From the Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.
J Clin Psychopharmacol. 2021;41(3):255-259. doi: 10.1097/JCP.0000000000001390.
This study aimed to investigate the combined effects of dose, age, sex, body weight, and smoking on plasma concentrations of olanzapine (OLA) and N-desmethyl olanzapine (DMO) in Chinese inpatients with schizophrenia.
A retrospective study including 185 inpatients was conducted. The steady-state plasma concentrations of OLA (COLA) and DMO (CDMO) were measured using high-performance liquid chromatography-tandem mass spectrometry. The combined effects of dose, age, sex, body weight, and smoking on COLA and CDMO were evaluated.
Multiple linear regression analyses revealed that dose, age, body weight, and smoking had significant effects on COLA and CDMO in inpatients with schizophrenia treated with OLA. The dose was the most important determinant of COLA and CDMO and was positively correlated with both. Furthermore, smokers exhibited a significantly lower COLA and COLA + DMO, whereas higher body weight led to the reduction of COLA, CDMO, and COLA + DMO. Advanced age was associated with lower CDMO.
These results suggest that dose, age, body weight, and smoking have a significant influence on the plasma concentration of OLA and its metabolite DMO. Clinicians should consider the combined effects when prescribing OLA to patients with schizophrenia.
本研究旨在探讨剂量、年龄、性别、体重和吸烟对中国精神分裂症住院患者奥氮平（OLA）和 N-去甲基奥氮平（DMO）血浆浓度的联合影响。
进行了一项回顾性研究，纳入了 185 名住院患者。使用高效液相色谱-串联质谱法测定 OLA（COLA）和 DMO（CDMO）的稳态血浆浓度。评估了剂量、年龄、性别、体重和吸烟对奥氮平治疗的精神分裂症住院患者 COLA 和 CDMO 的联合影响。
多元线性回归分析显示，剂量、年龄、体重和吸烟对奥氮平治疗的精神分裂症住院患者的 COLA 和 CDMO 有显著影响。剂量是 COLA 和 CDMO 的最重要决定因素，与两者均呈正相关。此外，吸烟者的 COLA 和 COLA+DMO 显著降低，而体重较高则导致 COLA、CDMO 和 COLA+DMO 降低。年龄较大与 CDMO 降低有关。
这些结果表明，剂量、年龄、体重和吸烟对奥氮平及其代谢物 DMO 的血浆浓度有显著影响。临床医生在给精神分裂症患者开奥氮平时应考虑这些联合作用。
