Correlation Between Serum Amisulpride Concentration, Therapeutic Efficacy, and Glycolipid Metabolism in the Treatment of Adult Female Schizophrenia

Abstract

Background: Amisulpride is a novel atypical antipsychotic (AAP) with slower absorption, metabolism, and excretion in females, potentially leading to elevated plasma concentrations. This study aimed to explore the correlation between serum amisulpride levels and therapeutic efficacy, glycolipid metabolism and side effects in adult female patients with schizophrenia (SCH).

Methods: A retrospective study was conducted involving 122 adult female SCH patients admitted to the Third People's Hospital of Yongkang between January 2020 and January 2022. Fasting venous blood samples were collected at baseline and 1, 2, 4 and 8 weeks post-treatment with amisulpride. Key parameters measured included serum amisulpride concentration, Brief Psychiatric Rating Scale (BPRS) scores, fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and side effect scores.

Results: Serum amisulpride levels significantly increased at 2, 4, and 8 weeks compared to the first week (p < 0.05), while BPRS scores significantly decreased at all time points compared to those before treatment (p < 0.05). A strong negative correlation was observed between amisulpride concentration and BPRS scores (r = –0.948, p < 0.001). Significant alterations in fasting blood glucose, TC, TG, HDL, and LDL levels were observed post-treatment (p < 0.05). Serum amisulpride concentration negatively correlated with fasting blood glucose, TC, and LDL (r = –0.622, –0.160, –0.796, respectively, p < 0.001) and positively correlated with TG (r = 0.447, p < 0.001). Side effects scores increased significantly after 2, 4, and 8 weeks compared to the first week (p < 0.05), with amisulpride concentration positively correlating with side effects scores (r = 0.739, p < 0.001).

Conclusion: Serum amisulpride levels in female SCH patients are closely correlated with therapeutic efficacy, glycolipid metabolism and incidence of side effects, respectively. Monitoring serum concentrations may provide valuable insights for guiding personalized medication management and optimize treatment outcomes.