Advances in psychotropic formulations.
BACKGROUND
Successful pharmacotherapy is dependent on several factors. While efficacy is obviously important, other factors that are often overlooked include the availability of optimal dosage forms, treatment compliance and reduction in side effects. A number of innovative delivery systems have been developed to address suboptimal therapy outcomes by enhancing drug delivery, assuring efficacy of treatment, reducing side effects, and improving compliance.


OBJECTIVE
The purpose of this review is to discuss the advances in formulations for various psychotropic agents that have been developed for the treatment of psychiatric illnesses such as depression, attention deficit hyperactivity disorder, schizophrenia and other psychotic disorders.


METHODS
Information was identified via a MEDLINE and EMBASE search of data published between 2002 and 2005 with keywords 'psychotropic', 'atypical antipsychotic', 'antidepressant' or 'anxiolytic' in combination with 'new/novel/advanced formulation/delivery/technology', or 'controlled release/extended release', or 'fast-acting/fast-dissolving/orodispensible', or 'intramuscular/inject'.


RESULTS
In antidepressant therapy, formulations that allow extended release for once-daily and even once-weekly administration, orally disintegrating tablets, and transdermal systems have all been introduced. Long-acting central nervous system stimulants for the treatment of attention deficit hyperactivity disorder eliminate the need for multiple dosing. A number of new formulations of atypical antipsychotic agents have become available, offering important alternatives in certain patient groups. These include rapid-acting intramuscular injections, liquid formulations, and fast-dissolving tablets, all of which are useful options in the acute treatment setting as well as for geriatric and/or pediatric populations. Furthermore, formulations that deliver sustained levels of medications, including a long-acting antipsychotic and a new extended-release oral formulation, are important new developments that may improve compliance and offer efficacy and safety benefits in long-term management.


CONCLUSIONS
New formulations of psychotropics can offer advantages over older formulations in terms of convenience, side-effect profiles, efficacy, and/or a fast onset of action. Treatment-related factors can help to enhance patient's satisfaction with treatment and compliance, thereby improving patient prognosis and outcomes in both acute and outpatient management.
Keith
Samuel
S
Department of Psychiatry and Psychology, University of New Mexico, 2400 Tucker, NE Room 404, Albuquerque, 87131, USA. SKeith@salud.unm.edu