Clinical pharmacokinetics of antipsychotics in pediatric populations: a scoping review focusing on dosing regimen.

Autor:	Liang J; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Maasstad Hospital, Rotterdam, the Netherlands., Ringeling LT; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands., Hermans RA; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands., Bayraktar I; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands., Bosch TM; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Maasstad Hospital, Rotterdam, the Netherlands.; Department of Clinical Pharmacology & Toxicology, Maasstad Lab, Maasstad Hospital, Rotterdam, the Netherlands., Egberts KM; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany., Kloosterboer SM; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands., de Winter B; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands., Dierckx B; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands., Koch BCP; Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Expert opinion on drug metabolism & toxicology [Expert Opin Drug Metab Toxicol] 2023 Jul-Dec; Vol. 19 (8), pp. 501-509. Date of Electronic Publication: 2023 Sep 12.
DOI:	10.1080/17425255.2023.2252340
Abstrakt:	Introduction: Achieving optimal clinical responses and minimizing side effects through precision dosing of antipsychotics in children and adolescents with psychiatric disorders remains a challenge. Identifying patient characteristics (covariates) that affect pharmacokinetics can inform more effective dosing strategies and ultimately improve patient outcomes. This review aims to provide greater insight into the impact of covariates on the clinical pharmacokinetics of antipsychotics in pediatric populations. Areas Covered: A comprehensive literature search was conducted, and the main findings regarding the effects of the covariates on the pharmacokinetics of antipsychotics in children and adolescents are presented. Expert Opinion: Our study highlights significant covariates, including age, sex, weight, CYP2D6 phenotype, co-medication, and smoking habits, which affect the pharmacokinetics of antipsychotics. However, the findings were generally limited by the small sample sizes of naturalistic, open-label, observational studies, and the homogeneous subgroups. Dosing based on weight and preemptive genotyping could prove beneficial for optimizing the dosing regimen in pediatric populations. Future research is needed to refine dosing recommendations and establish therapeutic reference ranges critical for precision dosing and Therapeutic Drug Monitoring (TDM). The integration of individual patient characteristics with TDM can further optimize the efficacy and safety of antipsychotics for each patient.
Databáze:	MEDLINE
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