A population approach to characterise amisulpride pharmacokinetics in older people and Alzheimer's disease.

Introduction: Current prescribing guidelines for the antipsychotic amisulpride are based largely on pharmacokinetic (PK) studies in young adults, and there is a relative absence of data on older patients, who are at greatest risk of developing adverse events. Methods: This study aimed to develop a p...

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Detalles Bibliográficos
Publicado en:Psychopharmacology Vol. 233; no. 18; pp. 3371 - 3382
Autores principales: Reeves, Suzanne, Bertrand, Julie, D'Antonio, Fabrizia, McLachlan, Emma, Nair, Akshay, Brownings, Stuart, Greaves, Suki, Smith, Alan, Taylor, David, Howard, Robert
Formato: Journal Article
Publicado: Springer Nature Sep2016
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:Introduction: Current prescribing guidelines for the antipsychotic amisulpride are based largely on pharmacokinetic (PK) studies in young adults, and there is a relative absence of data on older patients, who are at greatest risk of developing adverse events. Methods: This study aimed to develop a population PK model for amisulpride specifically in older people, by combining data from a richly sampled phase 1, single (50 mg) dose study in healthy older people ( n = 20, 65-79 years), with a clinical dataset obtained during off label, low-dose (25-75 mg daily) amisulpride prescribing in older people with Alzheimer's disease (AD) ( n = 25, 69-92 years), as part of an observational study. Results: After introducing a scaling factor based on body weight, age accounted for 20 % of the inter-individual variability in drug clearance (CL), resulting in a 54 % difference in CL between those aged 65 and those aged 85 years, and higher blood concentrations in older patients. Discussion: These findings argue for the consideration of age and weight-based dose stratification to optimise amisulpride prescribing in older people, particularly in those aged 85 years and above.