Psychiatry Research Center, HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Peking University, Beijing, China.
J Child Adolesc Psychopharmacol. 2023 Feb;33(1):27-33. doi: 10.1089/cap.2022.0068. Epub 2023 Feb 2.
To investigate the relationship between plasma aripiprazole (ARI) and its metabolite dehydroaripiprazole (DARI) concentrations and prolactin (PRL) levels in Chinese children and adolescents. This was a retrospective cross-sectional study and the data were collected at Beijing HuiLongGuan Hospital, a Beijing City owned psychiatric hospital, between January 1 and December 31, 2021. Fifty-two child and adolescent inpatients (17 males, 35 females) aged 13-18 years and received ARI regardless of diagnosis were included. The steady-state ARI and DARI plasma concentrations were measured using high-performance liquid chromatography-tandem mass spectrometry. The serum PRL levels were measured by chemiluminescence immunoassay. The plasma concentrations of ARI, DARI, and the total of ARI and DARI were negatively correlated with serum PRL levels in female children and adolescents. Approximately 15% of child and adolescent inpatients treated with ARI exhibited subnormal PRL serum levels. The results suggest that in addition to regularly monitoring PRL levels, therapeutic drug monitoring for ARI and its main metabolite DARI can help to mitigate the adverse medical consequences associated with PRL reduction. Thus, clinicians should consider the ARI-induced reduction of PRL levels when prescribing ARI to child and adolescent patients, particularly among females.
探讨中国儿童和青少年人群中阿立哌唑(ARI)及其代谢物脱氢阿立哌唑(DARI)的血浆浓度与催乳素(PRL)水平之间的关系。
这是一项回顾性的横断面研究,数据收集于 2021 年 1 月 1 日至 12 月 31 日期间的北京市回龙观医院。该医院是一家北京市属的精神病医院,共纳入了 52 名年龄在 13-18 岁之间、接受了无论何种诊断均使用阿立哌唑治疗的住院儿童和青少年患者(男性 17 名,女性 35 名)。采用高效液相色谱-串联质谱法测定稳态阿立哌唑和脱氢阿立哌唑的血浆浓度,采用化学发光免疫分析法测定血清催乳素水平。
女性儿童和青少年的阿立哌唑、脱氢阿立哌唑及二者总和的血浆浓度与血清催乳素水平呈负相关。大约 15%的接受阿立哌唑治疗的儿童和青少年住院患者存在血清催乳素水平降低。
除了定期监测催乳素水平外,对阿立哌唑及其主要代谢物脱氢阿立哌唑进行治疗药物监测有助于减轻与催乳素降低相关的不良医学后果。因此,临床医生在为儿童和青少年患者开具阿立哌唑处方时,特别是女性患者,应考虑到阿立哌唑引起的催乳素水平降低。