Analysis of Influencing Factors of Serum Olanzapine Concentrations in Children and Adolescents Based on Therapeutic Drug Monitoring
OBJECTIVE To analyze the monitoring results and influencing factors of olanzapine in children and adolescents with mental disorders,and to provide basis for rational drug use of olanzapine in children and adolescents.METHODS The diagnosis and treatment of 385 children and adolescents who received olanzapine treatment and serum concentration monitoring during hospitalization in a hospital from 2019 to 2022 were retrospectively collected.The effects of gender,age,dose,whether or not the original product and different combination drugs on the concentration dose ratio were analyzed.RESULTS The median daily dose of olanzapine for children and adolescents was 12.50 mg·d-1,the median serum concentration was 34.30 ng·mL-1,and the median concentration dose ratio was 2.98 ng·mL-1·mg·d-1.The median serum concentration of male and female were 31.20and 39.75 ng·mL-1 and the median concentration dose ratio were 2.50and 3.50 ng·mL-1·mg·d-1,respectively.The median serum concentration of patients aged≤14 years and those aged＞14 years were 32.00 and 36.70 ng·mL-1,and the median concentration dose ratio were 3.24 and 2.77 ng·mL-1·mg·d-1.The median serum concentration of≤10 mg·d-1 and＞10 mg·d-1 were 22.00 and 49.30 ng·mL-1,and the median concentration dose ratio were 3.18 and 2.79 ng·mL-1·mg·d-1.Gender,daily dose,and the combination of fluoxetine,fluvoxamine and valproate had significant effects on concentration dose ratio value(P＜0.05).CONCLUSION The clinical use of olanzapine in the treatment of children and adolescents with mental disorders,the influence of gender,daily dose and number of combined drugs should be fully considered in the analysis of serum concentration to better guide clinical drug use.
olanzapinechildren and adolescentsconcentration dose ratiotherapeutic drug monitoring
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