Book contents
- The Clinical Use of Antipsychotic Plasma Levels
- Reviews
- The Clinical Use of Antipsychotic Plasma Levels
- Copyright page
- Half title page
- Contents
- Foreword
- Preface: How to Use This Handbook and Useful Tables for Handy Reference
- Introduction
- 1 Sampling Times for Oral and Long-Acting Injectable Agents
- 2 The Therapeutic Threshold and the Point of Futility
- 3 Level Interpretation Including Laboratory Reporting Issues, Responding to High Plasma Levels, Special Situations (Hepatic Dysfunction, Renal Dysfunction and Hemodialysis, Bariatric Surgery)
- 4 Tracking Oral Antipsychotic Adherence
- 5 What Is an Adequate Antipsychotic Trial? Using Plasma Levels to Optimize Psychiatric Response and Tolerability
- 6 Important Concepts about First-Generation Antipsychotics
- 7 Haloperidol and Haloperidol Decanoate
- 8 Fluphenazine and Fluphenazine Decanoate
- 9 Perphenazine and Perphenazine Decanoate
- 10 Zuclopenthixol and Zuclopenthixol Decanoate; Flupenthixol and Flupenthixol Decanoate
- 11 Chlorpromazine, Loxapine, Thiothixene, Trifluoperazine
- 12 Important Concepts about Second-Generation Antipsychotics
- 13 Clozapine
- 14 Risperidone Oral and Long-Acting Injectable; Paliperidone Oral and Long-Acting Injectable
- 15 Olanzapine and Olanzapine Pamoate
- 16 Aripiprazole, Aripiprazole Monohydrate, and Aripiprazole Lauroxil
- 17 Amisulpride, Asenapine, Lurasidone, Brexpiprazole, Cariprazine
- Appendix Therapeutic Threshold, Point of Futility, AGNP/ASCP Laboratory Alert Level, and Average Oral Concentration–Dose Relationships
- Index
- References
6 - Important Concepts about First-Generation Antipsychotics
Published online by Cambridge University Press: 19 October 2021
- The Clinical Use of Antipsychotic Plasma Levels
- Reviews
- The Clinical Use of Antipsychotic Plasma Levels
- Copyright page
- Half title page
- Contents
- Foreword
- Preface: How to Use This Handbook and Useful Tables for Handy Reference
- Introduction
- 1 Sampling Times for Oral and Long-Acting Injectable Agents
- 2 The Therapeutic Threshold and the Point of Futility
- 3 Level Interpretation Including Laboratory Reporting Issues, Responding to High Plasma Levels, Special Situations (Hepatic Dysfunction, Renal Dysfunction and Hemodialysis, Bariatric Surgery)
- 4 Tracking Oral Antipsychotic Adherence
- 5 What Is an Adequate Antipsychotic Trial? Using Plasma Levels to Optimize Psychiatric Response and Tolerability
- 6 Important Concepts about First-Generation Antipsychotics
- 7 Haloperidol and Haloperidol Decanoate
- 8 Fluphenazine and Fluphenazine Decanoate
- 9 Perphenazine and Perphenazine Decanoate
- 10 Zuclopenthixol and Zuclopenthixol Decanoate; Flupenthixol and Flupenthixol Decanoate
- 11 Chlorpromazine, Loxapine, Thiothixene, Trifluoperazine
- 12 Important Concepts about Second-Generation Antipsychotics
- 13 Clozapine
- 14 Risperidone Oral and Long-Acting Injectable; Paliperidone Oral and Long-Acting Injectable
- 15 Olanzapine and Olanzapine Pamoate
- 16 Aripiprazole, Aripiprazole Monohydrate, and Aripiprazole Lauroxil
- 17 Amisulpride, Asenapine, Lurasidone, Brexpiprazole, Cariprazine
- Appendix Therapeutic Threshold, Point of Futility, AGNP/ASCP Laboratory Alert Level, and Average Oral Concentration–Dose Relationships
- Index
- References
Summary
First-generation antipsychotics (FGAs) have no unique therapeutic benefit compared to newer antipsychotics, but their utility derives from the fact that they are inexpensive, that multiple formulations exist including long-acting injectable (LAI) preparations, and that there is an extensive trove of plasma level studies for the more commonly used medications [1–5]. Large randomized trials such as the UK Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS-1) (n = 227) found that there was no disadvantage over 1 year of treatment in terms of quality of life, symptoms, or associated costs of care when using FGAs, compared to second-generation antipsychotics (SGAs) (clozapine excepted) [6].
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- Chapter
- Information
- The Clinical Use of Antipsychotic Plasma LevelsStahl's Handbooks, pp. 147 - 156Publisher: Cambridge University PressPrint publication year: 2021