Effects of Dose, Age, Sex, Body Weight, and Smoking on Plasma Concentrations of Olanzapine and N-desmethyl Olanzapine in Inpatients With Schizophrenia.
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Antipsychotic Agents
/ administration & dosage
Body Weight
Chromatography, High Pressure Liquid
Dose-Response Relationship, Drug
Female
Humans
Inpatients
Male
Middle Aged
Olanzapine
/ administration & dosage
Pirenzepine
/ analogs & derivatives
Retrospective Studies
Schizophrenia
/ drug therapy
Sex Factors
Smoking
/ epidemiology
Tandem Mass Spectrometry
Young Adult
Journal
Journal of clinical psychopharmacology
ISSN: 1533-712X
Titre abrégé: J Clin Psychopharmacol
Pays: United States
ID NLM: 8109496
Informations de publication
Date de publication:
Historique:
pubmed:
6
4
2021
medline:
10
11
2021
entrez:
5
4
2021
Statut:
ppublish
Résumé
This study aimed to investigate the combined effects of dose, age, sex, body weight, and smoking on plasma concentrations of olanzapine (OLA) and N-desmethyl olanzapine (DMO) in Chinese inpatients with schizophrenia. A retrospective study including 185 inpatients was conducted. The steady-state plasma concentrations of OLA (COLA) and DMO (CDMO) were measured using high-performance liquid chromatography-tandem mass spectrometry. The combined effects of dose, age, sex, body weight, and smoking on COLA and CDMO were evaluated. Multiple linear regression analyses revealed that dose, age, body weight, and smoking had significant effects on COLA and CDMO in inpatients with schizophrenia treated with OLA. The dose was the most important determinant of COLA and CDMO and was positively correlated with both. Furthermore, smokers exhibited a significantly lower COLA and COLA + DMO, whereas higher body weight led to the reduction of COLA, CDMO, and COLA + DMO. Advanced age was associated with lower CDMO. These results suggest that dose, age, body weight, and smoking have a significant influence on the plasma concentration of OLA and its metabolite DMO. Clinicians should consider the combined effects when prescribing OLA to patients with schizophrenia.
Identifiants
pubmed: 33814547
doi: 10.1097/JCP.0000000000001390
pii: 00004714-202105000-00006
doi:
Substances chimiques
Antipsychotic Agents
0
Pirenzepine
3G0285N20N
desmethylolanzapine
C1053I7P65
Olanzapine
N7U69T4SZR
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
255-259Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Références
Fulton B, Goa KL. Olanzapine. A review of its pharmacological properties and therapeutic efficacy in the management of schizophrenia and related psychoses. Drugs. 1997;53:281–298.
Lieberman JA, Tollefson G, Tohen M, et al. Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. Am J Psychiatry. 2003;160:1396–1404.
Bymaster FP, Calligaro DO, Falcone JF, et al. Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology. 1996;14:87–96.
Kassahun K, Mattiuz E, Nyhart E Jr., et al. Disposition and biotransformation of the antipsychotic agent olanzapine in humans. Drug Metab Dispos. 1997;25:81–93.
Ring BJ, Catlow J, Lindsay TJ, et al. Identification of the human cytochromes P450 responsible for the in vitro formation of the major oxidative metabolites of the antipsychotic agent olanzapine. J Pharmacol Exp Ther. 1996;276:658–666.
Callaghan JT, Bergstrom RF, Ptak LR, et al. Olanzapine. Pharmacokinetic and pharmacodynamic profile. Clin Pharmacokinet. 1999;37:177–193.
Olesen OV, Linnet K. Olanzapine serum concentrations in psychiatric patients given standard doses: the influence of comedication. Ther Drug Monit. 1999;21:87–90.
Wang CY, Zhang ZJ, Li WB, et al. The differential effects of steady-state fluvoxamine on the pharmacokinetics of olanzapine and clozapine in healthy volunteers. J Clin Pharmacol. 2004;44:785–792.
Bachmann CJ, Haberhausen M, Heinzel-Gutenbrunner M, et al. Large intraindividual variability of olanzapine serum concentrations in adolescent patients. Ther Drug Monit. 2008;30:108–112.
Bigos KL, Pollock BG, Coley KC, et al. Sex, race, and smoking impact olanzapine exposure. J Clin Pharmacol. 2008;48:157–165.
