Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics

Takahiko NagamineDivision of Psychiatric Internal Medicine, Seiwakai-Kitsunan Hospital 3381 Suzenji, Yamaguchi City, JapanAbstract: Aspiration pneumonia is a major cause of death in patients with dysphagia, often accompanied by psychiatric symptoms. The inhibition of swallowing and cough reflexes, w...

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Autor principal:	Takahiko Nagamine
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e08d4e3121c74ea8a07d2a584b8e0b41
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spelling	oai:doaj.org-article:e08d4e3121c74ea8a07d2a584b8e0b412021-12-02T07:36:09ZSerum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics1176-63281178-2021https://doaj.org/article/e08d4e3121c74ea8a07d2a584b8e0b412008-03-01T00:00:00Zhttp://www.dovepress.com/serum-substance-p-levels-in-patients-with-chronic-schizophrenia-treate-a1011https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Takahiko NagamineDivision of Psychiatric Internal Medicine, Seiwakai-Kitsunan Hospital 3381 Suzenji, Yamaguchi City, JapanAbstract: Aspiration pneumonia is a major cause of death in patients with dysphagia, often accompanied by psychiatric symptoms. The inhibition of swallowing and cough reflexes, which contribute to a significant risk for aspiration, may be related to decreased levels of substance P. Clinical studies indicate a strong association of an increased mortality in psychiatric patients with the use of antipsychotics. The present study documented fewer positive episodes of swallowing reflex in patients treated with haloperidol for schizophrenia (7/11; 63.6%) than those treated with risperidone (10/11; 90.9%). In addition, patients treated with risperidone had serum substance P levels comparable with control subjects (29.0 &plusmn; 7.8 pg/mL, 29.6 &plusmn; 7.6, respectively; p = 0.9), while patients treated with haloperidol had significantly lower serum substance P levels (20.6 &plusmn; 5.5 pg/mL; p &lt; 0.01). Among patients on haloperidol, those with negative episodes of reflex (4/11; 36.4%) had serum substance P levels at 15.8 &plusmn; 1.0 pg/mL, in contrast with those with positive episodes (7/11; 63.6%) who had serum levels at 23.4 &plusmn; 4.9 pg/mL. However, in the patient group treated with risperidone, serum substance P levels in the majority of patients with positive episodes of reflexes (10/11, 90.9%; 30.1 &plusmn; 7.2 pg/mL) was found to be as high as in control subjects, all with positive episodes (5/5, 100%; 29.6 &plusmn; 7.6 pg/mL) (p = 0.866), and higher than in one patient with negative reflex (1/11, 9.1%; 18.0 &plusmn; 0.0 pg/mL). These results suggest that the decreased serum substance P levels are strongly associated with the use of haloperidol, as well as decreased swallowing reflexes. This suggests that serum substance P levels may be a useful predictive marker for the increased risk of developing aspiration, or subsequently aspiration pneumonia. Moreover, this increased incidence of aspiration may contribute to an increased mortality in patients following antipsychotic therapy. Risperidone, which has little influence on serum substance P productions, may be a more appropriate first-line drug of choice for treatment of schizophrenia.Keywords: schizophrenia, aspiration pneumonia, substance P, risperidone, haloperidol Takahiko NagamineDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2008, Iss Issue 1, Pp 289-294 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Takahiko Nagamine Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
description	Takahiko NagamineDivision of Psychiatric Internal Medicine, Seiwakai-Kitsunan Hospital 3381 Suzenji, Yamaguchi City, JapanAbstract: Aspiration pneumonia is a major cause of death in patients with dysphagia, often accompanied by psychiatric symptoms. The inhibition of swallowing and cough reflexes, which contribute to a significant risk for aspiration, may be related to decreased levels of substance P. Clinical studies indicate a strong association of an increased mortality in psychiatric patients with the use of antipsychotics. The present study documented fewer positive episodes of swallowing reflex in patients treated with haloperidol for schizophrenia (7/11; 63.6%) than those treated with risperidone (10/11; 90.9%). In addition, patients treated with risperidone had serum substance P levels comparable with control subjects (29.0 &plusmn; 7.8 pg/mL, 29.6 &plusmn; 7.6, respectively; p = 0.9), while patients treated with haloperidol had significantly lower serum substance P levels (20.6 &plusmn; 5.5 pg/mL; p &lt; 0.01). Among patients on haloperidol, those with negative episodes of reflex (4/11; 36.4%) had serum substance P levels at 15.8 &plusmn; 1.0 pg/mL, in contrast with those with positive episodes (7/11; 63.6%) who had serum levels at 23.4 &plusmn; 4.9 pg/mL. However, in the patient group treated with risperidone, serum substance P levels in the majority of patients with positive episodes of reflexes (10/11, 90.9%; 30.1 &plusmn; 7.2 pg/mL) was found to be as high as in control subjects, all with positive episodes (5/5, 100%; 29.6 &plusmn; 7.6 pg/mL) (p = 0.866), and higher than in one patient with negative reflex (1/11, 9.1%; 18.0 &plusmn; 0.0 pg/mL). These results suggest that the decreased serum substance P levels are strongly associated with the use of haloperidol, as well as decreased swallowing reflexes. This suggests that serum substance P levels may be a useful predictive marker for the increased risk of developing aspiration, or subsequently aspiration pneumonia. Moreover, this increased incidence of aspiration may contribute to an increased mortality in patients following antipsychotic therapy. Risperidone, which has little influence on serum substance P productions, may be a more appropriate first-line drug of choice for treatment of schizophrenia.Keywords: schizophrenia, aspiration pneumonia, substance P, risperidone, haloperidol
format	article
author	Takahiko Nagamine
author_facet	Takahiko Nagamine
author_sort	Takahiko Nagamine
title	Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
title_short	Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
title_full	Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
title_fullStr	Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
title_full_unstemmed	Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
title_sort	serum substance p levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/e08d4e3121c74ea8a07d2a584b8e0b41
work_keys_str_mv	AT takahikonagamine serumsubstanceplevelsinpatientswithchronicschizophreniatreatedwithtypicaloratypicalantipsychotics
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Serum substance P levels in patients with chronic schizophrenia treated with typical or atypical antipsychotics

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