Therapeutic drug monitoring data on Olanzapine and its N-demethyl metabolite in the naturalistic clinical setting
Olanzapine (Zyprexa) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite, N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM...
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| creator | SKOGH, Elisabeth REIS, Margareta DAHL, Marja-Liisa LUNDMARK, Jöns BENGTSSON, Finn |
| description | Olanzapine (Zyprexa) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite, N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyzed. Additional patient information on certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process, samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg vs 5.2 nmol/L/mg). Nonsmokers had a higher (P < 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P < 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P < 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits, and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future. |
| doi_str_mv | 10.1097/00007691-200208000-00010 |
| format | Article |
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During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyzed. Additional patient information on certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process, samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg vs 5.2 nmol/L/mg). Nonsmokers had a higher (P < 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P < 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P < 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits, and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future.</description><identifier>ISSN: 0163-4356</identifier><identifier>ISSN: 1536-3694</identifier><identifier>EISSN: 1536-3694</identifier><identifier>DOI: 10.1097/00007691-200208000-00010</identifier><identifier>PMID: 12142637</identifier><identifier>CODEN: TDMODV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Administration, Oral ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antipsychotic Agents - administration & dosage ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - blood ; Basic Medicine ; Benzodiazepines ; Biological and medical sciences ; Drug Interactions ; Drug Monitoring ; Farmakologi och toxikologi ; Female ; gender ; Humans ; Läkemedelskemi ; Male ; Medical and Health Sciences ; Medical sciences ; MEDICIN ; Medicin och hälsovetenskap ; Medicinal Chemistry ; MEDICINE ; Medicinska och farmaceutiska grundvetenskaper ; Middle Aged ; Neuropharmacology ; Olanzapine ; Pharmacology and Toxicology ; Pharmacology. Drug treatments ; Pirenzepine - administration & dosage ; Pirenzepine - adverse effects ; Pirenzepine - analogs & derivatives ; Pirenzepine - blood ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; Sex Factors ; side-effect ; smoking ; Smoking - metabolism ; therapeutic drug monitoring</subject><ispartof>Therapeutic drug monitoring, 2002-08, Vol.24 (4), p.518-526</ispartof><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c599t-dab98a6aed730c1321e7cc392dd3f8ffe49bc9fbda3f5442365fcf2ec46ba3903</citedby><cites>FETCH-LOGICAL-c599t-dab98a6aed730c1321e7cc392dd3f8ffe49bc9fbda3f5442365fcf2ec46ba3903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13823725$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12142637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-27669$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/332191$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:1934791$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>SKOGH, Elisabeth</creatorcontrib><creatorcontrib>REIS, Margareta</creatorcontrib><creatorcontrib>DAHL, Marja-Liisa</creatorcontrib><creatorcontrib>LUNDMARK, Jöns</creatorcontrib><creatorcontrib>BENGTSSON, Finn</creatorcontrib><title>Therapeutic drug monitoring data on Olanzapine and its N-demethyl metabolite in the naturalistic clinical setting</title><title>Therapeutic drug monitoring</title><addtitle>Ther Drug Monit</addtitle><description>Olanzapine (Zyprexa) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite, N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyzed. Additional patient information on certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process, samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg vs 5.2 nmol/L/mg). Nonsmokers had a higher (P < 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P < 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P < 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits, and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antipsychotic Agents - administration & dosage</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - blood</subject><subject>Basic Medicine</subject><subject>Benzodiazepines</subject><subject>Biological and medical sciences</subject><subject>Drug Interactions</subject><subject>Drug Monitoring</subject><subject>Farmakologi och toxikologi</subject><subject>Female</subject><subject>gender</subject><subject>Humans</subject><subject>Läkemedelskemi</subject><subject>Male</subject><subject>Medical and Health Sciences</subject><subject>Medical sciences</subject><subject>MEDICIN</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicinal Chemistry</subject><subject>MEDICINE</subject><subject>Medicinska och farmaceutiska grundvetenskaper</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Olanzapine</subject><subject>Pharmacology and Toxicology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pirenzepine - administration & dosage</subject><subject>Pirenzepine - adverse effects</subject><subject>Pirenzepine - analogs & derivatives</subject><subject>Pirenzepine - blood</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Sex Factors</subject><subject>side-effect</subject><subject>smoking</subject><subject>Smoking - metabolism</subject><subject>therapeutic drug