ABSTRACT
A highly feasible and reliable ultra-high performance liquid chromatography tandem mass spectrometry method was presented for therapeutic drug monitoring of five anti-schizophrenic drugs (amisulpride, olanzapine, aripiprazole, paliperidone and ziprasidone) simultaneously. To meet the requirements of practical clinical usage (easy handling, high throughput and cost effectiveness), the pretreatment process was simplified (only including protein precipitation and mobile phase dilution steps) and the UPLC separation cycle was set within 6 min. The whole methodology was carefully validated according to the latest international guidelines showing the excellent selectivity, accuracy, precision, applicability and stability. After a 10 month clinical application, a retrospective analysis of 253 positive samples was carried out to investigate conformance with the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie therapeutic reference range for Chinese patients. The results suggested good consistency for olanzapine, aripiprazole, paliperidone and ziprasidone, while for amisulpride, the plasma concentration level (445.2 ± 231.5 ng/mL) was relatively higher than the recommended range (100-320 ng/mL). We supposed that such phenomenon indicated the necessity of reconstructing a Chinese-specific therapeutic reference range for amisulpride treatment, which would be helpful to improve medication efficiency and safety for Chinese patients.
Subject(s)
Antipsychotic Agents/blood , Aripiprazole/blood , Benzodiazepines/blood , Drug Monitoring/methods , Paliperidone Palmitate/blood , Piperazines/blood , Thiazoles/blood , Adult , China , Chromatography, High Pressure Liquid/methods , Female , Humans , Limit of Detection , Male , Middle Aged , Olanzapine , Reference Values , Tandem Mass Spectrometry/methods , Young AdultABSTRACT
The high incidence of schizophrenia causes a greater burden on society and family. In the past of half century, with the widespread use of schizophrenic drugs,the prognosis of clinical schizophrenia has been substantially improved after following the principles of early, effective and maintenance therapy.In this overview,the clinical characteristics at different stages of disease progression with the recent advances in drug therapy of schizophrenia was combined, to introduce clinical selection of schizophrenic drugs.
ABSTRACT
The high incidence of schizophrenia causes a greater burden on society and family. In the past of half century, with the widespread use of schizophrenic drugs,the prognosis of clinical schizophrenia has been substantially improved after following the principles of early, effective and maintenance therapy.In this overview,the clinical characteristics at different stages of disease progression with the recent advances in drug therapy of schizophrenia was combined, to introduce clinical selection of schizophrenic drugs.