Gex-Fabry M, Balant-Gorgia AE, Balant LP. Therapeutic drug monitoring of olanzapine: the combined effect of age, gender, smoking, and comedication. Ther Drug Monit. 2003;25:46–53.
Skogh E, Reis M, Dahl ML, et al. Therapeutic drug monitoring data on olanzapine and its N-demethyl metabolite in the naturalistic clinical setting. Ther Drug Monit. 2002;24:518–526.
Aichhorn W, Marksteiner J, Walch T, et al. Age and gender effects on olanzapine and risperidone plasma concentrations in children and adolescents. J Child Adolesc Psychopharmacol. 2007;17:665–674.
Castberg I, Westin AA, Skogvoll E, et al. Effects of age and gender on the serum levels of clozapine, olanzapine, risperidone, and quetiapine. Acta Psychiatr Scand. 2017;136:455–464.
Weiss U, Marksteiner J, Kemmler G, et al. Effects of age and sex on olanzapine plasma concentrations. J Clin Psychopharmacol. 2005;25:570–574.
Hiemke C, Bergemann N, Clement HW, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51:9–62.
Perry PJ, Lund BC, Sanger T, et al. Olanzapine plasma concentrations and clinical response: acute phase results of the North American Olanzapine Trial. J Clin Psychopharmacol. 2001;21:14–20.
Lu ML, Chen CH, Kuo PT, et al. Application of plasma levels of olanzapine and N-desmethyl-olanzapine to monitor metabolic parameters in patients with schizophrenia. Schizophr Res. 2018;193:139–145.
Lu ML, Wu YX, Chen CH, et al. Application of plasma levels of olanzapine and N-desmethyl-olanzapine to monitor clinical efficacy in patients with schizophrenia. PLoS One. 2016;11:e0148539.
Zhang X, Zhao Y, Shao H, et al. Metabolic and endocrinal effects of N-desmethyl-olanzapine in mice with obesity: implication for olanzapine-associated metabolic changes. Psychoneuroendocrinology. 2019;108:163–171.
Bergemann N, Frick A, Parzer P, et al. Olanzapine plasma concentration, average daily dose, and interaction with co-medication in schizophrenic patients. Pharmacopsychiatry. 2004;37:63–68.
Theisen FM, Haberhausen M, Schulz E, et al. Serum levels of olanzapine and its N-desmethyl and 2-hydroxymethyl metabolites in child and adolescent psychiatric disorders: effects of dose, diagnosis, age, sex, smoking, and comedication. Ther Drug Monit. 2006;28:750–759.
Wu TH, Chiu CC, Shen WW, et al. Pharmacokinetics of olanzapine in Chinese male schizophrenic patients with various smoking behaviors. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:1889–1893.
Carrillo JA, Herraiz AG, Ramos SI, et al. Role of the smoking-induced cytochrome P450 (CYP)1A2 and polymorphic CYP2D6 in steady-state concentration of olanzapine. J Clin Psychopharmacol. 2003;23:119–127.
Tveito M, Smith RL, Molden E, et al. Age impacts olanzapine exposure differently during use of oral versus long-acting injectable formulations: an observational study including 8,288 patients. J Clin Psychopharmacol. 2018;38:570–576.
Kelly DL, Conley RR, Tamminga CA. Differential olanzapine plasma concentrations by sex in a fixed-dose study. Schizophr Res. 1999;40:101–104.
Pollock BG. Gender differences in psychotropic drug metabolism. Psychopharmacol Bull. 1997;33:235–241.
Yonkers KA, Kando JC, Cole JO, et al. Gender differences in pharmacokinetics and pharmacodynamics of psychotropic medication. Am J Psychiatry. 1992;149:587–595.
Catterson ML, Preskorn SH, Martin RL. Pharmacodynamic and pharmacokinetic considerations in geriatric psychopharmacology. Psychiatr Clin North Am. 1997;20:205–218.
Cabaleiro T, Lopez-Rodriguez R, Ochoa D, et al. Polymorphisms influencing olanzapine metabolism and adverse effects in healthy subjects. Hum Psychopharmacol. 2013;28:205–214.
Czerwensky F, Leucht S, Steimer W. CYP1A2*1D and *1F polymorphisms have a significant impact on olanzapine serum concentrations. Ther Drug Monit. 2015;37:152–160.
Soderberg MM, Haslemo T, Molden E, et al. Influence of FMO1 and 3 polymorphisms on serum olanzapine and its N-oxide metabolite in psychiatric patients. Pharm J. 2013;13:544–550.