Relationship between serum concentration and clinical efficacy of aripiprazole in the treatment of patients with schizophrenia

Abstract

Abstract: AIM: To explore the relationship between serum concentration and clinical efficacy of aripiprazole in the treatment of patients with schizophrenia,and the suitable therapeutic window of aripiprazole.METHODS: Prospective study method was adopted.The dosages of aripiprazole were unfixed for eight weeks.The trough serum concentrations were determined by high performance liquid chromatography (HPLC).The clinical efficacy was evaluated with the Positive and Negative Syndrome Scale ( PANSS) and the Clinical Global Impression-Severity of Illnes (CGI-SI), side effects were done with the Treatment Emergent Symptom Scale(TESS).The optimized cutoff value of serum concentration was procured by the receiver operator curve (ROC), and the therapeutic window of aripiprazole was evaluated combining quartering interval.The correlation among serum concentration and dosage, therapeutic effect and side effect of aripiprazole were analyzed.RESULTS: 80 subjects were participated in the study, 47 cases were effective, 29 cases were ineffective, 4 cases were lost. The total side effect incidence rate was 32.5%.The trough serum concentration was significantly positive correlated with dosages, the decreasing ratios of PANSS scores and TESS scores,respectively, and the trough serum concentration was significantly negative correlated with CGI-SI scores.There was no significant correlation between dosages and therapeutic effect.The lowest effective trough serum concentration was 363 μg/L, the trough serum concentration threshold occurring side effects was 540 μg/L, the quartering interval of trough serum concentration in the effective group was 348-623 μg/L.The efficacy of aripiprazole was best and its side effects were mildest when serum aripiprazole levels were in the range of 350-540 μg/L.CONCLUSION: The serum concentration of aripiprazole in the treatment of patients with schizophrenia is correlated with clinical efficacy. The suitable therapeutic window for patients treated with aripiprazole is 350-540 μg/L.

Key words: Aripiprazole, Schizophrenia, Serum concentration, Clinical efficacy therapeutic window , , , ,

CLC Number:

R749.3

LI Jian-hua, ZHONG Hua, SHEN Wei-min, SUN Ju-shui, CHEN Hai-zhi, FAN Zhen-guo, LU Gui-hua. Relationship between serum concentration and clinical efficacy of aripiprazole in the treatment of patients with schizophrenia[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(1): 76-81.

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