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
12 - Important Concepts about Second-Generation Antipsychotics
Published online by Cambridge University Press: 19 October 2021
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
Summary
While FGAs share the common mechanism of action (MOA) of D2 antagonism, SGAs are a heterogeneous group that includes agents with limited D2 occupancy and the dopamine partial agonists [3]. Among SGAs whose principal MOA is D2 blockade, positron imaging tomography (PET) studies indicate that the ‘sweet spot’ for receptor occupancy is the same as for FGAs, 65%–80%, with decreased response rates below this threshold, and greater risk for neurological adverse effects above 80% [18].
- Type
- Chapter
- Information
- The Clinical Use of Antipsychotic Plasma LevelsStahl's Handbooks, pp. 241 - 248Publisher: Cambridge University PressPrint publication year: 2021
References
Huhn, M., Nikolakopoulou, A., Schneider-Thoma, J., et al. (2019). Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet, 394, 939–951.Google Scholar
Pillinger, T., McCutcheon, R. A., Vano, L., et al. (2020). Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry, 7, 64–77.Google Scholar
Meyer, J. M. (2018). Pharmacotherapy of psychosis and mania. In Brunton, L. L., Hilal-Dandan, R. and Knollmann, B. C., eds., Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 13th edn. Chicago, IL: McGraw-Hill, pp. 279–302.Google Scholar
Poyurovsky, M. and Weizman, A. (2018). Very low-dose mirtazapine (7.5 mg) in treatment of acute antipsychotic-associated akathisia. J Clin Psychopharmacol, 38, 609–611.Google Scholar
Kahn, R. S., Winter van Rossum, I., Leucht, S., et al. (2018). Amisulpride and olanzapine followed by open-label treatment with clozapine in first-episode schizophrenia and schizophreniform disorder (OPTiMiSE): a three-phase switching study. Lancet Psychiatry, 5, 797–807.Google Scholar
Meyer, J. M. and Stahl, S. M. (2019). The Clozapine Handbook. Cambridge: Cambridge University Press.Google Scholar
Xiong, G. L., Pinkhasov, A., Mangal, J. P., et al. (2020). QTc monitoring in adults with medical and psychiatric comorbidities: expert consensus from the Association of Medicine and Psychiatry. J Psychosom Res, 135, 110138.Google Scholar
Indik, J. H., Pearson, E. C., Fried, K., et al. (2006). Bazett and Fridericia QT correction formulas interfere with measurement of drug-induced changes in QT interval. Heart Rhythm, 3, 1003–1007.Google Scholar
Nielsen, J., Graff, C., Kanters, J. K., et al. (2011). Assessing QT prolongation of antipsychotic drugs. CNS Drugs, 25, 473–490.Google Scholar
Vandenberk, B., Vandael, E., Robyns, T., et al. (2016). Which QT correction formulae to use for QT monitoring? J Am Heart Assoc, 5, e003264.Google Scholar
Schoretsanitis, G., Kane, J. M., Correll, C. U., et al. (2020). Blood levels to optimize antipsychotic treatment in clinical practice: a joint consensus statement of the American Society of Clinical Psychopharmacology (ASCP) and the Therapeutic Drug Monitoring (TDM) Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). J Clin Psychiatry, 81, http://doi.org/10.4088/JCP.4019cs13169.Google Scholar
Leucht, S., Samara, M., Heres, S., et al. (2016). Dose equivalents for antipsychotic drugs: the DDD method. Schizophr Bull, 42 Suppl 1, S90–94.Google Scholar
Leucht, S., Crippa, A., Siafis, S., et al. (2020). Dose-response meta-analysis of antipsychotic drugs for acute schizophrenia. Am J Psychiatry, 177, 342–353.Google Scholar
