Circadian patterns of hallucinatory experiences in patients with schizophrenia: Potentials for chrono-pharmacology

Teruki Koizumi, Takefumi Suzuki, Nikhil Sasidharan Pillai, Robert Bies, Hiroyoshi Takeuchi, Kimio Yoshimura, Masaru Mimura, Hiroyuki Uchida

Research output: Contribution to journalArticle

Abstract

The objective of this study was to investigate possible circadian pattern of psychotic symptoms in patients with schizophrenia, which could be reflected on the dosing schedule/regimen, i.e. chrono-pharmacology. Patients with schizophrenia (ICD-10) who reported having auditory hallucination, receiving monotherapy with risperidone, olanzapine or paliperidone for at least two weeks were included. The subjects were provided a diary and asked to record the time and duration of auditory hallucinations during the eight time periods (i.e. 00:00–03:00, 03:00–06:00, 06:00–09:00, 09:00–12:00, 12:00–15:00, 15:00–18:00, 18:00–21:00, and 21:00–24:00). In the diary, times of medication doses and sleep were also recorded. Time and degree of peak and trough dopamine D2 receptor blockade with antipsychotics were estimated from 2 sparsely collected plasma drug concentrations. The prevalence and duration of auditory hallucinations were statistically examined among the eight time periods, respectively. Forty-nine patients participated in this study (mean ± SD age, 50.7 ± 14.8 years; 36 men (73.5%); 34 inpatients (69.4%)). Auditory hallucinations occurred most frequently and lasted for the longest duration in the period of 18:00–21:00 (75.5% (37/49) and 1.37 ± 1.67 h). This happened despite the fact that the difference in D2 receptor occupancy between the peak and trough was less than 2%, indicating a stable drug delivery. Since the dopamine D2 receptor blockade by antipsychotics was stable, the nocturnal circadian pattern found in this study may reflect intrinsic dopaminergic fluctuation or generally quieter environments at night. These circadian patterns may be considered to devise individualized treatment approach in the context of “chrono-pharmacology” for patients with schizophrenia.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Psychiatric Research
Volume117
DOIs
StatePublished - Oct 1 2019
Externally publishedYes

Fingerprint

Hallucinations
Schizophrenia
Pharmacology
Dopamine D2 Receptors
olanzapine
Antipsychotic Agents
Risperidone
International Classification of Diseases
Pharmaceutical Preparations
Inpatients
Appointments and Schedules
Sleep
Therapeutics

Keywords

  • Antipsychotic
  • Dopamine
  • Dopamine D receptor
  • Positron emission tomography
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Circadian patterns of hallucinatory experiences in patients with schizophrenia : Potentials for chrono-pharmacology. / Koizumi, Teruki; Suzuki, Takefumi; Pillai, Nikhil Sasidharan; Bies, Robert; Takeuchi, Hiroyoshi; Yoshimura, Kimio; Mimura, Masaru; Uchida, Hiroyuki.

In: Journal of Psychiatric Research, Vol. 117, 01.10.2019, p. 1-6.

Research output: Contribution to journalArticle

Koizumi, Teruki ; Suzuki, Takefumi ; Pillai, Nikhil Sasidharan ; Bies, Robert ; Takeuchi, Hiroyoshi ; Yoshimura, Kimio ; Mimura, Masaru ; Uchida, Hiroyuki. / Circadian patterns of hallucinatory experiences in patients with schizophrenia : Potentials for chrono-pharmacology. In: Journal of Psychiatric Research. 2019 ; Vol. 117. pp. 1-6.
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