DƯỢC LÍ Goodman & Gilman's The Pharmacological Basis of Therapeutics 12th, 2010

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Table 16–1
Chemical Structures, Dosages for Acute Psychosis and Schizophrenia Maintenance, and Metabolic Risk Profile a (continued)
NONPROPRIETARY NAME
(TRADE NAME)
ORAL DOSAGE (mg/day)
ACUTE PSYCHOSIS MAINTENANCE METABOLIC SIDE EFFECTS
Dosage Forms 1 ST Episode Chronic 1 ST Episode Chronic Weight Gain Lipids Glucose
Quetiapine (SEROQUEL, SEROQUEL XR) 200–600 400–900 200–600 300–900 + + +/−
SECTION II
NEUROPHARMACOLOGY
O
Risperidone (RISPERDAL) 2–4 3–6 2–6 3–8 + +/− +/−
O, S, ODT
RISPERDAL CONSTA Not for acute use 25–50 mg/2 wks
Depot IM
Sertindole (SERDOLECT, SERLECT) d 4–16 12–20 12–20 12–32 +/− − −
O
Ziprasidone (GEODON, ZELDOX) e 120–160 120–200 80–160 120–200 +/− − −
O, IM
Dosage Forms: O, tablet; S, solution; IM, acute intramuscular; ODT, orally dissolving tablet.
a
For further information on antipsychotic dosing in psychotic disorders, see Expert Consensus Panel for Optimizing Pharmacologic Treatment of Psychotic Disorders. The expert consensus
guideline series. Optimizing pharmacologic treatment of psychotic disorders. J Clin Psychiatry, 2003, 64(Suppl 12):2–97.
Note that doses in first-episode, younger, or antipsychotic-naïve patients are lower than for chronic schizophrenia patients. Dose in elderly schizophrenia patients is approximately 50% of that
used in younger adults with schizophrenia; dosing for dementia-related psychosis is approximately 25%.
b
Due to orthostasis risk, dose titration of iloperidone is 1 mg bid on day 1, increasing to 2, 4, 6, 8, 10, and 12 mg bid on days 2, 3, 4, 5, 6, and 7 (as needed). Safety data exist for daily doses up to 16 mg bid.
c
Paliperidone palmitate dosing: in acute schizophrenia, deltoid IM loading doses of 234 mg at day 1 and 156 mg at day 8 provide paliperidone levels equivalent to 6 mg oral paliperidone during the first
week, and peaking on day 15 at a level comparable to 12 mg oral paliperidone. No oral antipsychotic needed in first week. Maintenance IM doses can be given in deltoid or gluteus every 4 weeks after
day 8. Maintenance dose options: 39, 78, 117, 156, or 234 mg every 4 weeks. Failure to give initiation doses (except for those switching from depot) will result in subtherapeutic levels for months.
d
Not available in the U.S.
e
Oral dose must be given with food (500 kcal) to facilitate absorption. Food increases the absorption of single doses of 20-, 40-, and 80-mg capsules by 48%, 87%, and 101%, respectively.