Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4930783 | European Neuropsychopharmacology | 2016 | 9 Pages |
Abstract
Population pharmacokinetic analysis of lithium during therapeutic drug monitoring and drug compliance assessment was performed in 54 patients and 246 plasma concentrations levels were included in this study. Patients received several treatment cycles (1-9) and one plasma concentration measurement for each patient was obtained always before starting next cycle (pre-dose) at steady state. Data were analysed using the population approach with NONMEM version 7.2. Lithium measurements were described using a two-compartment model (CL/F=0.41Â LÂ hâ1, V1/F=15.3Â L, Q/F=0.61Â LÂ hâ1, and V2/F = 15.8Â L) and the most significant covariate on lithium CL was found to be creatinine clearance (reference model). Lithium compliance was analysed using inter-occasion variability or Markovian features (previous lithium measurement as ordered categorical covariate) on bioavailability parameter. Markov-type model predicted the lithium compliance in the next cycle with higher success rate (79.8%) compared to IOV model (65.2%) and reference model (43.2%). This model becomes an efficient tool, not only being able to adequately describe the observed outcome, but also to predict the individual drug compliance in the next cycle. Therefore, Bipolar disorder patients can be classified regarding their probability to become extensive or poor compliers in the next cycle and then, individual probabilities lower than 0.5 highlight the need of intensive monitoring, as well as other pharmaceutical care measurements that might be applied to enhance drug compliance for a better and safer lithium treatment.
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Biological Psychiatry
Authors
Isabel Pérez-Castelló, VÃctor Mangas-Sanjuan, Ignacio González-GarcÃa, Isabel Gonzalez-Alvarez, Marival Bermejo, Jose Luis Marco-Garbayo, Iñaki F. Trocóniz,