title: Novel Atypical Antipsychotics: Metabolism and Therapeutic Drug Monitoring (TDM).
abstract: Medicinal chemistry is continually developing and testing new drugs and drug candidates to satisfactorily address the needs of patients suffering from schizophrenia. In the last few years, some significant additions have been made to the list of widely available atypical antipsychotics. In particular, iloperidone, asenapine and lurasidone have been approved by the USA's Food and Drug Administration in 2009-10. In this paper, the most notable metabolic characteristics of these new drugs are addressed, with particular attention to their potential for pharmacokinetic interactions, and to the respective advantages and disadvantages in this regard. Moreover, current perspectives on the therapeutic drug monitoring (TDM) of the considered drugs are discussed. Since TDM is most valuable when it allows the personalisation and optimisation of therapeutic practices, it is even more interesting in the case of novel drugs, such as those discussed here, whose real impact in terms of side and toxic effects on very large populations is still unknown. Some analytical notes, related to TDM application, are included for each drug.
authors.affiliation: Alma Mater Studiorum - University of Bologna, Department for Life Quality Studies (QuVi), Corso d'Augusto 237, 47921 Rimini, Italy. roberto.mandrioli@unibo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mandrioli
authors.forename: Michele
authors.initials: M
authors.lastname: Protti
authors.forename: Laura
authors.initials: L
authors.lastname: Mercolini
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003986:Dibenzocycloheptenes; D017277:Drug Approval; D015195:Drug Design; D016903:Drug Monitoring / Q000379:methods*; D006576:Heterocyclic Compounds, 4 or More Rings / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069056:Lurasidone Hydrochloride / Q000493:pharmacokinetics / Q000627:therapeutic use; D010880:Piperidines / Q000493:pharmacokinetics / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; D007555:Isoxazoles; D010880:Piperidines; C522667:asenapine; D000069056:Lurasidone Hydrochloride; C081732:iloperidone