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Journal of Psychiatric Practice:
doi: 10.1097/01.pra.0000422741.95118.9f
COLUMNS: Psychopharmacology

Clinically Important Differences in the Pharmacokinetics of the Ten Newer “Atypical” Antipsychotics: Part 3. Effects of Renal and Hepatic Impairment

PRESKORN, SHELDON H. MD

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Abstract

The “atypical” antipsychotics are grouped together based on what they are not (i.e., not dopamine-2 selective antagonists like haloperidol). While sharing this characteristic, these agents differ substantially in pharmacokinetics and pharmacodynamics. The first two columns in this series reviewed the bioavailability, half-life, and metabolism of the 10 newer “atypical” antipsychotics, including the most recently marketed members of this class (asenapine, iloperidone, and lurasidone). This third column in the series discusses the effect hepatic and renal impairment has on the clearance and hence dosing recommendations for these agents. An understanding of the pharmacokinetic differences among the “atypical” antipsychotics discussed in this series of columns can help clinicians optimize drug selection and dose for specific patients under specific treatment conditions. A subsequent column in the series will review the substantial and clinically important pharmacodynamic differences among these agents. (Journal of Psychiatric Practice 2012;18:430–437)

© 2012 Lippincott Williams & Wilkins, Inc.

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