In the present study, we investigated the effects of levomepromazine on plasma risperidone concentrations in a steady state. Twenty patients taking risperidone at a stable dose for more than 2 weeks who were considered to require levomepromazine coadministration were selected. The scores of excitement in BPRS significantly decreased 2 weeks after the coadministration of levomepromazine. Plasma risperidone concentrations and the ratio of risperidone and 9-hydroxyrisperidone (risperidone/9-hydroxyrisperidone) did not change between before and 2 weeks after the coadministration of levomepromazine. The extrapyramidal symptoms were not worsened by the coadministration of levomepromazine. These results suggest that a low dosage of levomepromazine, use as a sedative adjuvant to risperidone treatment, have no statistically significant effect on the trough plasma concentrations of risperidone.
References
-
1
Brøsen K, Zengin T, Meyer U A.
Role of P450IID6, the target of the sparteine/debrisoquine oxidation polymorphism, in the metabolism of imipramine.
Clin Pharmacol Ther.
1991;
4
609-617
-
2
Fang J, Bourin M, Baker G B.
Metabolism of risperidone to 9-hydroxyrisperidone by human cytochrome P450 2D6 3A4.
Naunyn Schmiedebergs Arch Pharmacol.
1999;
359
147-151
-
3
Huang M L, Van Peer A, Woestenborghs R, De Coster R, Heykants J, Jansen A AI, Zylicz Z, Visscher H W, Jonkman J HG.
Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects.
Clin Pharmacol Ther.
1993;
54
257-268
-
4
Loennechen T, Andersen A, Hals P A, Dahl S G.
High-performance liquid chromatographic determination of levomepromazine (methotrimeprazine) and its main metabolites in serum and urine.
Ther Drug Monit.
1990;
12
574-581
-
5
Mannens G, Huang M L, Meuldermans W, Hendrickx J, Woestenborghs R, Heykants J.
Absorption, metabolism and excretion of risperidone in humans.
Drug Metab Dispos.
1993;
21
1134-1141
-
6
Olesen O V, Linnet K.
Simplified high-performance liquid chromatographic method for determination of risperidone and 9-hydroxyrisperidone in serum from patients comedicated with other psychotic drugs.
J Chromatgr Biomed Sci Appl.
1997;
698
209-216
-
7
Scordo M G, Spina E, Faccila G, Avenoso A, Johansson I, Dahl M L.
Cytochrome P450 2D6 genotype and steady state plasma levels of risperidone and 9-hydroxyrisperidone.
Psychopharmacology.
1999;
147
300-305
-
8
Spina E, Avenoso A, Facciola G, Salemi M, Scordo M G, Ancione M, Madia A G, Perucca E.
Relationship between plasma risperidone and 9-hydroxyrisperidone concentrations and clinical response in patients with schizophrenia.
Psychopharmacology.
2001;
153
238-243
-
9
Sylvälahti E, Lindberg R, Kallio J, De Vocht M.
Inhibitory effects of neuroleptics on debrisoquine oxidation in man.
Br J Clin Pharmacol.
1986;
22
89-92
-
10
Van Beijstervelt L, Geerts R, Leysen J, Mengens A, Van den Eynde H, Meuldermans W, Heykans J.
Regional brain distribution of risperidone and its active metabolite 9-hydroxyrisperidone in the rat.
Psychopharmacology.
1994;
114
53-62
-
11
Yoshimura R, Ueda N, Nakamura J.
Low dosage of levomepromazine did not increase plasma concentrations of fluvoxamine.
Int Clin Psychopharmacol.
2000c ;
15
233-235
-
12
Yoshimura R, Ueda N, Nakamura J.
Possible relationship between combined plasma concentrations of risperidone plus 9-hydroxyrisperidone and extrapyramidal symptoms.
Neuropsychobiology.
2001;
44
129-133
Dr. Reiji Yoshimura
Department of Psychiatry
University of Occupational and Environmental Health
Iseigaoka
Yahatanishi-ku
Kitakyushu
Fukuoka 807-8555
Japan
Phone: +81 936 917253
Fax: +81 936 924894
Email: yoshi621@med.uoeh-u.ac.jp
