1Psychopharmacology Resource Network, California Dept. of State Hospitals,Patton, California,USA.
CNS Spectr. 2017 Dec;22(S1):14-28. doi: 10.1017/S1092852917000840.
There has been increasing recognition that antipsychotic nonadherence is common across all stages of schizophrenia, starting from the first episode. Moreover, numerous meta-analyses of the existing literature indicate superiority of long-acting injectable (LAI) over oral antipsychotics when one adjusts for the greater illness severity and duration among patients in LAI antipsychotic trials. The increasing availability of LAI antipsychotic options has raised interest in converting patients from oral medication; however, the successful transition from oral to the comparable LAI antipsychotic requires an understanding of the current extent of antipsychotic exposure, the kinetics of the LAI preparation, and the expected plasma levels achieved by the LAI formulation. The purpose of this article is to provide, in a concise format, the essential information for converting patients to the LAI forms of haloperidol, fluphenazine, risperidone, paliperidone, olanzapine, and aripiprazole from the comparable oral medication, and how the use of plasma antipsychotic levels can be invaluable for this process.
人们越来越认识到，抗精神病药的不依从在精神分裂症的所有阶段都很常见，从首次发作开始就是如此。此外，对现有文献的大量荟萃分析表明，在调整接受长效注射（LAI）抗精神病药物治疗的患者的疾病严重程度和持续时间后，长效注射抗精神病药物优于口服抗精神病药物。越来越多的长效注射抗精神病药物选择增加了人们对将患者从口服药物转换的兴趣；然而，要成功地从口服药物转换为等效的长效注射抗精神病药物，需要了解当前的抗精神病药物暴露程度、LAI 制剂的动力学以及 LAI 制剂达到的预期血浆水平。本文的目的是以简洁的格式提供将患者从可比的口服药物转换为氟哌啶醇、氟奋乃静、利培酮、帕利哌酮、奥氮平、阿立哌唑的 LAI 形式的基本信息，以及如何使用血浆抗精神病药物水平对此过程非常有价值。
