Denis O'Brien, Anne Marie Healy, Andrew Harkin, Cathal Cadogan
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引用次数: 0
Abstract
Aims: To identify, evaluate and summarize all published literature that investigated manipulations to pharmaceutical dosage forms of psychotropic medications that could be used for the purposes of tapering.
Methods: A systematic literature review was carried out of the available published literature on manipulations performed to psychotropic medications to obtain a decreased dose of the active pharmaceutical ingredient. All studies that involved the manipulation of pharmaceutical dosage forms of antidepressants or benzodiazepine receptor agonists and subsequent pharmaceutical analysis of active pharmaceutical ingredient content were eligible for inclusion. The electronic databases searched were: MEDLINE, Web of Science, EMBASE, PsycINFO and CINAHL.
Results: Sixteen studies met inclusion criteria. The manipulation methods carried out in the identified studies involved tablet splitting (4 studies), formulation of liquid suspensions (8 studies) and diluting existing marketed liquid formulations (4 studies). Ten of the included studies reported a mean target dose recovery within the 95-105% range after the manipulation was performed. All studies in which a dilution was performed to an oral liquid formulation (n = 4) reported results within this percentage recovery range. None of the included studies investigated the accuracy of manipulations across the full dose range of a tapering schedule.
Conclusion: This review identified a limited amount of published research on the accuracy of different methods of manipulating psychotropic medications. Diluting liquid formulations to achieve lower doses merits further investigation. Further research comparing different manipulation methods is also required to determine the best approach for tapering to lower doses.
目的:识别、评估和总结所有已发表的研究可用于减量目的的精神药物药物剂型操纵的文献。方法:对已发表的对精神药物进行操作以获得减少剂量的有效药物成分的文献进行系统的回顾。所有涉及操纵抗抑郁药或苯二氮卓受体激动剂的药物剂型以及随后对活性药物成分含量的药物分析的研究均符合纳入条件。检索的电子数据库有:MEDLINE、Web of Science、EMBASE、PsycINFO和CINAHL。结果:16项研究符合纳入标准。在确定的研究中进行的操作方法包括片剂拆分(4项研究)、液体悬浮液配方(8项研究)和稀释现有上市液体配方(4项研究)。纳入的研究中有10项报告了操作后平均靶剂量恢复在95-105%范围内。所有对口服液制剂进行稀释的研究(n = 4)报告的结果都在该百分比回收率范围内。没有一项纳入的研究调查了在一个逐渐减少的时间表的整个剂量范围内操作的准确性。结论:本综述确定了有限数量的已发表的关于操纵精神药物的不同方法的准确性的研究。稀释液体配方以达到较低剂量值得进一步研究。还需要进一步研究比较不同的操作方法,以确定逐渐减少剂量的最佳方法。
期刊介绍:
Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.