Researchers warn overmedication
possible after finding medications linger in brain
By DAWN WALTON
The Globe & Mail, Canada
Wednesday, March 20, 2002 - Print Edition, Page A10
Patients taking drugs to treat psychiatric disorders including schizophrenia,
depression and dementia may be taking too much medication, a study suggests. A
report published yesterday in the journal Molecular Psychiatry found that some
antipsychotic medications linger in the brain longer than is indicated by blood
samples.
The findings by a team of researchers affiliated with the University of Toronto
raise questions about traditional prescribing procedures that are based on
medication levels found in the blood.
"The drugs that were sometimes being prescribed twice a day, even three times a
day, may be able to be given less frequently, based on these findings," said
study co-author Dr. Gary Remington, who is director of the schizophrenia and
continuing-care medication-assessment program at the Centre for Addiction and
Mental Health.
"It would mean that people could take their medication less frequently and still
maintain the same response."
Using positron-emission tomography, or PET scans, the scientists tracked
olanzapine and risperidone -- North America's most commonly used antipsychotic
drugs -- in the brains of 10 healthy volunteers and five patients being treated
for schizophrenia.
The researchers found that medication in a pill taken on a Monday could be
detected in the brain on Friday, although there was no trace of the drug in the
blood.
Beyond prescribing practices, the findings could have implications for drug
development, with a focus on what's happening in the brain rather than in the
blood, Dr. Remington said.
And the findings could lead to cost cuts for patients and health-care insurers
if less medication is prescribed, he added.
The implications are far-reaching but are being viewed skeptically by some
physicians, the researchers said.
"Historically we wag our fingers and tell people to take their medication every
day and don't forget it," Dr. Remington said. "This is a kind of reverse of what
we've been saying for many years."
Dr. Remington is among a group of researchers examining whether antipsychotic
medications taken once every few days could be as effective as medications taken
daily.
While preliminary results suggest it's possible to cut dosages, Dr. Remington
said, it is too soon for patients to request that their medications be changed.
The research was financed in part by a grant from pharmaceutical company Eli
Lilly Canada.
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