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Effects of long-acting injectable antipsychotics versus oral antipsychotics on autonomic nervous system activity in schizophrenic patients

Authors Suda A, Hattori S, Kishida I, Miyauchi M, Shiraishi Y, Fujibayashi M, Tsujita N, Ishii C, Ishii N, Moritani T, Hirayasu Y

Received 14 May 2018

Accepted for publication 6 July 2018

Published 17 September 2018 Volume 2018:14 Pages 2361—2366


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Taro Kishi

Akira Suda,1 Saki Hattori,1 Ikuko Kishida,1,2 Masatoshi Miyauchi,1 Yohko Shiraishi,1 Mami Fujibayashi,3 Natsuki Tsujita,4 Chie Ishii,2 Norio Ishii,2 Toshio Moritani,5 Yoshio Hirayasu1,6

1Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, 2Department of Psychiatry, Fujisawa Hospital, Kanagawa, 3Division of Physical and Health Education, Setsunan University, Osaka, 4Graduate School of Human and Environmental Studies, Kyoto University, 5Department of Health and Sports Sociology, Faculty of General Education, Kyoto Sangyo University, Kyoto, 6Department of Psychiatry, Hirayasu Hospital, Okinawa, Japan

Long-acting injections (LAIs) of antipsychotics show distinct pharmacokinetic profiles from oral antipsychotics (OAPs). Although there may be differences in adverse event frequency, any differences in their effects on autonomic nervous system (ANS) remain unclear.
Patients and methods: In total, 270 schizophrenic patients were recruited in this study: 241 received OAPs (risperidone, olanzapine, quetiapine, or aripiprazole) and 29 received LAIs (risperidone LAI, aripiprazole LAI, or paliperidone palmitate) as monotherapy. Heart rate variability was measured as an index of ANS activity, and the low-frequency (0.03–0.15 Hz) component, high-frequency (0.15–0.40 Hz) component, and total power (0.03–0.40 Hz) were calculated. Components were compared between the groups using t-tests.
Results: A significant difference was detected in the low-frequency component between the OAP and LAI groups (P=0.046). No significant difference was found in total power or the high-frequency component between the two groups.
Conclusion: Compared with OAPs, LAIs have fewer adverse effects on ANS activity, particularly the low-frequency component, as determined using a spectral analysis of heart rate variability.

Keywords: long-acting injectable antipsychotics, autonomic nervous system, heart rate variability, adverse effect

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