Treatment resistant or resistant to treatment? Antipsychotic plasma levels in patients with poorly controlled psychotic symptoms

Journal of Psychopharmacology
Robert McCutcheonOliver D Howes

Abstract

A large proportion of individuals with schizophrenia show an inadequate response to treatment with antipsychotics. It can be unclear whether this is secondary to subtherapeutic antipsychotic plasma levels or to medication ineffectiveness. The purpose of the present study was to determine the extent of subtherapeutic antipsychotic plasma levels in a group of patients clinically identified as treatment-resistant. In addition we investigated the frequency of antipsychotic plasma level monitoring in standard clinical practice. Antipsychotic plasma levels were measured in 36 patients identified as having treatment-resistant schizophrenia by their treating clinicians. Sixteen (44%) patients showed either undetectable (19%) or subtherapeutic levels (25%), and 20 (56%) patients had levels in the therapeutic range. Subtherapeutic plasma levels were significantly associated with black ethnicity, shorter duration of current treatment and antipsychotics other than olanzapine and amisulpride. Antipsychotic plasma levels had been measured in only one patient in the year prior to our study. We found over one-third of patients identified as treatment-resistant have subtherapeutic antipsychotic levels. This indicates that they may be under-trea...Continue Reading

References

Jun 1, 1985·Journal of Clinical Psychopharmacology·J M Kane
Jan 1, 1988·Acta Psychiatrica Scandinavica·G BartkóG Zádor
May 1, 1995·Acta Psychiatrica Scandinavica·M S Razali, H Yahya
Sep 1, 1993·The Journal of Nervous and Mental Disease·S G Adams, J T Howe
Jul 29, 2004·Schizophrenia Bulletin·Marcia ValensteinThomas Stavenger
Aug 5, 2004·Psychiatric Services : a Journal of the American Psychiatric Association·Peter J WeidenJulie Locklear
Oct 27, 2004·European Psychiatry : the Journal of the Association of European Psychiatrists·M LambertD Naber
May 19, 2006·Schizophrenia Bulletin·Dawn I VelliganAlexander L Miller
Sep 4, 2007·Psychiatric Services : a Journal of the American Psychiatric Association·Dawn I VelliganAlexander L Miller
Jan 18, 2008·Journal of Clinical Pharmacology·Kristin L BigosRobert R Bies
Mar 4, 2008·The Journal of Clinical Psychiatry·Michael R LawAlyce S Adams
Aug 2, 2008·Expert Opinion on Pharmacotherapy·Christian G HuberMartin Lambert
Nov 26, 2008·The Journal of Clinical Psychiatry·Kuan GandelmanSheldon H Preskorn
Apr 3, 2010·The American Journal of Psychiatry·David M GardnerRoss J Baldessarini
Jul 21, 2010·Clinical Schizophrenia & Related Psychoses·Ann M MortimerJunais Puthiryackal
Jun 23, 2011·Journal of Clinical Psychopharmacology·Maxine X PatelRobert James Flanagan
Oct 1, 2011·Pharmacopsychiatry·A ConcaG Giupponi
Sep 8, 2012·The British Journal of Psychiatry : the Journal of Mental Science·Oliver D HowesDavid Taylor
Oct 5, 2012·The American Journal of Psychiatry·Arsime DemjahaOliver D Howes
Mar 13, 2013·Forensic Science International : Synergy·Danielle S FisherRobert J Flanagan

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Citations

Oct 27, 2017·Acta Psychiatrica Scandinavica·R McCutcheonO D Howes
Nov 9, 2018·Expert Opinion on Pharmacotherapy·Justin Faden, Leslie Citrome
Nov 28, 2018·Irish Journal of Psychological Medicine·J Lally, F Gaughran
Dec 21, 2019·The Mental Health Clinician·James L Roerig
Jun 27, 2019·Journal of Psychopharmacology·Katherine BeckOliver D Howes
Jul 9, 2020·Journal of Clinical Psychopharmacology·Oddur IngimarssonEngilbert Sigurdsson
Aug 24, 2020·The Lancet. Psychiatry·Robert A McCutcheon
Jul 15, 2021·Molecular Psychiatry·Oliver D HowesToby Pillinger
Jul 24, 2021·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Chi-Un PaePrakash S Masand
Nov 21, 2017·ACS Chemical Neuroscience·Jeffrey J SutherlandTimothy P Ryan
Apr 15, 2020·Psychotherapy and Psychosomatics·Jose de LeonCarlos De Las Cuevas

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