolactinaemia were among the most common adverse reactions associated with blonanserin in noncomparative long-term studies. Further prospective and long-term comparative studies are required in order to definitively position blonanserin with respect to other antipsychotic agents. In the meantime, available clinical data suggest that blonanserin is an effective and generally well tolerated option for the short-term treatment of schizophrenia and for those requiring longer-term therapy.
Literature
3.
go back to reference Falkai P, Wobrock T, Lieberman J, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 1: acute treatment of schizophrenia. World J Biol Psychiatry 2005; 6(3): 132–91PubMedCrossRef Falkai P, Wobrock T, Lieberman J, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 1: acute treatment of schizophrenia. World J Biol Psychiatry 2005; 6(3): 132–91PubMedCrossRef
5.
go back to reference Leucht S, Corves C, Arbter D, et al. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009 Jan 3; 373(9657): 31–41PubMedCrossRef Leucht S, Corves C, Arbter D, et al. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009 Jan 3; 373(9657): 31–41PubMedCrossRef
6.
go back to reference Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics: differential risk and clinical implications. CNS Drugs 2007; 21(11): 911–36PubMedCrossRef Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics: differential risk and clinical implications. CNS Drugs 2007; 21(11): 911–36PubMedCrossRef
7.
go back to reference Bishara D, Taylor D. Upcoming agents for the treatment of schizophrenia. Drugs 2008; 68(16): 2269–92PubMedCrossRef Bishara D, Taylor D. Upcoming agents for the treatment of schizophrenia. Drugs 2008; 68(16): 2269–92PubMedCrossRef
8.
go back to reference Lonansen® (Blonanserin): prescribing information. Osaka: Dainippon Sumitomo Pharma Co. Ltd, 2009 Jan Lonansen® (Blonanserin): prescribing information. Osaka: Dainippon Sumitomo Pharma Co. Ltd, 2009 Jan
10.
go back to reference Murasaki M. Clinical evaluation of blonanserin for schizophrenia: a double-blind trial comparing blonanserin with haloperidol [English abstract]. Jpn J Clin Psychopharmacol 2007; 10: 2059–79 Murasaki M. Clinical evaluation of blonanserin for schizophrenia: a double-blind trial comparing blonanserin with haloperidol [English abstract]. Jpn J Clin Psychopharmacol 2007; 10: 2059–79
11.
go back to reference Miura S. Clinical evaluation of blonanserin for schizophrenia: a randomized study comparing blonanserin with risperidone [English abstract]. Jpn J Clin Psychopharmacol 2008; 11:297–314 Miura S. Clinical evaluation of blonanserin for schizophrenia: a randomized study comparing blonanserin with risperidone [English abstract]. Jpn J Clin Psychopharmacol 2008; 11:297–314
12.
go back to reference Oka T, Hamamura T, Lee Y, et al. Atypical properties of several classes of antipsychotic drugs on the basis of differential induction of Fos-like immunoreactivity in the rat brain. Life Sci 2004 Nov 26; 76(2): 225–37PubMedCrossRef Oka T, Hamamura T, Lee Y, et al. Atypical properties of several classes of antipsychotic drugs on the basis of differential induction of Fos-like immunoreactivity in the rat brain. Life Sci 2004 Nov 26; 76(2): 225–37PubMedCrossRef
13.
go back to reference Oka M, Noda Y, Ochi Y, et al. Pharmacological profile of AD-5423, a novel antipsychotic with both potent dopamine-D2 and serotonin-S2 antagonist properties. J Pharmacol Exp Ther 1993 Jan; 264(1): 158–65PubMed Oka M, Noda Y, Ochi Y, et al. Pharmacological profile of AD-5423, a novel antipsychotic with both potent dopamine-D2 and serotonin-S2 antagonist properties. J Pharmacol Exp Ther 1993 Jan; 264(1): 158–65PubMed
14.
