Therapeutic drug monitoring of atypical antipsychotics. 2017

Anna Emilia Urban, and Wiesław Jerzy Cubała
Klinika Psychiatrii Dorosłych Gdańskiego Uniwersytetu Medycznego.

The paper presents an overview and analysis of the results of research on therapeutic ranges of concentrations and receptor occupancy, mainly D2 receptors, in the treatment with some atypical antipsychotic drugs. Amisulpride, aripiprazole, clozapine, quetiapine, olanzapine, risperidone, paliperidone, sertindole, and ziprasidone were taken into account. The benefits of therapeutic drug monitoring to optimize the effectiveness of treatment and avoid side effects or toxicity were shown. The safety of patients, with the possibility to use the lowest effective dose, is an undoubted profit of TDM. This helps to avoid overdosing resulting in adverse events (with particular emphasis on extrapyramidal symptoms and seizures).The need and desirability of TDM is due to the inter -and intraindividual differences in the pharmacokinetics of drugs, because only some of them have a close correlation between dose and plasma concentration. The plasma concentration correlates well with the occupancy of D2 receptors. The efficient and safe level is determined at 60-80%. Based on the knowledge of the indications for TDM and therapeutic concentration ranges, amisulpride, clozapine and olanzapine have the highest level of recommendation to use TDM. Therapeutic ranges of plasma concentrations of the analyzed drugs were determined to be 200-320 ng/ml for amisulpride, 150-210 ng/ml for aripiprazole, over 350-500 ng/ml for clozapine, 50-500 ng/ml for quetiapine, 20-40 ng/ml for olanzapine, 20-60 ng/ml for risperidone and paliperidone, 50-100 ng/ml for sertindole and 50-130 ng/ml for ziprasidone.

UI MeSH Term Description Entries
D008297 Male Males
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012559 Schizophrenia A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior. Dementia Praecox,Schizophrenic Disorders,Disorder, Schizophrenic,Disorders, Schizophrenic,Schizophrenias,Schizophrenic Disorder
D014150 Antipsychotic Agents Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. Antipsychotic,Antipsychotic Agent,Antipsychotic Drug,Antipsychotic Medication,Major Tranquilizer,Neuroleptic,Neuroleptic Agent,Neuroleptic Drug,Neuroleptics,Tranquilizing Agents, Major,Antipsychotic Drugs,Antipsychotic Effect,Antipsychotic Effects,Antipsychotics,Major Tranquilizers,Neuroleptic Agents,Neuroleptic Drugs,Tranquillizing Agents, Major,Agent, Antipsychotic,Agent, Neuroleptic,Drug, Antipsychotic,Drug, Neuroleptic,Effect, Antipsychotic,Major Tranquilizing Agents,Major Tranquillizing Agents,Medication, Antipsychotic,Tranquilizer, Major
D016903 Drug Monitoring The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. Monitoring, Drug,Therapeutic Drug Monitoring,Drug Monitoring, Therapeutic,Monitoring, Therapeutic Drug
D065127 Dopamine D2 Receptor Antagonists Compounds and drugs that bind to and inhibit or block the activation of DOPAMINE D2 RECEPTORS. Dopamine D2 Antagonist,Dopamine D2 Receptor Antagonist,Dopamine D2 Antagonists,Receptor Antagonists, Dopamine D2,Antagonist, Dopamine D2,Antagonists, Dopamine D2,D2 Antagonist, Dopamine,D2 Antagonists, Dopamine

Related Publications

Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2024, Prague medical report,
Anna Emilia Urban, and Wiesław Jerzy Cubała
February 2004, Current medicinal chemistry,
Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2015, Current drug metabolism,
Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2001, Psychopharmacology bulletin,
Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2002, Pharmazie in unserer Zeit,
Anna Emilia Urban, and Wiesław Jerzy Cubała
December 2012, Therapeutic drug monitoring,
Anna Emilia Urban, and Wiesław Jerzy Cubała
May 2003, Medizinische Monatsschrift fur Pharmazeuten,
Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2020, Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata,
Anna Emilia Urban, and Wiesław Jerzy Cubała
January 2024, International clinical psychopharmacology,
Copied contents to your clipboard!