ArticleTherapeutic drug monitoring2025
The Effect of Age on Antipsychotic Serum Concentration in Males and Females: A Study Based on Therapeutic Drug Monitoring Data From 19,926 Patients.
Article in Therapeutic drug monitoring, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Central and peripheral glutamatergic biomarkers delineate heterogeneous clinical phenotypes in olanzapine-treated schizophrenia.Scientific reports · 2026Observational
- Sex Differences in Psychotropic Drug Exposure and Safety: A Systematic Review Toward Personalized Dosing Strategies.Journal of personalized medicine · 2026Review
- Development and Internal Validation of a Nomogram for Subtherapeutic Total Aripiprazole Concentrations: A Retrospective Real-World Study.Drug design, development and therapy · 2026Article
- Risk Factors for Amisulpride-Associated Hyperprolactinemia: Gender-Specific Plasma Concentration Cutoffs Derived from ROC Analysis.Drug design, development and therapy · 2026Article
- Impact of valproate co-medication and age on lurasidone exposure: a population pharmacokinetic study and real-world evaluation in Chinese psychiatric inpatients.Frontiers in pharmacology · 2026Article
- Antipsychotic load during olanzapine mono- versus polytherapy and in relation to age.European journal of clinical pharmacology · 2025Article
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6 authors.
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Abstract
backgroundAntipsychotic medications are commonly prescribed for older patients; however, documentation on their safety and efficacy in this population is limited. This study aimed to investigate and compare the effect of age on dose-adjusted serum concentrations of 6 commonly used antipsychotic medications in both sexes.
methodsPatients with serum concentration measurements of amisulpride, aripiprazole, clozapine, olanzapine, risperidone, and zuclopenthixol were retrospectively included from a therapeutic drug monitoring service. The primary outcome measure for each antipsychotic was the dose-adjusted serum concentration (C:D ratio), assessed across groups divided by sex and age (18-49 years, 50-74 years, and ≥75 years). The data were analyzed using linear mixed modeling with restricted maximum likelihood estimation.
resultsA total of 19,926 patients (53% male) with 74,194 serum concentration measurements were included. For most antipsychotics, the C:D ratios increased significantly with age, with generally larger differences observed in females compared with males. The largest impact of age was observed for risperidone, where C:D ratios in the age groups 50-74 years and ≥75 years were 20% and 81% higher for males, respectively, compared with the reference group (18-49 years). For females, the C:D ratios were 28% and 92% higher, respectively, compared with females aged 18-49 years (all P < 0.001). The smallest impact of age was observed for aripiprazole, with no significant differences in C:D ratios across age groups for males. For females treated with aripiprazole, C:D ratios were 8% and 28% higher in the 50-74 and ≥75 years age groups, respectively, compared with females aged 18-49 years (both P < 0.001).
conclusionsThe age-dependent increase in dose-adjusted serum concentrations among males and females varied across different antipsychotics and was highest for risperidone. These findings emphasize the importance of proper monitoring of antipsychotic use in older adults.
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