The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-
- PDF / 667,941 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 55 Downloads / 161 Views
ORIGINAL INVESTIGATION
The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis J. A. Arnaiz 1,2 & C. Rodrigues-Silva 3 & G. Mezquida 2,4,5,6 & S. Amoretti 4,5,6 & M. J. Cuesta 7 & D. Fraguas 8 & A. Lobo 5,9 & A. González-Pinto 5,10 & M. C. Díaz-Caneja 11 & I. Corripio 5,12 & E. Vieta 13 & I. Baeza 14 & A. Mané 5,15,16 & C. García-Rizo 5,6,17,18 & M. Bioque 5,6,17,18 & J. Saiz 5,19 & M. Bernardo 5,6,17,18 & S. Mas 2,5,6 & PEPs group Received: 23 July 2020 / Accepted: 10 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The role of Olanzapine therapeutic drug monitoring is controversial. The present study explores the associations of Olanzapine plasma concentrations with clinical response and metabolic side effects in first episode psychosis (FEP) after 2 months of treatment. Methods Forty-seven patients were included. Improvement in clinical symptomatology was assessed using the PANSS. Metabolic assessment included weight, blood pressure, waist circumference, blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. Results The Olanzapine plasma concentrations after 2 months of treatment were positively correlated with weight gain (r = 0.49, p = 0.003), and a concentration > 23.28 ng/mL was identified as a positive predictor of weight gain (≥ 7%). The Olanzapine concentration to dose (C/D) ratio was positively correlated with the percentage of improvement in the total PANSS (r = 0.46, p = 0.004), and a C/D ratio > 2.12 was identified as a positive predictor of a good response (percentage of improvement > 30%) after 2 months of treatment. We also identified several factors that could alter Olanzapine pharmacokinetics: gender (p = 0.03), diagnosis (p = 0.05), smoking habit (p = 0.05), and co-medications such as valproic acid (p = 0.05) and anxiolytics (p = 0.01). Discussion In conclusion, our results suggest that therapeutic drug monitoring of Olanzapine could be helpful to evaluate therapeutic efficacy and metabolic dysfunction in FEP patients treated with Olanzapine. Keywords Olanzapine . Therapeutic drug monitoring . Pharmacokinetics . First-episode psychosis . Drug level . Efficacy . Weight gain
Introduction Olanzapine is a second-generation antipsychotic (AP) commonly prescribed for the treatment of schizophrenia and the World Federation of Biological Psychiatry suggests it as a first-line therapeutic option (Hasan et al. 2013). Several pharmacological guidelines for schizophrenia treatment also recommend Olanzapine as one of the two non-clozapine AP trials before a trial of clozapine is considered in first-episode psychosis (FEP) patients (Keating et al. 2017). Olanzapine is effective in the acute reduction of psychopathological * S. Mas [email protected] Extended author information available on the last page of the article
symptoms in FEP patients, showing relative advantages in therapeutic response in comparison to other APs with highe
Data Loading...
