Source:http://linkedlifedata.com/resource/pubmed/id/16324716
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
8
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| pubmed:dateCreated |
2007-4-3
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| pubmed:abstractText |
Amisulpride is a clinically effective antipsychotic drug in a broad dose range with low propensity for extrapyramidal symptoms (EPS). Daily doses and plasma levels of amisulpride were analyzed within a large-scale therapeutic drug monitoring (TDM) survey to find plasma level ranges for optimized treatment under naturalistic conditions. Data of 378 schizophrenic patients treated with amisulpride (100-1550 mg) were included (40% female). Amisulpride plasma levels were analyzed at steady state; assessment comprised improvement (CGI-I) and side-effects, particularly EPS. For detection of cut-off values regarding non-response or EPS, receiver operating characteristics (ROC) curves were applied and the area under the ROC curve (AUC) was calculated. Amisulpride daily doses (594+/-262 mg) and plasma levels (315+/-277 ng/ml) were significantly correlated (r=0.53; P<0.0001). Patients with non-response to amisulpride (8.9%) had significantly (P<0.05) lower plasma levels (248+/-291 ng/ml) than patients with at least moderate improvement (316+/-253 ng/ml) despite comparable amisulpride doses (628+/-253 vs. 590+/-263 mg). Patients with EPS (14.6%) had significantly (P<0.05) higher amisulpride plasma levels (377+/-290 ng/ml) than patients without EPS (305+/-274 ng/ml) despite similar doses in both groups (595+/-266 vs. 594+/-246 mg). ROC analyses revealed significant predictive properties of amisulpride plasma levels (P<0.05) for non-response (AUC=0.65+/-0.05) and EPS (AUC=0.62+/-0.05), respectively. Daily amisulpride doses did not significantly predict non-response or EPS. Optimal amisulpride plasma level values to avoid non-response and EPS were 100 or 320 ng/ml, respectively. Analysis of clinical utility revealed that blood levels must be analyzed in 7 patients until one patient benefits from the TDM procedure by avoiding non-response or EPS. Although our results were mainly explorative, TDM of amisulpride seems very useful for clinical decision making.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Oct
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| pubmed:issn |
0022-3956
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
41
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
673-9
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| pubmed:dateRevised |
2007-11-15
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| pubmed:meshHeading |
pubmed-meshheading:16324716-Adolescent,
pubmed-meshheading:16324716-Adult,
pubmed-meshheading:16324716-Aged,
pubmed-meshheading:16324716-Aged, 80 and over,
pubmed-meshheading:16324716-Antipsychotic Agents,
pubmed-meshheading:16324716-Dose-Response Relationship, Drug,
pubmed-meshheading:16324716-Drug Monitoring,
pubmed-meshheading:16324716-Dyskinesia, Drug-Induced,
pubmed-meshheading:16324716-Female,
pubmed-meshheading:16324716-Germany,
pubmed-meshheading:16324716-Humans,
pubmed-meshheading:16324716-Male,
pubmed-meshheading:16324716-Middle Aged,
pubmed-meshheading:16324716-Neurologic Examination,
pubmed-meshheading:16324716-Psychiatric Status Rating Scales,
pubmed-meshheading:16324716-ROC Curve,
pubmed-meshheading:16324716-Retrospective Studies,
pubmed-meshheading:16324716-Schizophrenia,
pubmed-meshheading:16324716-Statistics as Topic,
pubmed-meshheading:16324716-Sulpiride
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| pubmed:year |
2007
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| pubmed:articleTitle |
Therapeutic drug monitoring for optimizing amisulpride therapy in patients with schizophrenia.
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| pubmed:affiliation |
Department of Psychiatry, University of Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany. mjmueller@gmx.de
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| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
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