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Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders

OBJECTIVE: Therapeutic drug monitoring helps clinicians in choosing the right drug and adjust its dose in specific patients. To this end, we aimed to assess time patterns of risperidone and its metabolite, 9-hydroxyrisperidone, in children and adolescents with oppositional defiant and/or conduct dis...

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Autores principales: Piacentino, Daria, Kotzalidis, Georgios D., Schoretsanitis, Georgios, Paulzen, Michael, Haen, Ekkehard, Cappelletti, Simone, Giupponi, Giancarlo, Grözinger, Michael, Conca, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean College of Neuropsychopharmacology 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006987/
https://www.ncbi.nlm.nih.gov/pubmed/31958904
http://dx.doi.org/10.9758/cpn.2020.18.1.41
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author Piacentino, Daria
Kotzalidis, Georgios D.
Schoretsanitis, Georgios
Paulzen, Michael
Haen, Ekkehard
Cappelletti, Simone
Giupponi, Giancarlo
Grözinger, Michael
Conca, Andreas
author_facet Piacentino, Daria
Kotzalidis, Georgios D.
Schoretsanitis, Georgios
Paulzen, Michael
Haen, Ekkehard
Cappelletti, Simone
Giupponi, Giancarlo
Grözinger, Michael
Conca, Andreas
author_sort Piacentino, Daria
collection PubMed
description OBJECTIVE: Therapeutic drug monitoring helps clinicians in choosing the right drug and adjust its dose in specific patients. To this end, we aimed to assess time patterns of risperidone and its metabolite, 9-hydroxyrisperidone, in children and adolescents with oppositional defiant and/or conduct disorder. METHODS: We measured plasma concentrations of risperidone and 9-hydroxyrisperidone, their sum (active moiety, AM) and ratio, as well as plasma concentrations corrected for daily dose (C/D), from 140 children/adolescents with the above-mentioned disorders. We used Student’s t test to compare females versus males, patients under versus over 16-year-old, patients with lower versus higher than the median body weight, and patients with lower versus higher than the median body mass index (BMI). Two mixed-effects logistic regression models were fitted for risperidone/9-hydroxyrisperidone ratio and AM, respectively, by considering risperidone daily dose and patients’ demographic characteristics. RESULTS: Females had higher 9-hydroxyrisperidone and AM plasma concentrations than males (p = 0.004 and p = 0.034). Younger patients had lower risperidone plasma concentration and risperidone/9-hydroxyrisperidone ratio (p = 0.02 and p = 0.021), but higher C/D 9-hydroxyrisperidone and AM than older patients (p = 0.013 and p = 0.043). Lower-weight patients had lower plasma risperidone and risperidone/9-hydroxyrisperidone ratio (p = 0.014 and p = 0.019), but higher C/D 9-hydroxyrisperidone concentration than heavier patients (p = 0.03). All these results could be accounted for by daily dose. Patients with lower and higher BMI did not differ significantly. Regression analyses showed that only risperidone daily dose predicted risperidone/9-hydroxyrisperidone ratio, whereas risperidone daily dose, sex, and age predicted AM. CONCLUSION: Clinicians prescribing risperidone need to consider sex, age, and weight, but not BMI when adjusting daily doses.
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spelling pubmed-70069872020-02-20 Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders Piacentino, Daria Kotzalidis, Georgios D. Schoretsanitis, Georgios Paulzen, Michael Haen, Ekkehard Cappelletti, Simone Giupponi, Giancarlo Grözinger, Michael Conca, Andreas Clin Psychopharmacol Neurosci Original Article OBJECTIVE: Therapeutic drug monitoring helps clinicians in choosing the right drug and adjust its dose in specific patients. To this end, we aimed to assess time patterns of risperidone and its metabolite, 9-hydroxyrisperidone, in children and adolescents with oppositional defiant and/or conduct disorder. METHODS: We measured plasma concentrations of risperidone and 9-hydroxyrisperidone, their sum (active moiety, AM) and ratio, as well as plasma concentrations corrected for daily dose (C/D), from 140 children/adolescents with the above-mentioned disorders. We used Student’s t test to compare females versus males, patients under versus over 16-year-old, patients with lower versus higher than the median body weight, and patients with lower versus higher than the median body mass index (BMI). Two mixed-effects logistic regression models were fitted for risperidone/9-hydroxyrisperidone ratio and AM, respectively, by considering risperidone daily dose and patients’ demographic characteristics. RESULTS: Females had higher 9-hydroxyrisperidone and AM plasma concentrations than males (p = 0.004 and p = 0.034). Younger patients had lower risperidone plasma concentration and risperidone/9-hydroxyrisperidone ratio (p = 0.02 and p = 0.021), but higher C/D 9-hydroxyrisperidone and AM than older patients (p = 0.013 and p = 0.043). Lower-weight patients had lower plasma risperidone and risperidone/9-hydroxyrisperidone ratio (p = 0.014 and p = 0.019), but higher C/D 9-hydroxyrisperidone concentration than heavier patients (p = 0.03). All these results could be accounted for by daily dose. Patients with lower and higher BMI did not differ significantly. Regression analyses showed that only risperidone daily dose predicted risperidone/9-hydroxyrisperidone ratio, whereas risperidone daily dose, sex, and age predicted AM. CONCLUSION: Clinicians prescribing risperidone need to consider sex, age, and weight, but not BMI when adjusting daily doses. Korean College of Neuropsychopharmacology 2020-02 2020-02-29 /pmc/articles/PMC7006987/ /pubmed/31958904 http://dx.doi.org/10.9758/cpn.2020.18.1.41 Text en Copyright © 2020, Korean College of Neuropsychopharmacology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Piacentino, Daria
Kotzalidis, Georgios D.
Schoretsanitis, Georgios
Paulzen, Michael
Haen, Ekkehard
Cappelletti, Simone
Giupponi, Giancarlo
Grözinger, Michael
Conca, Andreas
Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title_full Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title_fullStr Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title_full_unstemmed Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title_short Plasma Risperidone-related Measures in Children and Adolescents with Oppositional Defiant/Conduct Disorders
title_sort plasma risperidone-related measures in children and adolescents with oppositional defiant/conduct disorders
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006987/
https://www.ncbi.nlm.nih.gov/pubmed/31958904
http://dx.doi.org/10.9758/cpn.2020.18.1.41
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