Future of depot neuroleptic therapy: pharmacokinetic and pharmacodynamic approaches

The future of depot neuroleptic therapy is discussed in terms of pharmacokinetic and pharmacodynamic research opportunities. Analytic methods for neuroleptic assays, including chromatographic, radioreceptor, nuclear magnetic resonance, and radioimmunoassay techniques, are briefly reviewed. Elucidation of depot neuroleptic multicompartment kinetics utilizing nonlinear mixed-effects modeling and the usefulness of these data in interpreting plasma levels are discussed. The clinical significance of plasma monitoring of depot fluphenazine, including the development of dosage conversion guidelines, is presented. The relationships between haloperidol and its metabolite reduced haloperidol (RH) are discussed in terms of dosage form and response. Clinical advantages resulting from the availability of more depot neuroleptics are discussed.