title: [Plasma levels of antipsychotics and the severity of side-effects in the treatment of schizophrenia exacerbation].
abstract: OBJECTIVE
  To study a relationship between plasma levels of antipsychotics (AP) and severity of side-effects (SE) during the treatment of inpatients with exacerbation of schizophrenia.
  
  
  METHODS
  The study included 39 patients treated with risperidone, haloperidol, zuclopenthixol, clozapine, aripiprazole or olanzapine as monotherapy or in combination of two AP. Blood sampling to measure the AP plasma level was performed twice (at 7-10 and 26-30 day from start of treatment), the levels of prolactin and glucose were determined once (at 26-30 day from start of treatment). Patients were assessed by psychometric scales PANSS and NSA and the side-effects scale UKU.
  
  
  RESULTS
  The increased concentration of AP was noted in 33% of the patients. The high concentration of AP was significantly associated with akathisia and hyperkinesia (by UKU scale), NSA retardation factor and hyperprolactinemia. Patients with severe hyperprolactinemia were twice as likely to have a clinically significant depression. Increased blood glucose levels were observed in 18% of the patients, there was no significant association with AP plasma levels. Mental SE were most prominent, with a drift towards the neurological SE in the group with higher AP plasma levels. Chlorpromazine equivalent didn't significantly differ in the groups with normal, high and low AP concentrations.
  
  
  CONCLUSIONS
  Elevated AP plasma levels, which were associated with some clinically significant SE and some negative symptoms, were found in most patients. In this regard, therapeutic drug monitoring is a promising method for the individualization of schizophrenia exacerbation treatment in routine clinical practice.
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: S S
authors.initials: SS
authors.lastname: Potanin
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: D S
authors.initials: DS
authors.lastname: Burminskiy
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: M A
authors.initials: MA
authors.lastname: Morozova
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Platova
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: N V
authors.initials: NV
authors.lastname: Baymeeva
authors.affiliation: Mental Health Research Centre, Moscow, Russia.
authors.forename: I I
authors.initials: II
authors.lastname: Miroshnichenko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000097:blood* / Q000627:therapeutic use; D000068180:Aripiprazole / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D003024:Clozapine / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced / Q000175:diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011388:Prolactin / Q000097:blood; D018967:Risperidone / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D001569:Benzodiazepines; D000068180:Aripiprazole; D011388:Prolactin; D003024:Clozapine; D006220:Haloperidol; D018967:Risperidone; D000077152:Olanzapine