Plasma Concentration of Risperidone: Correlation with Clinical Response in Patients with Schizophrenia

A. Hamed, E. Hamdi, A. Hussein, W. T. Soliman, M. M. Mahmoud
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Abstract

Background: Determination of plasma concentration of antipsychotic drug may provide a valuable tool in dose adjustment and therapeutic efficacy but studies in this area are limited and controversial. Purpose: To assess the relation between plasma concentration of Risperidone and its active metabolite (Paliperidone) and clinical response in Egyptian patients with schizophrenia. Patients and methods: One hundred inpatients diagnosed with schizophrenia were enrolled in the study. Fifty inpatients (33 males, 17 females, with age between 20- 60) completed the study. Risperidone was given in two fixed dose: 6 mg daily (Group I) and 8 mg daily (Group II) for three months. Positive and Negative Syndrome Scales (PANSS) were used for determination of psychopathological state and High- performance liquid chromatography (HPLC) was used for measurement of plasma concentration. These assessments were performed at 1 and 3 months. Results: A highly significant decrease was found in PANSS subscales and total score at 1 and 3 months (P 0.05). Conclusion: Measuring plasma concentration of Risperidone is not useful to enhance efficacy of treatment at 1 or 3 months. More research is required for assessment of other factors affecting the efficacy of Risperidone e.g., receptor occupancy and pharmacogenetics.
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精神分裂症患者血浆利培酮浓度与临床反应的相关性
背景:测定抗精神病药物的血药浓度可能为剂量调整和治疗效果提供有价值的工具,但这方面的研究有限且存在争议。目的:探讨埃及精神分裂症患者利培酮及其活性代谢物(帕利培酮)血药浓度与临床疗效的关系。患者和方法:100名被诊断为精神分裂症的住院患者被纳入研究。50例住院患者(男性33例,女性17例,年龄在20- 60岁之间)完成了研究。利培酮分为两种固定剂量:每日6mg(第一组)和每日8mg(第二组),连续3个月。采用阳性和阴性症状量表(PANSS)测定精神病理状态,采用高效液相色谱法(HPLC)测定血浆浓度。这些评估分别在1个月和3个月时进行。结果:两组患者在第1个月和第3个月的PANSS量表和总分均显著降低(P < 0.05)。结论:利培酮1、3个月血药浓度测定对提高治疗效果无明显作用。需要更多的研究来评估影响利培酮疗效的其他因素,如受体占用和药物遗传学。
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