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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Mood Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1497119

Model-informed precision dosing of quetiapine in bipolar affective disorder patients: initial dose recommendation

Provisionally accepted
Zi-Qiang Zheng Zi-Qiang Zheng 1*Ying-Wei Jin Ying-Wei Jin 2*Di Yin Di Yin 3*Xiao Chen Xiao Chen 2Sumei He Sumei He 4*Chen-Xu Liu Chen-Xu Liu 5*Cun Zhang Cun Zhang 6*Dongdong Wang Dongdong Wang 2*
  • 1 The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
  • 2 Xuzhou Medical University, Xuzhou, China
  • 3 Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu Province, China
  • 4 Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Liaoning Province, China
  • 5 Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong Province, China
  • 6 Xuzhou Oriental Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Objective: Bipolar affective disorder (BAD) is a mood disorder with high morbidity and mortality and quetiapine can be used in the treatment of BAD patients, however the precise administration regimen of quetiapine in BAD patients is still unknown. This study constructed a population pharmacokinetic (PPK) model of quetiapine in BAD patients based on model-informed precision dosing (MIPD) and real-world clinical data and recommended the optimal initial dose of quetiapine in BAD patients. Methods: Total 99 BAD patients treated by quetiapine were collected, at the same time, quetiapine concentrations, physical and chemical indexes of patients, and drug combination information were also collected, constructing quetiapine PPK model of BAD patients and recommending initial dose based on Monte Carlo simulation. Results: In the final model of quetiapine in BAD patients, the CL/F and V/F were 76.1 L/h and 530 L, respectively. For BAD patients weighting 40-66 kg, the initial dose recommendation was 16 mg/kg/day and probability reaching therapeutic window was 78.8-82.2%, probability exceeding the upper limit of the therapeutic window was 5.2-10.3%. For BAD patients weighting 66-120 kg, the initial dose recommendation was 12 mg/kg/day and probability reaching therapeutic window was 81.5-85.5%, probability exceeding the upper limit of the therapeutic window was 3.6-8.1%. Conclusion: The present study recommended initial dose of quetiapine in BAD patients based on MIPD and real-world data for the first time, providing individualized reference for administration of quetiapine in BAD patients.

    Keywords: Model-informed precision dosing, quetiapine, Bipolar affective disorder, initial dose recommendation, Real-world data

    Received: 25 Sep 2024; Accepted: 11 Nov 2024.

    Copyright: © 2024 Zheng, Jin, Yin, Chen, He, Liu, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Zi-Qiang Zheng, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
    Ying-Wei Jin, Xuzhou Medical University, Xuzhou, China
    Di Yin, Wuxi Maternity and Child Health Care Hospital, Wuxi, 211166, Jiangsu Province, China
    Sumei He, Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Liaoning Province, China
    Chen-Xu Liu, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong Province, China
    Cun Zhang, Xuzhou Oriental Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, China
    Dongdong Wang, Xuzhou Medical University, Xuzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.