Title | Pharmacokinetics of antipsychotics | |
Authors | Dejana T. Ruzic1, Vassiliki Mirtsou-Fidani2 and Slobodan M. Jankovic3
1. Department of Pharmacology, Medical Faculty, Kragujevac, Serbia, FR Yugoslavia 2. Department of Pharmacology, Medical Faculty, Aristotle University of Thessaloniki, Greece 3. Center for Clinical and Experimental Pharmacology, Clinical Hospital Center, Kragujevac, Serbia, FR Yugoslavia |
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Citation | Ruzic, D.T., Mirtsou-Fidani, V., Jankovic, S.M.: Pharmacokinetics of antipsychotics, Epitheorese Klin. Farmakol. Farmakokinet. 12(3): 9-14 (1998) | |
Publication Date | Received for publication: 1 October 1997
Accepted for publication: 5 October 1997 |
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Full Text Language | English | |
Order – Buy | pharmakonpress[at]pharmakonpress[.]gr | |
Keywords | Neuroleptics, pharmacokinetics, dose regimen, individualization. | |
Other Terms | review article | |
Summary | The antipsychotics comprise chemically diverse group of heterocyclic compounds, which are effective in relieving positive schizophrenic symptoms and psychotic symptoms in other neuropsychiatric diseases. They are well absorbed from the gastrointestinal tract and undergo substantial pre-systemic elimination (bioavailability: 10-80%). Most of the antipsychotics are highly lipophilic and highly bound to plasma proteins (90-99%). They tend to have large volumes of distribution (usually >7 l/kg). The main route of elimination for most antipsychotics is hepatic metabolism; biotransformation produces mostly biologically inactive metabolites. However, a few oxidized metabolites are active and may contribute to biological activity of the parent drug. There are wide interindividual variabilities in pharmacokinetics, which result in large differences considering steady-state plasma concentrations on the same dose regimen. The influence of age, sex, smoking behavior, renal and liver functional impairment, combined with problems of noncompliance and drug interactions may change clinical response and produce serious adverse effects. Therefore, we suggest individualization of dosage regimen for every particular patient. | |
References | 1. Verghese C., Kessel J.B., Simpson G.M.: Pharmacokinetics of neuroleptics. Psychopharmacol. Bull. 27: 551-563 (1991)
2. Reynolds J.E.F., ed.: MARTINDALE The Extra Pharmacopoeia. 30th ed. London: The Pharmaceutical Press, pp. 573-581 (1993) 3. Van Putten T., Marder S.R., Wirshing W.C., Aravagiri M., Chabert N.: Neuroleptic plasma levels. Schizophr. Bull. 17: 197-216 (1991) 4. Javaid J.I.: Clinical pharmacokinetics of antipsychotics. J. Clin. Pharmacol. 34: 286-295 (1994) 5. Koytchev R., Aiken R.G., Kirkov V., Neshev G.: Absolute bioavailability of chlorpromazine, promazine and promethazine. Arzneimitlelforschung 44: 121-125 (1994) 6. Chang W.H., Lam Y.W., Jann M.W., Chen N.: Pharmacokinetics of haloperidol and reduced haloperidol in Chinese schizophrenic patients after intravenous and oral administration of haloperidol. Psychopharmacology Bert. 106: 517-522 (1992) 7. Seiler W.f Wetzel N., Hillert A., Schollnhammer G., Langer M., Barlage U., Hiemke C.: Pharmacokinetics and bioavailability of benperidol in schizophrenic patients after intravenous and two different kinds of oral application. Psychopharmacology Bert. 116: 457-463 (1994) 8. Hardman J.G., Limbird L.E., Molinof P.B., Rudon R.W., Gilman A.G. (eds): GOODMAN AND GILMAN’S THE PHARMACOLOGICAL BASIS OF THERAPEUTICS. 9th ed., McGrow Hill, New York, St. Louis, 1996 9. He N., Richardson J.S.: A pharmacological, pharmacokinetic and clinical overview of risperidone, a new antipsychotic that blocks serotonin 5-HT2 and dopamine D2 receptors. Int. Clin. Psychopharmacol. 