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A Compilation of Serum Concentrations of 12 Antipsychotic Drugs in a Therapeutic Drug Monitoring Setting
Natl Board Forens Med, Dept Forens Chem and Genet, Linkoping, Sweden.
St Olavs Univ Hosp, Norway; Norwegian Univ Sci and Technol, Norway.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Sickle Univ Hosp, Sweden.ORCID iD: 0000-0002-6041-0744
2019 (English)In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 41, no 3, p. 348-356Article in journal (Refereed) Published
Abstract [en]

Background: No comprehensive collection of routine therapeutic drug monitoring data for antipsychotic drugs has been published. Methods: In this compilation, data on 12 antipsychotics are presented. The drugs included are amisulpride (n = 506), aripiprazole (n = 1610), clozapine (n = 1189), flupentixol (n = 215), haloperidol (n = 390), olanzapine (n = 10,268), perphenazine (n = 1065), quetiapine (n = 5853), risperidone (n = 3255), sertindole (n = 111), ziprasidone (n = 1235), and zuclopenthixol (n = 691). Because only one sample per patient is included, the number of patients equals the number of samples. For each drug, median serum concentrations as well as that of the 10th and 90th percentiles are given for a range of daily doses. Comparisons are made between males and females, between patients younger than 65 years and 65 years and older, and between those treated with a low and a high dose of each drug. The concentration-to-dose (C/D) ratio is the primary variable used in these comparisons. Coefficients of variation (CVs) for the serum concentrations of each drug within and between subjects are presented. Results: In general, the C/D ratios were higher in females than in males, higher in those 65 years and older than in younger subjects, and lower in those treated with higher doses than in those treated with lower doses. CVs between individuals were larger than within subjects, and the CVs were highest for the drugs with short elimination half-lives. Conclusions: For each antipsychotic drug, the results presented can serve as a reference tool for pharmacokinetic interpretation of the individual patients serum drug level. The compiled serum concentrations and the C/D ratios can support the physicians decision when individualizing dosing and determining treatment strategies for a specific patient.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2019. Vol. 41, no 3, p. 348-356
Keywords [en]
antipsychotic drugs; TDM; age; sex; dose
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:liu:diva-160066DOI: 10.1097/FTD.0000000000000585ISI: 000480710500008PubMedID: 31025986OAI: oai:DiVA.org:liu-160066DiVA, id: diva2:1348159
Available from: 2019-09-03 Created: 2019-09-03 Last updated: 2019-09-03

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