monitoring</subject><issn>0163-4356</issn><issn>1536-3694</issn><issn>1536-3694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ks1u1DAUhSMEokPhFZA37EixfR0nXlblp0gjuilsrRv_zBgySbAdofL0eJhpZzWRrq4Tfd_xIqeqCKNXjKr2Ay1PKxWrOaWcduWtLsPos2rFGpA1SCWeVyvKJNQCGnlRvUrpZyFEYV9WF4wzwSW0q-r3_dZFnN2SgyE2Lhuym8aQpxjGDbGYkUwjuRtw_ItzGB3B0ZKQE_lWW7dzefswkLKwn4aQHQkjyVtHRsxLxCGkfagZwhgMDiS5nEvq6-qFxyG5N8d9WX3__On-5rZe3335enO9rk2jVK4t9qpDic62QA0DzlxrDChuLfjOeydUb5TvLYJvhOAgG288d0bIHkFRuKzqQ2764-al13MMO4wPesKgj59-lZPTjQImReHbs_wcJ3uSHkWmQLSKFXN91hyWuUxfZm_0HDgoxTXlDrRoPNV9L50W2LnOMt5yZUvc-7NxH8OPaz3FjR7ConkrpSp4d8BNnFKKzj8JjOp9W_RjW_RTW_T_thT17UEt1-ycPYnHehTg3RHAVH6hjziakE4cdBxa3sA_hffL6Q</recordid><startdate>20020801</startdate><enddate>20020801</enddate><creator>SKOGH, Elisabeth</creator><creator>REIS, Margareta</creator><creator>DAHL, Marja-Liisa</creator><creator>LUNDMARK, Jöns</creator><creator>BENGTSSON, Finn</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DG8</scope><scope>D95</scope></search><sort><creationdate>20020801</creationdate><title>Therapeutic drug monitoring data on Olanzapine and its N-demethyl metabolite in the naturalistic clinical setting</title><author>SKOGH, Elisabeth ; REIS, Margareta ; DAHL, Marja-Liisa ; LUNDMARK, Jöns ; BENGTSSON, Finn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c599t-dab98a6aed730c1321e7cc392dd3f8ffe49bc9fbda3f5442365fcf2ec46ba3903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antipsychotic Agents - administration & dosage</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - blood</topic><topic>Basic Medicine</topic><topic>Benzodiazepines</topic><topic>Biological and medical sciences</topic><topic>Drug Interactions</topic><topic>Drug Monitoring</topic><topic>Farmakologi och toxikologi</topic><topic>Female</topic><topic>gender</topic><topic>Humans</topic><topic>Läkemedelskemi</topic><topic>Male</topic><topic>Medical and Health Sciences</topic><topic>Medical sciences</topic><topic>MEDICIN</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicinal Chemistry</topic><topic>MEDICINE</topic><topic>Medicinska och farmaceutiska grundvetenskaper</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Olanzapine</topic><topic>Pharmacology and Toxicology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pirenzepine - administration & dosage</topic><topic>Pirenzepine - adverse effects</topic><topic>Pirenzepine - analogs & derivatives</topic><topic>Pirenzepine - blood</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Sex Factors</topic><topic>side-effect</topic><topic>smoking</topic><topic>Smoking - metabolism</topic><topic>therapeutic drug monitoring</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SKOGH, Elisabeth</creatorcontrib><creatorcontrib>REIS, Margareta</creatorcontrib><creatorcontrib>DAHL, Marja-Liisa</creatorcontrib><creatorcontrib>LUNDMARK, Jöns</creatorcontrib><creatorcontrib>BENGTSSON, Finn</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Linköpings universitet</collection><collection>SWEPUB Lunds universitet</collection><jtitle>Therapeutic drug monitoring</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SKOGH, Elisabeth</au><au>REIS, Margareta</au><au>DAHL, Marja-Liisa</au><au>LUNDMARK, Jöns</au><au>BENGTSSON, Finn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Therapeutic drug monitoring data on Olanzapine and its N-demethyl metabolite in the naturalistic clinical setting</atitle><jtitle>Therapeutic drug monitoring</jtitle><addtitle>Ther Drug Monit</addtitle><date>2002-08-01</date><risdate>2002</risdate><volume>24</volume><issue>4</issue><spage>518</spage><epage>526</epage><pages>518-526</pages><issn>0163-4356</issn><issn>1536-3694</issn><eissn>1536-3694</eissn><coden>TDMODV</coden><abstract>Olanzapine (Zyprexa) was approved for general prescription in Sweden in November 1996, and an HPLC-based therapeutic drug monitoring (TDM) routine for serum olanzapine (OLA) and its major metabolite, N-demethylolanzapine (DMO) was established in February 1997. During 1997 to 1999, a total of 753 TDM requests for a total of 545 Swedish patients was analyzed. Additional patient information on certain clinical variables was collected on specifically designed TDM request forms. After the exclusion process, samples from 194 patients were found to be eligible for further scrutiny. The concentration-to-dose (C/D) ratio for OLA varied 25-fold and that of DMO 22-fold. Women had a higher (P < 0.01) median C/D ratio for OLA than men (median, 7.2 nmol/L/mg vs 5.2 nmol/L/mg). Nonsmokers had a higher (P < 0.001) C/D ratio for OLA than smokers (median, 9.2 nmol/L/mg vs 4.0 nmol/L/mg). Smokers got higher prescribed (P < 0.05) doses of OLA than nonsmokers did. In the group with reported side effects, the median serum OLA concentration was 22% higher (P < 0.05) than in the group without side effects. Patients co-medicated with carbamazepine had a 71% lower median C/D ratio for OLA than patients on OLA monotherapy. The present TDM-based follow-up suggests that the influence of gender, smoking habits, and certain drug interactions may need to be considered for optimal dosage of OLA. TDM may be used for this purpose more readily in the future.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12142637</pmid><doi>10.1097/00007691-200208000-00010</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Therapeutic drug monitoring, 2002-08, Vol.24 (4), p.518-526 |
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| subjects | Administration, Oral Adolescent Adult Age Factors Aged Aged, 80 and over Antipsychotic Agents - administration & dosage Antipsychotic Agents - adverse effects Antipsychotic Agents - blood Basic Medicine Benzodiazepines Biological and medical sciences Drug Interactions Drug Monitoring Farmakologi och toxikologi Female gender Humans Läkemedelskemi Male Medical and Health Sciences Medical sciences MEDICIN Medicin och hälsovetenskap Medicinal Chemistry MEDICINE Medicinska och farmaceutiska grundvetenskaper Middle Aged Neuropharmacology Olanzapine Pharmacology and Toxicology Pharmacology. Drug treatments Pirenzepine - administration & dosage Pirenzepine - adverse effects Pirenzepine - analogs & derivatives Pirenzepine - blood Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopharmacology Sex Factors side-effect smoking Smoking - metabolism therapeutic drug monitoring |
| title | Therapeutic drug monitoring data on Olanzapine and its N-demethyl metabolite in the naturalistic clinical setting |
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