10.19-30 (1995) 10. Mannens G., Meuldermans W., Snoeck E.. Heykants J.: Plasma protein binding of risperidone and its distribution in blood. Psychopharmacology Bert. 114: 566-572 (1994) 11. Curry S.H.: Chlorpromazine: Pharmacokinetics, plasma levels and clinical response. In: (Burrows G.D., Norman T.R., eds) Psychotropic Drugs: Plasma Concentration and Clinical Response. Pp. 243-286, M. Dekker, New York, 1981 12. Pons G., Rey E., Matheson I.: Excretion of psychoactive drugs into breast milk. Pharmacokinetic principles and recommendations. Clin. Pharmacokinet. 27: 270-289 (1994) 13. Marder S.R., Midha K.K., Van-Putten T., Aravagiri M., Hawes E.M., Hubbard J.W., McKay G., Mintz J.: Plasma levels of fluphenazine in, patients receiving fluphenazine decanoate. Relationship to clinical response. Br. J. Psychiatry 16a: 422-423 (1991) 14. Froemming J.S., Lam Y.W.F., Jann M.W., Davis C.M.: Pharmacokinetics of haloperidol. Clin. Pharmacokinet. 17: 396-423 (1989) 15. Jann M.W., Grimsley S.R., Gray E.C., Chang W.H: Pharmacokinetics and pharmacodynamics of clozapine, Clin. Pharmacokinet. 24: 161-176 (1993) 16. DeVane C.L.: Brief comparison of the pharmacokinetics and pharmacodynamics of the traditional and newer antipsychotic drugs. Am. J. Health Syst. Pharm. 52(Suppl 1): 15-18 (1995) 17. Kuoppamaki M., Syvalahti E., Hietala J.: Clozapine and N-desmethylclozapine are potent 5-HT1c receptor antagonists. Eur. J. Pharmacol. 245: 179-182 (1993) 18. Meltzer N.: The mechanism of action of novel atypical antipsychotic drugs. Schizophr. Bull.17: 262-287 (1991) 19. Lam Y.W., Chang W.H., Jann M.W., Chen N.: Interindividual variabilities in haloperidol interconversion and the reduced haloperidol/haloperidol ratio. Neuropsychopharmacology 7: 33-39 (1992)
20. Llerena A., Dahl M.L., Ekqvist B., Bertilsson L.: Genetic factors in the metabolism of haloperidol. Clin. Neuropharmacol. 15 (Suppl 1): 84A-85A (1992) 21. Yeung P.K., Hubbard J.W., Korchinski E.D., Midha K.K.: Pharmacokinetics of chlorpromazine and key metabolites. Eur. J. Clin. Pharmacol. 45: 563-569 (1993) 22. Perry P.J., Miller D.D., Arndt S.V., Smith D.A., Holman T.L.: Haloperidol dosing requirements: the contribution of smoking and nonlinear pharmacokinetics. J. Clin. Psychopharmacol. 13: 46-51 (1993) 23. Bond W.S.: Ethnicity and psychotropic drugs. Clin. Pharm. 10: 467-470 (1991) 24. Potkin S.G., Shen Y., Pardes N.: Haloperidol concentrations elevated in Chinese patients. Psychiatr. Res. 12: 167- 172 (1984) 25. Bres J., Bressolle F.: Pharmacokinetics of sulpiride in humans after intravenous and intramuscular administrations. J. Pharm. Sci. 801119-1124 (1991) 26. Chetty M., Miller R., Moodley S.V.: Smoking and body weight influence the clearance of chlorpromazine. Eur. J. Clin. Pharmacol. 46: 523-526 (1994) 27. Ereshefsky L., Saklad S.R., Waianabe M.D., Davis C.M., Jann M.W.: Thiothixene pharmacokinetic interactions: a study of hepatic enzyme inducers, clearance inhibitors, and demographic variables. J. Clin. Psychopharmacol. 11: 296-301 (1991) 28. Snoeck E., Van Peer A., Sack M., Horton M., Mannens G., Woestenborghs R., Meibach R., Heykants J.: Influence of age, renal and liver impairment on the pharmacokinetics of risperidone in man. Psychopharmacology Bed. 122: 223- 229 (1995) 29. Baldessarini R.J., Cohen B.M., Teicher N.N.: Significance of neuroleptic dose and plasma level in pharmacological treatment of psychosis. Arch. Gen. Psychiatry 45: 79-91 (1988) 30. Javaid J.I., Janicak P.G., Holland D.: Blood level monitoring of antipsychotic and antidepressants. In: (Janicak P.G., Davis J.M., eds) Psychiatric Medicine. Orlando, FL; Ryandic Publishing 9:163-187 (1991) 31. Markowitz, J.S., Wells B.G., Carson W.H.: Interactions between antipsychotic and antihypertensive drugs. Ann. Pharmacother. 29: 603-609 (1995) |
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