, Volume 24, Issue 1, pp 65-84
Date: 29 Aug 2012


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Oral blonanserin (Lonasen®) is an atypical antipsychotic agent indicated for use in patients with schizophrenia in Japan and Korea. It is effective in the treatment of patients with schizophrenia, providing short- and long-term efficacy against both the positive and negative symptoms of the disorder in several randomized and noncomparative trials. Notably, in two randomized, double-blind trials of 8 weeks’ duration, blonanserin was noninferior to haloperidol or risperidone for primary endpoints, although it appeared to be better than haloperidol in improving negative symptoms. Blonanserin is generally well tolerated and appears to have an acceptable profile in terms of bodyweight gain. Potential tolerability benefits of the drug in short-term trials included fewer extrapyramidal symptoms than haloperidol and fewer reports of prolactin level increases or hyperprolactinaemia than risperidone. Nevertheless, extrapyramidal symptoms and hyperprolactinaemia were among the most common adverse reactions associated with blonanserin in noncomparative long-term studies. Further prospective and long-term comparative studies are required in order to definitively position blonanserin with respect to other antipsychotic agents. In the meantime, available clinical data suggest that blonanserin is an effective and generally well tolerated option for the short-term treatment of schizophrenia and for those requiring longer-term therapy.

Various sections of the manuscript reviewed by: H. Kaiya, Clinical Research Association for Anxiety and Depression, Akasaka Clinic, Tokyo, Japan; T. Suzuki, Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; N. Watanabe, Department of Psychiatry and Cognitive-Behavioural Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

Data Selection

Sources: Medical literature published in any language since 1980 on ‘blonanserin’, identified using MEDLINE and EMBASE, supplemented by AdisBase (a proprietary database). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company developing the drug.
Search strategy: MEDLINE, EMBASE and AdisBase search terms were ‘blonanserin’ and ‘schizophrenia’. Searches were last updated 18 November 2009.
Selection: Studies in patients with schizophrenia who received blonanserin. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic and pharmacokinetic data are also included.
Index terms: Blonanserin, schizophrenia, pharmacodynamics, pharmacokinetics, therapeutic use, tolerability. Contents