Asmal, L., Flegar, S. J., Wang, J., et al. (2013). Quetiapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev, CD006625.Google Scholar
Vanasse, A., Blais, L., Courteau, J., et al. (2016). Comparative effectiveness and safety of antipsychotic drugs in schizophrenia treatment: a real-world observational study. Acta Psychiatr Scand, 134, 374–384.Google Scholar
Meyer, J. M., Davis, V. G., Goff, D. C., et al. (2008). Change in metabolic syndrome parameters with antipsychotic treatment in the CATIE Schizophrenia Trial: prospective data from phase 1. Schizophr Res, 101, 273–286.Google Scholar
Meyer, J. M. (2010). Antipsychotics and metabolics in the post-CATIE era. Curr Top Behav Neurosci, 4, 23–42.Google Scholar
Kapur, S., Zipursky, R., Jones, C., et al. (2000). Relationship between dopamine D(2) occupancy, clinical response, and side effects: a double-blind PET study of first-episode schizophrenia. Am J Psychiatry, 157, 514–520.Google Scholar
Kelly, D. L., Richardson, C. M., Yang, Y., et al. (2006). Plasma concentrations of high-dose olanzapine in a double-blind crossover study. Hum Psychopharmacol, 21, 393–398.Google Scholar
Schwieler, L., Linderholm, K. R., Nilsson-Todd, L. K., et al. (2008). Clozapine interacts with the glycine site of the NMDA receptor: electrophysiological studies of dopamine neurons in the rat ventral tegmental area. Life Sci, 83, 170–175.Google Scholar
Uchida, H., Takeuchi, H., Graff-Guerrero, A., et al. (2011). Predicting dopamine D2 receptor occupancy from plasma levels of antipsychotic drugs: a systematic review and pooled analysis. J Clin Psychopharmacol, 31, 318–325.Google Scholar
McKinzie, D. L. and Bymaster, F. P. (2012). Muscarinic mechanisms in psychotic disorders. Handb Exp Pharmacol, 213, 233–265.Google Scholar
Pei, Y., Asif-Malik, A., and Canales, J. J. (2016). Trace amines and the trace amine-associated receptor 1: pharmacology, neurochemistry, and clinical implications. Front Neurosci, 10, 148.Google Scholar
Dedic, N., Jones, P. G., Hopkins, S. C., et al. (2019). SEP-363856, a novel psychotropic agent with a unique, non-D2 receptor mechanism of action. J Pharmacol Exp Ther, 371, 1–14.Google Scholar
Meyer, J. M. (2020). Monitoring and improving antipsychotic adherence in outpatient forensic diversion programs. CNS Spectr, 25, 136–144.Google Scholar
Devinsky, O., Honigfeld, G., and Patin, J. (1991). Clozapine-related seizures. Neurology, 41, 369–371.Google Scholar
Pacia, S. V. and Devinsky, O. (1994). Clozapine-related seizures: experience with 5,629 patients. Neurology, 44, 2247–2249.Google Scholar
Vyas, P., Hwang, B. J., and Brasic, J. R. (2019). An evaluation of lumateperone tosylate for the treatment of schizophrenia. Expert Opin Pharmacother, 30, 1–7.Google Scholar
Mamo, D., Graff, A., Mizrahi, R., et al. (2007). Differential effects of aripiprazole on D(2), 5-HT(2), and 5-HT(1A) receptor occupancy in patients with schizophrenia: a triple tracer PET study. Am J Psychiatry, 164, 1411–1417.Google Scholar
Sparshatt, A., Taylor, D., Patel, M. X., et al. (2010). A systematic review of aripiprazole – dose, plasma concentration, receptor occupancy, and response: implications for therapeutic drug monitoring. J Clin Psychiatry, 71, 1447–1556.Google Scholar
Girgis, R. R., Slifstein, M., D’Souza, D., et al. (2016). Preferential binding to dopamine D3 over D2 receptors by cariprazine in patients with schizophrenia using PET with the D3/D2 receptor ligand [(11)C]-(+)-PHNO. Psychopharmacology (Berl), 233, 3503–3512.Google Scholar