Naturalistic treatment of positive symptoms in schizophrenia with amisulpride: Are there gender differences?

Gender differences regarding prescribed amisulpride dose, plasma level, clinical response (CGI), and side-effects (UKU) were investigated in a naturalistic study. The analyzed subsample (n=91, 57% male, age 20–66) consisted of schizophrenic patients with predominant positive symptoms treated with amisulpride monotherapy at daily doses ≥400mg.

Female patients were significantly older (39.7±11.5y) than male patients (33.5±11.7y; P=0.013). Prescribed amisulpride doses were comparable for men (721±266mg) and women (649±228mg). However, dose-corrected steady state amisulpride plasma levels (men 0.41±0.23ng/ml*mg; women 0.58±0.37ng/ml*mg; P=0.011) were significantly higher in female patients even after age-adjustment. No significant differences between men and women emerged with respect to clinical response (73.5% vs. 82.4%) and the occurrence of any side-effect (40.4% vs. 48.7%).

The explorative study unveiled no clinically relevant gender-specific aspects regarding prescribed dose, effectiveness, and side-effects. The finding of higher dose-related plasma amisulpride levels in women could not be attributed to age and needs further elucidation.

The presented results are part of the doctoral thesis of B.R.

The study was supported by Sanofi-Synthelabo GmbH, Berlin.