The usefulness of Olanzapine plasma concentrations in monitoring treatment efficacy and metabolic disturbances in first-episode psychosis
Por:
Arnaiz, JA, Rodrigues-Silva, C, Mezquida, G, Amoretti, S, Cuesta, MJ, Fraguas, D, Lobo, A, Gonzalez-Pinto, A, Diaz-Caneja, MC, Corripio, I, Vieta, E, Baeza, I, Mane, A, Garcia-Rizo, C, Bioque, M, Saiz, J, Bernardo, M, Mas, S, PEPs Grp
Publicada:
1 mar 2021
Ahead of Print:
1 nov 2020
Resumen:
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.
Filiaciones:
Arnaiz, JA:
Hosp Clin Barcelona HCB, Dept Clin Pharmacol, Phase Unit 1, Barcelona, Spain
Univ Barcelona UB, Dept Basic Clin Practice, Casanova 143, E-08036 Barcelona, Spain
Rodrigues-Silva, C:
Univ Fed Goias, Inst Biol Sci, Dept Pharmacol, Goiania, Go, Brazil
Mezquida, G:
Univ Barcelona UB, Dept Basic Clin Practice, Casanova 143, E-08036 Barcelona, Spain
HCB, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Catalunya, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Amoretti, S:
HCB, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Catalunya, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Cuesta, MJ:
Inst Invest Sanitarias Navarra IdiSNa, Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Fraguas, D:
Univ Complutense, Sch Med, Hosp Clin San Carlos, Inst Psychiat & Mental Hlth,IdISSC,CIBERSAM, Madrid, Spain
Lobo, A:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Zaragoza Univ, Inst Invest Sanitaria Aragon IIS Aragon, Dept Med & Psychiat, Zaragoza, Spain
Gonzalez-Pinto, A:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Basque Country, Hosp Univ Araba, Serv Psiquiat, Bioaraba, Spain
Diaz-Caneja, MC:
Univ Complutense, Dept Child & Adolescent Psychiat, Inst Psychiat & Mental Hlth, CIBERSAM,IiSGM,Sch Med,Hosp Gen Univ Gregorio Mar, Madrid, Spain
Corripio, I:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Autonoma Barcelona UAB, Inst Invest Biomed St Pau IIB SANT PAU, Dept Psychiat, Hosp Santa Creu & Sant Pau, Barcelona, Spain
Vieta, E:
Univ Barcelona, IDIBAPS, CIBERSAM, Hosp Clin,Inst Neurosci, Barcelona, Catalonia, Spain
Baeza, I:
Univ Barcelona, CIBERSAM, IDIBAPS,Clin Inst Neurosci, Dept Child & Adolescent Psychiat & Psychol,Hosp C, Barcelona, Spain
Mane, A:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Hosp del Mar Med Res Inst IMIM, Barcelona, Spain
Autonomous Univ Barcelona UAB, Barcelona, Spain
Garcia-Rizo, C:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
UB, Dept Med, Barcelona, Spain
Bioque, M:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
UB, Dept Med, Barcelona, Spain
Saiz, J:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Alcala De Henares, Hosp Univ Ramon & Cajal IRYCIS, Dept Psychiat, Madrid, Spain
Bernardo, M:
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
UB, Dept Med, Barcelona, Spain
Mas, S:
Univ Barcelona UB, Dept Basic Clin Practice, Casanova 143, E-08036 Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
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