Effect of Blonanserin on Neurotrophic Factors in Patients With Non‐Responsive First‐Episode Schizophrenia Treated With Early Risperidone Monotherapy—A Randomized Controlled Trial

OBJECTIVE: To investigate the efficacy of Blonanserin in patients with schizophrenia who were refractory to Risperidone monotherapy and its effects on various neurotrophic factors. METHODS: A total of 120 patients with first-episode schizophrenia who were hospitalized in our hospital from January 2022 to December 2023 and did not respond to early Risperidone monotherapy were selected as the study participants. They were randomly divided into a control group and a research group, with 60 cases in each group. The control group was treated with Clozapine, and the research group was treated with Blonanserin for 3 months. The scores of the Positive and Negative Syndrome Scale (PANSS), the scores of the Generic Quality of Life Inventory (GQOLI-74), the serum brain-derived neurotrophic factor (BDNF), the serum S100β protein, the neuron-specific enolase (NSE), and the Neuregulin-1 (NRG1) levels of the two groups were compared, and the adverse drug reactions of patients were recorded. RESULTS: After 3 months of treatment, the PANSS scores of both groups decreased compared with those before treatment, and the PANSS scores of the research group were lower. The scores of physical function, social function, and psychological function of the two groups were higher than those before treatment, and the scores of the research group were higher than those of the control group. The differences were statistically significant (p < 0.05 for all). The serum BDNF and NRG1 levels of the two groups were higher than those before treatment, and those of the research group were higher than those of the control group. The S100β and NSE levels of the two groups were lower than those before treatment, and those of the research group were lower than those of the control group. The differences were statistically significant (p < 0.05 for all). No serious adverse reactions occurred in both groups. Most patients with adverse reactions could tolerate them or improved after symptomatic treatment. CONCLUSION: Blonanserin can effectively relieve the symptoms of schizophrenia and improve the quality of life of first-episode schizophrenia patients who have failed to respond to Risperidone monotherapy in the early stage. Due to the short follow-up time and small sample size of this study, further prospective multicenter studies should be carried out in the future to observe the long-term treatment effect and provide more favorable reference for clinical practice.