Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis

Martin Hýža,1,2 Petr &Scaron;ilhán,1,2 Eva Če&scaron;ková,1,2 Tomá&scaron; Skřont,1 Ivana Kacířová,3,4 Romana Uřinovská,3 Milan Grundmann4 1Department of Psychiatry, University Hospital Ostrava, Ostrava, Czech R...

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Autores principales:	Hýža M, Šilhán P, Češková E, Skřont T, Kacířová I, Uřinovská R, Grundmann M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	therapeutic drug monitoring antipsychotics psychotic disorders schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/0a94387aecc344cfb5efa8be06bfe03b
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spelling	oai:doaj.org-article:0a94387aecc344cfb5efa8be06bfe03b2021-12-02T14:39:09ZPlasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis1178-2021https://doaj.org/article/0a94387aecc344cfb5efa8be06bfe03b2021-04-01T00:00:00Zhttps://www.dovepress.com/plasma-levels-of-long-acting-injectable-antipsychotics-in-outpatient-c-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Martin Hýža,1,2 Petr &Scaron;ilhán,1,2 Eva Če&scaron;ková,1,2 Tomá&scaron; Skřont,1 Ivana Kacířová,3,4 Romana Uřinovská,3 Milan Grundmann4 1Department of Psychiatry, University Hospital Ostrava, Ostrava, Czech Republic; 2Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; 3Department of Clinical Pharmacology, Institute of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic; 4Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Ostrava, Czech RepublicCorrespondence: Petr &Scaron;ilhánDepartment of Psychiatry, University Hospital Ostrava, 17. Listopadu 1790, Ostrava, 708 52, Czech RepublicTel +420 59 737 3145Fax +420 59 737 3314Email petr.silhan@fno.czPurpose: Antipsychotic efficacy in schizophrenia depends on its availability in the body. Although therapeutic outcomes remain still far from satisfactory, therapeutic drug monitoring is not a common part of clinical practice during treatment with long-acting injectable antipsychotics (LAI AP). The real effectiveness of LAI AP is thus uncertain.Patients and Methods: We made a retrospective evaluation of plasma levels of LAI AP. Collection of blood samples was performed just before the drug application and one week later. Forty patients with a stabilized clinical condition and steady-state plasma levels were included.Results: In the observed cohort of patients, flupentixol decanoate (n = 23) was the most often used drug, followed by fluphenazine decanoate (n = 7), haloperidol decanoate (n = 5), paliperidone palmitate (n = 3), and risperidone microspheres (n = 2). Just 5 of 40 patients were treated with a monotherapy. In the period before the application, 60% of the patients did not reach the therapeutic reference range (TRR) and 20% of the patients had an undetectable plasma level. At the time of collection of the second blood samples performed after 7 days, 24% of the patients were under the TRR.Conclusion: We have found a surprisingly high incidence of plasma levels under the TRR in patients treated with LAI AP. Notwithstanding individual variability in pharmacokinetics, it seems that LAI AP may be underdosed in usual clinical practice.Keywords: therapeutic drug monitoring, antipsychotics, psychotic disorders, schizophreniaHýža MŠilhán PČešková ESkřont TKacířová IUřinovská RGrundmann MDove Medical Pressarticletherapeutic drug monitoringantipsychoticspsychotic disordersschizophreniaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 1069-1075 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	therapeutic drug monitoring antipsychotics psychotic disorders schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	therapeutic drug monitoring antipsychotics psychotic disorders schizophrenia Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Hýža M Šilhán P Češková E Skřont T Kacířová I Uřinovská R Grundmann M Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
description	Martin Hýža,1,2 Petr &Scaron;ilhán,1,2 Eva Če&scaron;ková,1,2 Tomá&scaron; Skřont,1 Ivana Kacířová,3,4 Romana Uřinovská,3 Milan Grundmann4 1Department of Psychiatry, University Hospital Ostrava, Ostrava, Czech Republic; 2Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; 3Department of Clinical Pharmacology, Institute of Laboratory Diagnostics, University Hospital Ostrava, Ostrava, Czech Republic; 4Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Ostrava, Czech RepublicCorrespondence: Petr &Scaron;ilhánDepartment of Psychiatry, University Hospital Ostrava, 17. Listopadu 1790, Ostrava, 708 52, Czech RepublicTel +420 59 737 3145Fax +420 59 737 3314Email petr.silhan@fno.czPurpose: Antipsychotic efficacy in schizophrenia depends on its availability in the body. Although therapeutic outcomes remain still far from satisfactory, therapeutic drug monitoring is not a common part of clinical practice during treatment with long-acting injectable antipsychotics (LAI AP). The real effectiveness of LAI AP is thus uncertain.Patients and Methods: We made a retrospective evaluation of plasma levels of LAI AP. Collection of blood samples was performed just before the drug application and one week later. Forty patients with a stabilized clinical condition and steady-state plasma levels were included.Results: In the observed cohort of patients, flupentixol decanoate (n = 23) was the most often used drug, followed by fluphenazine decanoate (n = 7), haloperidol decanoate (n = 5), paliperidone palmitate (n = 3), and risperidone microspheres (n = 2). Just 5 of 40 patients were treated with a monotherapy. In the period before the application, 60% of the patients did not reach the therapeutic reference range (TRR) and 20% of the patients had an undetectable plasma level. At the time of collection of the second blood samples performed after 7 days, 24% of the patients were under the TRR.Conclusion: We have found a surprisingly high incidence of plasma levels under the TRR in patients treated with LAI AP. Notwithstanding individual variability in pharmacokinetics, it seems that LAI AP may be underdosed in usual clinical practice.Keywords: therapeutic drug monitoring, antipsychotics, psychotic disorders, schizophrenia
format	article
author	Hýža M Šilhán P Češková E Skřont T Kacířová I Uřinovská R Grundmann M
author_facet	Hýža M Šilhán P Češková E Skřont T Kacířová I Uřinovská R Grundmann M
author_sort	Hýža M
title	Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
title_short	Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
title_full	Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
title_fullStr	Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
title_full_unstemmed	Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis
title_sort	plasma levels of long-acting injectable antipsychotics in outpatient care: a retrospective analysis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/0a94387aecc344cfb5efa8be06bfe03b
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Plasma Levels of Long-Acting Injectable Antipsychotics in Outpatient Care: A Retrospective Analysis

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