go back to reference Noda Y, Kurumiya S, Miura Y, et al. Comparative study of 2-(4-ethyl-1-piperazinyl)-4-(fluorophenyl)-5,6,7,8,9,10-hex ahydrocycloocta[b]pyridine (AD-5423) and haloperidol for their pharmacological activities related to antipsychotic efficacy and/or adverse side-effects. J Pharmacol Exp Ther 1993 May; 265(2): 745–51PubMed Noda Y, Kurumiya S, Miura Y, et al. Comparative study of 2-(4-ethyl-1-piperazinyl)-4-(fluorophenyl)-5,6,7,8,9,10-hex ahydrocycloocta[b]pyridine (AD-5423) and haloperidol for their pharmacological activities related to antipsychotic efficacy and/or adverse side-effects. J Pharmacol Exp Ther 1993 May; 265(2): 745–51PubMed
15.
go back to reference Nagai T, Noda Y, Une T, et al. Effect of AD-5423 on animal models of schizophrenia: phencyclidine-induced behavioural changes in mice. Neuroreport 2003 Feb 10; 14(2): 269–72PubMedCrossRef Nagai T, Noda Y, Une T, et al. Effect of AD-5423 on animal models of schizophrenia: phencyclidine-induced behavioural changes in mice. Neuroreport 2003 Feb 10; 14(2): 269–72PubMedCrossRef
16.
go back to reference Yokota K, Tatebayashi H, Matsuo T, et al. The effects of neuroleptics on the GABA-induced Cl− current in rat dorsal root ganglion neurons: differences between some neuroleptics. Br J Pharmacol 2002 Mar; 135(6): 1547–55PubMedCrossRef Yokota K, Tatebayashi H, Matsuo T, et al. The effects of neuroleptics on the GABA-induced Cl− current in rat dorsal root ganglion neurons: differences between some neuroleptics. Br J Pharmacol 2002 Mar; 135(6): 1547–55PubMedCrossRef
17.
go back to reference Investigator’s brochure. Osaka: Dainippon Sumitomo Pharma Co. Ltd, 2006 Feb. (Data on file) Investigator’s brochure. Osaka: Dainippon Sumitomo Pharma Co. Ltd, 2006 Feb. (Data on file)
18.
go back to reference Richelson E. Receptor pharmacology of neuroleptics: relation to clinical effects. J Clin Psychiatry 1999; 60Suppl. 10: 5–14PubMed Richelson E. Receptor pharmacology of neuroleptics: relation to clinical effects. J Clin Psychiatry 1999; 60Suppl. 10: 5–14PubMed
19.
go back to reference Robertson GS, Matsumura H, Fibiger HC. Induction patterns of Fos-like immunoreactivity in the forebrain as predictors of atypical antipsychotic activity. J Pharmacol Exp Ther 1994 Nov; 271(2): 1058–66PubMed Robertson GS, Matsumura H, Fibiger HC. Induction patterns of Fos-like immunoreactivity in the forebrain as predictors of atypical antipsychotic activity. J Pharmacol Exp Ther 1994 Nov; 271(2): 1058–66PubMed
20.
go back to reference Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004; 64(20): 2291–314PubMedCrossRef Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management. Drugs 2004; 64(20): 2291–314PubMedCrossRef
21.
go back to reference American Diabetes Association; American Association of Clinical Endocrinologists; American Psychiatric Association; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 2004 Feb; 65(2): 267–72CrossRef American Diabetes Association; American Association of Clinical Endocrinologists; American Psychiatric Association; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. J Clin Psychiatry 2004 Feb; 65(2): 267–72CrossRef
22.
go back to reference Suzuki H, Morokawa Y, Gen K, et al. The relationship between the daily dose, the plasma concentration of AD-5423 (blonanserin), and its plasma anti-dopamine (D2) and anti-serotonin (5-HT2A) activity, and the plasma serotonin/dopamine (S/D) ratio [abstract]. Int Clin Psychopharmacol 2003 May; 18: 187CrossRef Suzuki H, Morokawa Y, Gen K, et al. The relationship between the daily dose, the plasma concentration of AD-5423 (blonanserin), and its plasma anti-dopamine (D2) and anti-serotonin (5-HT2A) activity, and the plasma serotonin/dopamine (S/D) ratio [abstract]. Int Clin Psychopharmacol 2003 May; 18: 187CrossRef
23.
