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Blonanserin Similar Efficacy to Risperidone for Schizophrenia, but Side Effects Differ
The efficacy of blonanserin, a second-generation antipsychotic approved for the treatment of schizophrenia in Japan, South Korea, and China, is similar to that of risperidone, although the medications differ in terms of adverse events, according to a systematic review and meta-analysis published online in BMC Psychiatry.
“Risperidone is associated with a lower incidence of extrapyramidal symptoms, while blonanserin is associated with lower incidences of serum prolactin increases and weight gain,” wrote researchers from Qiqihar Medical University in China.
The systematic review and meta-analysis included 8 head-to-head randomized controlled trials that compared the efficacy and safety of blonanserin with risperidone in a total 1386 patients with schizophrenia.
Changes in the Positive and Negative Syndrome Scale (PANSS) total scores, the primary endpoint of the study, did not differ significantly between patients treated with blonanserin and patients treated with risperidone, according to the analysis. PANSS subscale scores for positive symptoms and for negative symptoms also did not differ between treatment groups.
How blonanserin compared with risperidone for improving cognitive and social function, however, was unclear due to varying assessments among trials, researchers reported.
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Compared with risperidone, the incidence of serum prolactin increases, and weight gain was lower in the blonanserin group, the study found, but the incidence of extrapyramidal symptoms was higher.
“Extrapyramidal symptoms, hyperprolactinemia, and weight gain are detrimental to patients’ health and can lead to adverse effects, such as endocrine disorders, disease burden increase, and poor compliance with drugs,” researchers wrote. “Thus, we should not only consider the efficacy but also pay attention to the safety to prevent these adverse reactions.”
The team called for more high-quality trials to investigate and clarify how the two treatments compare in efficacy, safety, and patient adherence.
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