Clinical-immunological predictors of prognosis of the efficiency of antipsychotic therapy with amisulpride in schizophrenia

Introduction Detection of clinical-biological predictors of the efficiency of antipsychotic therapy in schizophrenic patients, correction and individualization of therapeutic indication of antipsychotics are relevant questions of modern psychiatry. Immune dysfunctions, disturbance of psychoneuroimmunological interaction, metabolic imbalance worsen clinical pattern of disease, contribute to formation of therapeutic resistance and side effects, and decrease efficiency of treatment of patients. Objective To detect clinical-immunological predictors of the efficiency of therapy of schizophrenic patients with amisulpride. Methods We examined 19 schizophrenic patients, aged 18–64 years, who received treatment with amisulpride (Solian). The psychometric scale PANSS was used for evaluation of dynamics of psychopathological symptoms. Therapy efficiency was evaluated using CGI scale. The immunological investigation included identification of phenotypes of surface receptors of immunocompetent cells, level of IgM, IgG, IgA, phagocytic activity of leucocytes. Research was carried out in two points: first–at admission, second–by week 6 of treatment. Predictors of efficiency were identified relying on the analysis of interquartile ranges of clinical-immunological parameters. Results Predictors of high efficiency of amisulpride therapy were identified: clinical–total score according to PANSS less than 70, sum of scores according to subscale of negative disorders is more than 31 and immunological–number of HLADR ± lymphocytes below 0.34 × 109/L, СD16 ± lymphocytes more than 0.18 × 109/L. Conclusion Complex of informative clinical-immunological criteria is proposed, which enables prognosis of the efficiency of psychopharmacotherapy for patients at admission. It enables optimizing the choice of differentiated therapeutic tactics and heightening the quality of specialized medical care for schizophrenic patients.