唾液中バルプロ酸（ＶＰＡ）濃度測定による在宅ＴＤＭの試み（１）

Abstract

In the present study, we examined the clinical significance and utility of measuring salivary valproic acid (VPA) levels in saliva samples taken at patients' homes for therapeutic drug monitoring (TDM). The subjects were 74 patients (33 males and 41 females ; mean age 30.8 ± 1.9 years) under treatment at Outpatient Clinic, Department of Neuropsychiatry, Fukushima Medical University Hospital. For the VPA measurements, saliva samples and blood samples were taken at the Outpatient clinic simultaneously. Salivary VPA levels showed significant correlations with total and free VPA serum concentrations (r=0.71 and r=0.77, respectively) but were not significantly correlated with serum albumin concentration or salivary pH.From a preliminary experiment that we conducted, salivary VPA levels were found to remain stable when saliva samples were kept in home freezers at 4 and -20°C.Based upon the above results, we concluded that TDM based on measurements on saliva samples taken by patients receiving VPA has significant clinical utility because 1) saliva sampling is less invasive than blood sampling and easy to carry out for patients who do not wish their blood to be taken, 2) saliva sampling at home is convenient because either patients or their family members can take the samples and 3) samples taken at home can accurately show VPA levels as they are in everyday life.