The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis.
Drug level
Efficacy
First-episode psychosis
Olanzapine
Pharmacokinetics
Therapeutic drug monitoring
Weight gain
Journal
Psychopharmacology
ISSN: 1432-2072
Titre abrégé: Psychopharmacology (Berl)
Pays: Germany
ID NLM: 7608025
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
23
07
2020
accepted:
10
11
2020
pubmed:
25
11
2020
medline:
17
3
2021
entrez:
24
11
2020
Statut:
ppublish
Résumé
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. 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. 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). 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.
Identifiants
pubmed: 33230696
doi: 10.1007/s00213-020-05715-5
pii: 10.1007/s00213-020-05715-5
doi:
Substances chimiques
Antipsychotic Agents
0
Blood Glucose
0
Olanzapine
N7U69T4SZR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
665-676Subventions
Organisme : Instituto de Salud Carlos III
ID : PI 080208
Organisme : Instituto de Salud Carlos III
ID : PI0/00,283
Organisme : Instituto de Salud Carlos III
ID : PI14/00,612
Investigateurs
Mercè Torra
(M)
Adrian Llerena
(A)
Gerard Anmella
(G)
Lluc Colomer
(L)
Carmen Moreno
(C)
Manuel Durán-Cutilla
(M)
Anna Alonso Solís
(A)
Eva Grasa
(E)
Puri Lopez
(P)
Sainza García
(S)
Concepción De-la-Cámara
(C)
Zaragoza Aragón
(Z)
Pedro Saz
(P)
Maria Dolores Moltó
(MD)
Miguel Hernandez Viadel
(M)
Francesc Casanovas
(F)
David SanAgustin
(D)
Josefina Castro-Fornieles
(J)
Elena de la Serna
(E)
Fernando Contreras
(F)
Cristina Saiz
(C)
Julio Bobes
(J)
María Paz García-Portilla
(MP)
Miguel Gutierrez Fraile
(M)
Arantzazu Zabala Rabadán
(A)
Roberto Rodríguez-Jimenez
(R)
Natalia E Fares-Otero
(NE)
Judith Usall
(J)
Anna Butjosa
(A)
Salvador Sarró
(S)
Edith Pomarol-Clotet
(E)
Angela Ibañez
(A)
Marta Ribeiro
(M)
Vicent Balanzá-Martínez
(V)
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