scholarly journals Psychotropic Drugs Levels in Seminal Fluid: A New Therapeutic Drug Monitoring Analysis?

2021 ◽  
Vol 12 ◽  
Author(s):  
Rossella Mazzilli ◽  
Martina Curto ◽  
Donatella De Bernardini ◽  
Soraya Olana ◽  
Matilde Capi ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Seminal Fluid ◽  
Semen Analysis ◽  
Sperm Concentration ◽  
Psychotropic Medications ◽  
Therapeutic Drug ◽  
Progressive Motility ◽  
Drugs And Metabolites

The aim of this observational study was to develop a new quantitative liquid chromatography-mass spectrometry (LC-MS/MS) method for Therapeutic-Drug-Monitoring (TDM) of psychotropic drugs in seminal fluid to investigate potential gonadotoxic effects in patients with reduced fertility. After the validation of the LC-MS/MS method for psychotropics’ levels determination in seminal fluid, we included 20 male partners of infertile couples with idiopathic and/or unexplained male infertility, treated with psychotropic medications for more than 3 months and 10 untreated fertile controls. General and andrological clinical examination, semen analysis and seminal drugs, and metabolites levels determination were performed for each subject. Of the 20 patients included, 6 were treated with antidepressants; 4 with benzodiazepines and 10 with antipsychotics. Seminal drugs and metabolites levels were detectable in all samples. In particular, alprazolam, olanzapine, and levetiracetam showed seminal and serum similar concentrations, while fluoxetine, quetiapine, and aripiprazole were detectable, but seminal levels were significantly lower than the serum therapeutic range. Sperm progressive motility was significantly reduced in subjects treated with psychotropic drugs compared to the untreated controls (p = 0.03). Sperm concentration and progressive motility were significantly reduced in subjects treated with antipsychotics compared to the untreated controls and to the other classes of psychotropics (p < 0.05). In conclusion, this study reports a validated LC-MS/MS method for the detection of seminal psychotropic levels and preliminary data suggesting a potential correlation of seminal psychotropics with alterations of sperm concentration and motility. Pending larger studies, semen TDM might represent a new pivotal tool in the clinical management of reduced fertility in males treated with psychotropic medications.

The Complexity of Active Metabolites in Therapeutic Drug Monitoring of Psychotropic Drugs

2006 ◽  
Vol 39 (04) ◽  
pp. 121-127 ◽  
Author(s):  
M. Hendset ◽  
T. Haslemo ◽  
I. Rudberg ◽  
H. Refsum ◽  
E. Molden
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Active Metabolites

Pharmacokinetics and Therapeutic Drug Monitoring of Psychotropic Drugs in Pediatrics

2009 ◽  
Vol 31 (3) ◽  
pp. 283-318 ◽  
Author(s):  
Simona Pichini ◽  
Esther Papaseit ◽  
Xavier Joya ◽  
Oriol Vall ◽  
Magí Farré ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Therapeutic Drug

scholarly journals Use of therapeutic drug monitoring of risperidone microspheres long-acting injection in hemodialysis: A case report

2019 ◽  
Vol 9 (6) ◽  
pp. 404-407 ◽  
Author(s):  
Rebecca Tourtellotte ◽  
Robert Schmidt
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Plasma Concentrations ◽  
Psychotropic Medications ◽  
Therapeutic Drug ◽  
Optimal Dosing ◽  
Before And After ◽  
Long Acting ◽  
Stage Renal Disease ◽  
End Stage

Abstract Limited evidence exists for the use of psychiatric medications in patients with end-stage renal disease on hemodialysis. Many psychotropic medications are not well-studied in this population, and optimal dosing of these medications is not well-established. Therapeutic drug monitoring is a useful tool in assessing the safety and efficacy of psychotropic medications; however, the use is unclear with long-acting injectable antipsychotics. We present a case of a 73-year-old male initiated on hemodialysis while on risperidone microspheres long-acting injection (RMLAI). Risperidone and 9-hydroxyrisperidone plasma concentrations obtained from this patient were relatively similar before and after initiation of hemodialysis, therefore it appears hemodialysis does not significantly influence clearance of RMLAI. Plasma concentrations in this patient were higher than those reported in the literature for equivalent doses, which may indicate accumulation of the medication secondary to renal impairment.

scholarly journals Determination of Serum/Plasma Concentrations of Psychotropic Drugs in Therapeutic Drug Monitoring

2021 ◽  
pp. 3-13
Author(s):  
I. I. Miroshnichenko ◽  
N. V. Baymeeva ◽  
A. I. Platova
Keyword(s):  
Mental Health ◽  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Antipsychotic Drugs ◽  
Plasma Concentrations ◽  
Mental Health Research ◽  
Therapeutic Drug ◽  
Made In

The article considers the main methodological methods of therapeutic drug monitoring (TDM) of psychotropic drugs. Analytical methods that allow performing these studies have been described. It has been given the interpretation, examples and brief results of two studies of TDM of antipsychotic drugs made in FSBSI “Mental Health Research Center” and Psychiatric hospital No.14 in Moscow.

scholarly journals Managing Psychotropic Medications in Complex, Real-World Patients Using Comprehensive Therapeutic Drug Monitoring

2017 ◽  
Vol 8 (8) ◽  
pp. 1641-1644 ◽  
Author(s):  
Jeffrey J. Sutherland ◽  
Ryan D. Morrison ◽  
J. Scott Daniels ◽  
Stephen B. Milne ◽  
Timothy P. Ryan
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Real World ◽  
Drug Monitoring ◽  
Psychotropic Medications ◽  
Therapeutic Drug

scholarly journals Therapeutic Drug Monitoring of Second- and Third-Generation Antipsychotic Drugs—Influence of Smoking Behavior and Inflammation on Pharmacokinetics

2021 ◽  
Vol 14 (6) ◽  
pp. 514
Author(s):  
Nicole Moschny ◽  
Gudrun Hefner ◽  
Renate Grohmann ◽  
Gabriel Eckermann ◽  
Hannah B Maier ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Psychotropic Drugs ◽  
Drug Monitoring ◽  
Antipsychotic Drugs ◽  
Smoking Behavior ◽  
Mental Illnesses ◽  
Therapeutic Window ◽  
Therapeutic Drug ◽  
Third Generation ◽  
Drug Levels

Both inflammation and smoking can influence a drug’s pharmacokinetic properties, i.e., its liberation, absorption, distribution, metabolism, and elimination. Depending on, e.g., pharmacogenetics, these changes may alter treatment response or cause serious adverse drug reactions and are thus of clinical relevance. Antipsychotic drugs, used in the treatment of psychosis and schizophrenia, should be closely monitored due to multiple factors (e.g., the narrow therapeutic window of certain psychotropic drugs, the chronicity of most mental illnesses, and the common occurrence of polypharmacotherapy in psychiatry). Therapeutic drug monitoring (TDM) aids with drug titration by enabling the quantification of patients’ drug levels. Recommendations on the use of TDM during treatment with psychotropic drugs are presented in the Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology; however, data on antipsychotic drug levels during inflammation or after changes in smoking behavior—both clinically relevant in psychiatry—that can aid clinical decision making are sparse. The following narrative review provides an overview of relevant literature regarding TDM in psychiatry, particularly in the context of second- and third-generation antipsychotic drugs, inflammation, and smoking behavior. It aims to spread awareness regarding TDM (most pronouncedly of clozapine and olanzapine) as a tool to optimize drug safety and provide patient-tailored treatment.

Sign in / Sign up

Export Citation Format

Share Document