go back to reference Murasaki M. Phase II study results of AD-5423, a newly synthesized SDA neuroleptic in Japan. Psychopharmacol Bull 1997; 33(3): 560 Murasaki M. Phase II study results of AD-5423, a newly synthesized SDA neuroleptic in Japan. Psychopharmacol Bull 1997; 33(3): 560
24.
go back to reference Garcia E, Robert M, Peris F, et al. The efficacy and safety of blonanserin compared with haloperidol in acute-phase schizophrenia: a randomized, double-blind, placebo-controlled, multicentre study. CNS Drugs 2009; 23(7): 615–25PubMedCrossRef Garcia E, Robert M, Peris F, et al. The efficacy and safety of blonanserin compared with haloperidol in acute-phase schizophrenia: a randomized, double-blind, placebo-controlled, multicentre study. CNS Drugs 2009; 23(7): 615–25PubMedCrossRef
25.
go back to reference Miyake N, Miyamoto S, Takeuchi A, et al. Effect of new-generation antipsychotic blonanserin on cognitive impairment in schizophrenia: a randomized double-blind comparison with risperidone [English abstract]. Jpn J Clin Psychopharmacol 2008; 11: 315–26 Miyake N, Miyamoto S, Takeuchi A, et al. Effect of new-generation antipsychotic blonanserin on cognitive impairment in schizophrenia: a randomized double-blind comparison with risperidone [English abstract]. Jpn J Clin Psychopharmacol 2008; 11: 315–26
26.
go back to reference Kinoshita T. Long-term clinical study of blonanserin for schizophrenia: a multicenter open study to determine safety and effectiveness in schizophrenic patients (Japan-wide study) [English abstract]. Jpn J Clin Psychopharmacol 2008; 11: 135–53 Kinoshita T. Long-term clinical study of blonanserin for schizophrenia: a multicenter open study to determine safety and effectiveness in schizophrenic patients (Japan-wide study) [English abstract]. Jpn J Clin Psychopharmacol 2008; 11: 135–53
27.
go back to reference Murasaki M. Long-term clinical study of blonanserin for schizophrenia: a multicenter open study to determine safety and effectiveness in schizophrenic patients (Kanagawa Region Clinical Psychopharmacology Study Group) [English abstract]. Jpn J Clin Psychopharmacol 2007; 10: 2241–57 Murasaki M. Long-term clinical study of blonanserin for schizophrenia: a multicenter open study to determine safety and effectiveness in schizophrenic patients (Kanagawa Region Clinical Psychopharmacology Study Group) [English abstract]. Jpn J Clin Psychopharmacol 2007; 10: 2241–57
28.
go back to reference Keith SJ, Kane JM. Partial compliance and patient consequences in schizophrenia: our patients can do better. J Clin Psychiatry 2003 Nov; 64(11): 1308–15PubMedCrossRef Keith SJ, Kane JM. Partial compliance and patient consequences in schizophrenia: our patients can do better. J Clin Psychiatry 2003 Nov; 64(11): 1308–15PubMedCrossRef
29.
go back to reference Pfeiffer PN, Ganoczy D, Valenstein M. Dosing frequency and adherence to antipsychotic medications. Psychiatr Serv 2008 Oct; 59(10): 1207–10PubMedCrossRef Pfeiffer PN, Ganoczy D, Valenstein M. Dosing frequency and adherence to antipsychotic medications. Psychiatr Serv 2008 Oct; 59(10): 1207–10PubMedCrossRef
Metadata
Title
Blonanserin
A Review of its Use in the Management of Schizophrenia
Authors
Emma D. Deeks
Gillian M. Keating
Publication date
01-01-2010
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 1/2010
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/11202620-000000000-00000

Other articles of this Issue 1/2010

CNS Drugs 1/2010 Go to the issue