التفاصيل البيبلوغرافية
| العنوان: |
Therapeutic Reference Range for Aripiprazole in Schizophrenia Revised: a Systematic Review and Metaanalysis. |
| المؤلفون: |
Hart, Xenia M., Hiemke, Christoph, Eichentopf, Luzie, Lense, Xenija M., Clement, Hans Willi, Conca, Andreas, Faltraco, Frank, Florio, Vincenzo, Grüner, Jessica, Havemann-Reinecke, Ursula, Molden, Espen, Paulzen, Michael, Schoretsanitis, Georgios, Riemer, Thomas G., Gründer, Gerhard |
| المصدر: |
Psychopharmacology; Nov2022, Vol. 239 Issue 11, p3377-3391, 15p, 1 Diagram, 4 Charts, 3 Graphs |
| مصطلحات موضوعية: |
ARIPIPRAZOLE, SCHIZOPHRENIA, PHARMACOLOGY, DRUG side effects, DOPAMINE receptors |
| مستخلص: |
Rationale: While one of the basic axioms of pharmacology postulates that there is a relationship between the concentration and effects of a drug, the value of measuring blood levels is questioned by many clinicians. This is due to the often-missing validation of therapeutic reference ranges. Objectives: Here, we present a prototypical meta-analysis of the relationships between blood levels of aripiprazole, its target engagement in the human brain, and clinical effects and side effects in patients with schizophrenia and related disorders. Methods: The relevant literature was systematically searched and reviewed for aripiprazole oral and injectable formulations. Population-based concentration ranges were computed (N = 3,373) and pharmacokinetic influences investigated. Results: Fifty-three study cohorts met the eligibility criteria. Twenty-nine studies report blood level after oral, 15 after injectable formulations, and nine were positron emission tomography studies. Conflicting evidence for a relationship between concentration, efficacy, and side effects exists (assigned level of evidence low, C; and absent, D). Population-based reference ranges are well in-line with findings from neuroimaging data and individual efficacy studies. We suggest a therapeutic reference range of 120–270 ng/ml and 180–380 ng/ml, respectively, for aripiprazole and its active moiety for the treatment of schizophrenia and related disorders. Conclusions: High interindividual variability and the influence of CYP2D6 genotypes gives a special indication for Therapeutic Drug Monitoring of oral and long-acting aripiprazole. A starting dose of 10 mg will in most patients result in effective concentrations in blood and brain. 5 mg will be sufficient for known poor metabolizers. [ABSTRACT FROM AUTHOR] |
|
Copyright of Psychopharmacology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
