Abstract
Although blood is the basic test material to monitor levels of antipsychotic drugs in a person’s system, saliva could serve as a more convenient test material. Therefore, the aim of this novel study was to determine the correlations between the salivary levels of olanzapine and quetiapine (and their metabolites: N-demethyl olanzapine and norquetiapine) and the patient’s sex and age, dose level, and the time of sampling. The study involved two groups of patients: 21 female patients starting treatment immediately after being admitted to the hospital and 36 male and female nursing home residents, long-time users of the studied drugs. Women had lower levels of the tested analytes than men. Quetiapine levels in the saliva of people starting the treatment showed a positive correlation with the age of the patients and a strong positive correlation with the dose level. The saliva levels of olanzapine showed a strong correlation with its metabolite in patients who had recently started treatment. Among long-time users of this drug, salivary levels differed significantly before and after administration. In conclusion, the results indicate that there is a possibility of using saliva as a material for monitoring quetiapine or olanzapine concentrations, especially in people starting treatment.
Highlights
Olanzapine and quetiapine belong to the second-generation of antipsychotics, the most frequently applied drugs in personality disorders
In the case of people regularly treated with olanzapine or quetiapine for several years, samples were taken twice a day for 14 days—15 min before administration and about 2 h after its application
Blood quetiapine levels are known to weakly correlate with the dose of the drug [16,17,18], Spearman’s rank correlation in our study showed a strong positive correlation between the dose and the concentrations of quetiapine and its metabolite in saliva
Summary
Olanzapine and quetiapine belong to the second-generation of antipsychotics, the most frequently applied drugs in personality disorders. The values are 9% and 1.5 h, respectively. Both drugs give a quick healing effect and improve the patient’s emotional state and cause a smaller number of side effects than the previous generations of antipsychotics. Due to the frequent use of polypharmacy and the high risk of side effects when maximum doses are used [1], it is advisable to constantly monitor both side effects and drug concentrations in patients. It should be remembered that levels of the drug in the blood may vary according to the dose used, and the sex, age, or weight of the patient
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