Comorbidities and the right dose: antipsychotics.

IF 3.4 3区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Expert Opinion on Drug Metabolism & Toxicology Pub Date : 2022-07-01 Epub Date: 2022-08-22 DOI:10.1080/17425255.2022.2113378

Nicolas Simon, Romain Torrents, Jean-Michel Azorin

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引用次数: 2

Abstract

Introduction: The effects of antipsychotic drugs are dose-dependent, which is particularly true for their efficacy, each antipsychotic having a specific dose-response curve. This may justify individualizing doses for these agents.

Areas covered: We review the pharmacokinetic profiles of seven oral antipsychotics: haloperidol, risperidone, olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole. Their main indications are psychotic and affective disorders. They are prescribed in a very large population which may have comorbidities. Hence, we analyze the impact of the latter on the pharmacokinetic profiles of these antipsychotics, focusing on renal and hepatic impairment. Reviews and clinical trials were discussed based on a systematic literature search (PubMed) ranging from 1995 to 2022.

Expert opinion: Factors liable to impact antipsychotic dosage are numerous and their subsequent effects often hard to predict, due to multilevel interactions and compensatory phenomena. In clinical practice, physicians must be aware of these potential effects, but base their decisions on monitoring antipsychotic plasma levels.

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合并症和正确剂量:抗精神病药物。

抗精神病药物的作用是剂量依赖性的，特别是它们的疗效，每种抗精神病药物都有一个特定的剂量-反应曲线。这可能证明这些药物的个体化剂量是合理的。涵盖领域:我们回顾了七种口服抗精神病药物的药代动力学特征:氟哌啶醇、利培酮、奥氮平、氯氮平、喹硫平、齐拉西酮和阿立哌唑。他们的主要症状是精神和情感障碍。它们是在一个非常大的可能有合并症的人群中开的。因此，我们分析后者对这些抗精神病药物的药代动力学特征的影响，重点是肾脏和肝脏损害。根据1995年至2022年的系统文献检索(PubMed)对综述和临床试验进行了讨论。专家意见:可能影响抗精神病药物剂量的因素很多，由于多层次的相互作用和代偿现象，它们的后续影响往往难以预测。在临床实践中，医生必须意识到这些潜在的影响，但他们的决定是基于监测抗精神病药物的血浆水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Drug Metabolism & Toxicology 医学-生化与分子生物学

CiteScore

7.90

自引率

2.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Opinion on Drug Metabolism & Toxicology (ISSN 1742-5255 [print], 1744-7607 [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of ADME-Tox. Each article is structured to incorporate the author’s own expert opinion on the scope for future development. The Editors welcome: Reviews covering metabolic, pharmacokinetic and toxicological issues relating to specific drugs, drug-drug interactions, drug classes or their use in specific populations; issues relating to enzymes involved in the metabolism, disposition and excretion of drugs; techniques involved in the study of drug metabolism and toxicology; novel technologies for obtaining ADME-Tox data. Drug Evaluations reviewing the clinical, toxicological and pharmacokinetic data on a particular drug. The audience consists of scientists and managers in the pharmaceutical industry, pharmacologists, clinical toxicologists and related professionals.