Serum concentrations and side effects in psychiatric patients during risperidone therapy.
Steady state serum concentrations of risperidone and 9-hydroxyrisperidone (9-OH-risperidone), the active moiety, were measured in 42 patients. The concentration-to-dose ratios (C/D) varied by a factor of 20, from 1.8 to 36.8 (nmol/l)/(mg/24 hours), and 90% of the active moiety was constituted of 9-OH-risperidone. No correlation between the serum concentration of the active moiety and the side effects evaluated by the UKU Side Effect Scale was found. The absence of CYP2D6 (poor metabolizers) or the coadministration of drugs other than benzodiazepines increased the ratio between parent compound and metabolite but did not significantly influence the C/D of the total active moiety. A therapeutic range for serum risperidone has not been established, but 6 mg/day is considered the optimum dose for most patients. The authors found that in 90% of 22 patients administered 6 mg/day risperidone, the serum levels were within 50 to 150 nmol/l.
Institute for Basic Psychiatric Research, Department of Biological Psychiatry, Aarhus University Hospital, Risskov, Denmark.
O V
OV
Olesen
R W
RW
Licht
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E
Thomsen
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T
Bruun
J E
JE
Viftrup
K
K
Linnet
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000097:blood* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D019389:Cytochrome P-450 CYP2D6 / Q000378:metabolism; D004347:Drug Interactions; D005260:Female; D005838:Genotype; D006801:Humans; D007555:Isoxazoles / Q000097:blood; D008297:Male; D008875:Middle Aged; D000068882:Paliperidone Palmitate; D011619:Psychotropic Drugs / Q000494:pharmacology; D011743:Pyrimidines / Q000097:blood; D018967:Risperidone / Q000009:adverse effects* / Q000097:blood* / Q000627:therapeutic use
D014150:Antipsychotic Agents; D007555:Isoxazoles; D011619:Psychotropic Drugs; D011743:Pyrimidines; D019389:Cytochrome P-450 CYP2D6; D018967:Risperidone; D000068882:Paliperidone Palmitate