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PSYCHOPHARMACOLOGY/NEUROSCIENCE ROUNDS
September 18, 2008

 

Title:

Interpreting Atypical Antipsychotic Blood Levels

Presenter:

Charles F. Caley, Pharm.D., BCPP, Associate Clinical Professor, University of Connecticut, Storrs, CT; Clinical Psychopharmacology Consultant, Burlingame Research Center, The Institute of Living/Hartford Hospital

Location:

Hartford Room, The Commons Building, 2nd Floor, The Institute of Living/Hartford Hospital
200 Retreat Avenue, Hartford, CT 06106

Abstract:

Clinical practitioners occasionally find themselves in the situation of needing to measure atypical antipsychotic blood concentrations in order to either assess for medication compliance or for a drug–drug interaction. Thus, it is important to know the characteristics of atypical antipsychotic blood concentrations. Understanding when to order a blood level and how to interpret the information is an important clinical skill in order to optimally use this class of psychotropic medication.

Learning Objectives

The participants will be able to:

  • Understand the limitations of atypical antipsychotic blood levels

  • Know which atypical antipsychotic has a therapeutic range

  • Discuss the differences in the metabolism of the seven available atypical antipsychotics


Bibliography prepared by IOL Medical Library. Call 545-7276 for information.

 

Books

Csernansky JG & Lauriello J.  Atypical Antipsychotics: From Bench to Bedside.  Marcel Dekker, Inc., 2004.  QV 77.9 A8875.

 

Articles

<1>  Buckley PF.  Correll CU.  Strategies for dosing and switching antipsychotics for optimal clinical management. [Review] [60 refs]  Journal of Clinical Psychiatry.  69 Suppl 1:4-17, 2008.

<2>  de Leon J.  Beyond the "hype" on the association between metabolic syndrome and atypical antipsychotics: the confounding effects of cohort, typical antipsychotics, severe mental illness, comedications, and comorbid substance use.  Journal of Clinical Psychopharmacology.  28(2):125-31, 2008 Apr.  (ELECTRONIC FULL TEXT)

<3>  Dolder C et al.  Paliperidone for schizophrenia. [Review] [54 refs]  American Journal of Health-System Pharmacy.  65(5):403-13, 2008 Mar 1.  (ELECTRONIC FULL TEXT)

<4>  Wu RR et al.  Sex difference in effects of typical and atypical antipsychotics on glucose-insulin homeostasis and lipid metabolism in first-episode schizophrenia.  Journal of Clinical Psychopharmacology.  27(4):374-9, 2007 Aug.

<5>  Masand PS.  Differential pharmacology of atypical antipsychotics: clinical implications.  American Journal of Health-System Pharmacy.  64(2 Suppl 1):S3-8, 2007 Jan 15.  (ELECTRONIC FULL TEXT)

<6>  Fehsel K et al.  Clozapine induces oxidative stress and proapoptotic gene expression in neutrophils of schizophrenic patients.  Journal of Clinical Psychopharmacology.  25(5):419-26, 2005 Oct.

<7>  Knegtering R et al.  Predominant role of the 9-hydroxy metabolite of risperidone in elevating blood prolactin levels.  American Journal of Psychiatry.  162(5):1010-2, 2005 May.

<8>  Nasrallah HA.  Newcomer JW.  Atypical antipsychotics and metabolic dysregulation: evaluating the risk/benefit equation and improving the standard of care.  Journal of Clinical Psychopharmacology.  24(5 Suppl 1):S7-14, 2004 Oct.

<9>  Davis JM.  Chen N.  Dose response and dose equivalence of antipsychotics. [Review] [151 refs]  Journal of Clinical Psychopharmacology.  24(2):192-208, 2004 Apr.

<10> de Leon J.  Psychopharmacology: atypical antipsychotic dosing: the effect of co-medication with anticonvulsants.  Psychiatric Services.  55(2):125-8, 2004 Feb.

<11> Keith SJ et al.  Academic highlights: guidelines for the use of long-acting injectable atypical antipsychotics.  Journal of Clinical Psychiatry.  65(1):120-31, 2004 Jan.


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