Ngamsamut Nattawat, Hongkaew Yaowaluck, Vanwong Natchaya, Srisawasdi Pornpen, Puangpetch Apichaya, Chamkrachangpada Bhunnada, Tan-Khum Theerarat, Limsila Penkhae, Sukasem Chonlaphat
Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, Samut Prakan, Thailand.
Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Basic Clin Pharmacol Toxicol. 2016 Sep;119(3):267-72. doi: 10.1111/bcpt.12570. Epub 2016 Mar 18.
Although our previous study revealed an association between prolactin level and risperidone dosage, data regarding the plasma concentration of risperidone are lacking. Therefore, this study aimed to investigate the association between plasma drug concentrations of risperidone, 9-hydroxyrisperidone and serum prolactin level in Thai children and adolescents with autism spectrum disorder (ASD). The individuals for this study were 103 children and adolescents with ASD (90 males and 13 females). In the 12th hour after the last risperidone dose, blood samples were collected for analysis. Serum prolactin, plasma risperidone and 9-hydroxyrisperidone levels were measured. Patients' clinical data were collected from medical records - age, weight, height, body mass index, dose of risperidone and duration of treatment. Serum prolactin level was significantly positively correlated with plasma 9-hydroxyrisperidone level (rs = 0.355, p < 0.001). The median concentration of 9-hydroxyrisperidone in individuals with hyperprolactinaemia (7.59 ng/ml; IQR 4.86-15.55) was significantly higher than non-hyperprolactinaemic individuals (5.18 ng/ml; IQR 2.10-8.99) after risperidone treatment (p = 0.006). By multivariate analysis, high prolactin level was correlated to high 9-hydroxyrisperidone level (p = 0.010). The results of this study showed that serum prolactin levels, especially in autistic individuals with hyperprolactinaemia during risperidone treatment, were significantly correlated with the level of 9-hydroxyrisperidone. These results suggest that hyperprolactinaemia may develop during risperidone treatment.
尽管我们之前的研究揭示了催乳素水平与利培酮剂量之间的关联，但关于利培酮血浆浓度的数据仍很缺乏。因此，本研究旨在调查泰国自闭症谱系障碍（ASD）儿童和青少年中利培酮、9-羟基利培酮的血浆药物浓度与血清催乳素水平之间的关联。本研究的对象为103名患有ASD的儿童和青少年（90名男性和13名女性）。在最后一剂利培酮给药后12小时采集血样进行分析。测定血清催乳素、血浆利培酮和9-羟基利培酮水平。患者的临床数据从病历中收集——年龄、体重、身高、体重指数、利培酮剂量和治疗持续时间。血清催乳素水平与血浆9-羟基利培酮水平呈显著正相关（rs = 0.355，p < 0.001）。利培酮治疗后，高催乳素血症患者的9-羟基利培酮中位浓度（7.59 ng/ml；IQR 4.86 - 15.55）显著高于非高催乳素血症患者（5.18 ng/ml；IQR 2.10 - 8.99）（p = 0.006）。通过多变量分析，高催乳素水平与高9-羟基利培酮水平相关（p = 0.010）。本研究结果表明，血清催乳素水平尤其是在利培酮治疗期间患有高催乳素血症的自闭症患者中，与9-羟基利培酮水平显著相关。这些结果表明，在利培酮治疗期间可能会出现高催乳素血症。
