在精神分裂症治疗中,个人从口服转换为长效注射第二代抗精神病药物,使用药理动力学考虑
Georgios Schoretsanitis1,2,3, Jonathan M Meyer4, Andreas Conca5
1Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
Expert opinion on drug metabolism & toxicology
|June 1, 2023
概括
个性化长效注射 (LAI) 抗精神病治疗需要了解药理动力学. 在口服治疗期间测量患者的抗精神病药物水平有助于优化切换到LAI配方,改善坚持并降低复发风险.
科学领域:
- 心理药理学 心理药理学
- 临床药房 临床药房
- 精神分裂症治疗 治疗精神分裂症
背景情况:
- 长效注射 (LAI) 第二代抗精神病药物 (SGA) 对于精神分裂症治疗至关重要,增强坚持并减少复发.
- 患者从口服SGA过渡到LAI,由于个体的药理动力学差异,因此存在挑战.
研究的目的:
- 概述药物动力学考虑因素,以便无地从口服SGA过渡到LAI配方.
- 强调基于个体患者药物暴露的个性化剂量策略.
主要方法:
- 对PubMed和Embase数据库的文献评论 (2023年2月).
- 对药理动力学数据的分析,以指导LAI剂量选择和在过渡期间进行口服剂量调整.
主要成果:
- 在口服治疗期间,个体患者的SGA水平对LAI剂量选择比人口数据更有信息.
- 在注射LAI之前监测SGA水平可以指导在过渡期内对口服剂量进行调整.
结论:
- 了解LAI的药理动力学和测量SGA水平,可以个性化优化从口服到LAI治疗的转换.
- 这种方法可以改善精神分裂症谱系障碍和潜在的其他严重精神疾病的治疗结果.
相关概念视频
Psychosis: Goals of Pharmacotherapy
172
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
172
Drug Therapy
74
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
74
Psychosis and Antipsychotic Drugs: Overview
354
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
354
Insulin Formulations: Types and Delivery
239
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
239
Antipsychotic Drugs: Typical and Atypical Agents
267
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
267
Nonlinear Pharmacokinetics: Overview
461
Nonlinear or dose-dependent pharmacokinetics is a phenomenon that occurs when the pharmacokinetic parameters of certain drugs deviate from linear pharmacokinetics at higher doses. These drugs do not follow the expected first-order kinetics, where the rate of drug elimination is directly proportional to the drug concentration. Instead, they exhibit a nonlinear relationship, which can be attributed to several factors.
Nonlinearity can arise due to the saturation of plasma protein-binding or...
Nonlinearity can arise due to the saturation of plasma protein-binding or...
461


