Blood-Based Lipidomics Approach to Evaluate Biomarkers Associated With Response to Olanzapine, Risperidone, and Quetiapine Treatment in Schizophrenia Patients.

Adriano Aquino,Michael Murgu,Daniel Martins-De-Souza,Alexandre F Gomes,Fabio Augusto,Paul C Guest,Guilherme L Alexandrino,Johann Steiner

doi:10.3389/fpsyt.2018.00209

Abstract

This is the first study to identify lipidomic markers in plasma associated with response of acutely ill schizophrenia patients in response to specific antipsychotic treatments. The study population included 54 schizophrenia patients treated with antipsychotics for 6 weeks. Treatment led to significant improvement in positive and negative symptoms for 34 patients with little or no improvement for 20 patients. In addition, 37 patients showed an increase in body mass index after the 6 week treatment period, consistent with effects on metabolism and the association of such effects with symptom improvement. Profiling of plasma samples taken prior to therapy using liquid chromatography tandem mass spectrometry (LC-MS/MS) resulted in identification of 38, 10, and 52 compounds associated with the olanzapine, risperidone, and quetiapine treatment groups, which could be used to distinguish responders from non-responders. Limitations include the retroactive active nature of the study and the small sample size. Further investigations with larger sample sets could lead to the development of a molecular test that could be used to help psychiatrists determine the best treatment options for each patient.

Highlights

Disease management of acute schizophrenia is achieved by administration of antipyschotics
We reported on the analysis of plasma samples from a cohort of 58 schizophrenia patients using shotgun mass spectrometry proteomic profiling [15]
Our objective was to identify proteins and protein pathways involved with an effective response to atypical antipsychotics, as with the above studies, no attempt was made to identify treatment-specific signatures

Summary

Introduction

Disease management of acute schizophrenia is achieved by administration of antipyschotics. ∼40% of patients do not respond adequately to these medications and around 60% end up abandoning treatment due to intolerable side effects [1]. The moodrelated and cognitive functions of the patients may not improve, making these individuals less capable of functioning adequately in society. The side effects of second-generation (atypical) antipsychotics like olanzapine, risperidone, and quetiapine include metabolic-related responses such as hyperglycaemia, insulin resistance, and weight gain [2]. Some researchers have suggested that weight gain and other metabolic effects may be linked to the improvement of symptoms [3]. These side effects are most likely related to the high affinity of these compounds

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