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Therapeutic Drug Monitoring of Cariprazine - Updated Values for a Dose-Related Reference Range
Fabian Sattaf1, Maike Scherf-Clavel2, Stefan Unterecker2
1Department of Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt, Germany.
Therapeutic drug monitoring for cariprazine showed serum concentrations frequently deviated from established dose-related reference ranges. Real-world data suggests current cariprazine reference ranges are too high and require adjustment for accurate patient care.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Psychiatric Pharmacotherapy
Background:
- Therapeutic drug monitoring (TDM) utilizes dose-related reference ranges to optimize pharmacotherapy.
- Cariprazine, a newer antipsychotic, has limited established dose-related reference ranges.
- Observed deviations in patient cariprazine serum concentrations necessitate validation of existing reference ranges.
Purpose of the Study:
- To retrospectively analyze real-world cariprazine serum concentrations.
- To compare measured concentrations against existing dose-related reference ranges.
- To determine the validity of current cariprazine dose-related reference ranges.
Main Methods:
- Retrospective analysis of serum concentrations from 24 patients on daily cariprazine.
- Inclusion of patients without pharmacokinetic abnormalities.
- Comparison of measured serum concentrations with 2017 Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie consensus guidelines.
Main Results:
- Only 45.8% of measured cariprazine serum concentrations fell within the current dose-related reference range.
- Calculated an updated dose-related reference range of 0.85–2.31 (mean 1.58±0.73).
- The derived range is lower than currently recommended values, indicating potential overestimation.
Conclusions:
- Current dose-related reference range values for cariprazine appear to be too high.
- The established reference range requires adjustment based on real-world data.
- An updated range of 0.85–2.31 is proposed for cariprazine therapeutic drug monitoring.
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