A systematic review and combined analysis of therapeutic drug monitoring studies for longacting risperidone

Schoretsanitis, Georgios; Spina, Edoardo; Hiemke, Christoph; de Leon, Jose (2017). A systematic review and combined analysis of therapeutic drug monitoring studies for longacting risperidone. Expert review of clinical pharmacology, 10(9), pp. 965-981. Taylor & Francis 10.1080/17512433.2017.1345623

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Introduction: This systematic review of therapeutic drug monitoring (TDM) identifies three long-acting injectable (LAI) risperidone formulations. Areas covered: Limited data is available on two formulations (RBP-7000 and in Situ Microparticle), but 20 TDM articles on the microsphere formulation were found. Risperidone TDM includes the serum concentrations of risperidone and its active metabolite, 9-hydroxyrisperidone, used for calculating: 1) the risperidone/9-hydroxyrisperidone (R/9-OH-R) ratio (a measure of CYP2D6; values >1 are indicative of a CYP2D6 poor metabolizer) and 2) the total risperidone concentration-to-dose (C/D) ratio (a measure of risperidone clearance with a normal value around 7 in oral risperidone). The weighted mean R/9-OH-R ratio was 0.48 (approximately twice that of oral risperidone TDM) in a combined analysis from 329 patients in 6 risperidone LAI studies without major confounders. The total C/D ratios from 297 patients in 6 risperidone LAI studies ranged from 7.4 to 9.7 ng/ml/mg/day with a weighted mean of 8.8 ng/ml/mg/day. Expert commentary: Clinicians using TDM for risperidone LAI microsphere formulation need to: 1) consider steady state to be reached ≥ 6 weeks after the first injection, 2) pay attention to a) comedications with inducers/inhibitors, b) severe inflammations/infections, and c) hepatic/renal impairment, and 3) use Castberg’s recommendation to calculate risperidone dosing.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy

UniBE Contributor:

Schoretsanitis, Georgios

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1751-2433

Publisher:

Taylor & Francis

Language:

English

Submitter:

Georgios Schoretsanitis

Date Deposited:

28 Feb 2018 09:18

Last Modified:

25 Oct 2019 20:42

Publisher DOI:

10.1080/17512433.2017.1345623

PubMed ID:

28699847

BORIS DOI:

10.7892/boris.108504

URI:

https://boris.unibe.ch/id/eprint/108504

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