Результаты проведения терапевтического лекарственного мониторинга галоперидола у пациентов с алкогольными психозами и шизофренией

Abstract

The purpose of the study: was to conduct therapeutic drug monitoring in two groups of patients with different nosology (schizophrenia and alcoholic psychosis) taking haloperidol (HAL) in different drug forms, evaluate the distribution of HAL concentrations relative to the therapeutic range, compare the concentration-dose ratio data and make recommendations for personalized pharmacotherapy patients of these groups. Material and methods: Dur ing this study, clinical , pathological and psychometr ic approaches were used. The concentration of haloperidol was determined by high-performance liquid chromatography in combination with mass-spectrometry. Group A — male patients whose age were 30,02 ± 6,9 years; group B also included male patients whose age were 40,54 ± 9,34 years. Group B was divided into subgroups, where some patients took tablet form of GAL, whereas others received therapy in the form of infusions. The exclusion criterion was overweight and the presence of infectious diseases (HIV, hepatitis, liver disease). Inclusion criteria were a signed voluntary informed consent, clinical diagnosis and the absence of somatic diseases. Concomitant therapy in groupsA and B was different. Results: In group A, indicators of measured concentrations were in the subtherapeutic range — 18,2%, therapeutic — 54,5%, conditionally toxic range — 27,3%. In group B — for the infusion form of HAL in the subtherapeutic range were 51,6% of the measured concentrations, in the therapeutic range — 48,4%, in the conditionally toxic — 0,0%; for the tablet form, the distri-bution was as follows — 69,2% in the subtherapeutic range, 30,8% in the therapeutic range, in the conditionally toxic range no concentration indicators were recorded. Conclusion: This study has shown a significant difference between normalized concentrations when comparing indicators from the group of patients with schizophrenia to the patients from the group B, who took the tablet form. That observation allows usto conclude that significant effect on the biotransformation of GAL can have a comedic effect from inducer of the C3A4 isoform of the cytochrome R450 — carbamazepine, while the concomitant therapy in the group A included atypical antipsychotics that did not affect this enzyme.