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    Plasma methylphenidate levels in youths with attention deficit hyperactivity disorder treated with OROS formulation
    (Lippincott Williams and Wilkins, 2015) Yorbik O.; Mutlu C.; Ozilhan S.; Eryilmaz G.; Isiten N.; Alparslan S.; Saglam E.
    Background: There are limited studies investigating the relationship between oral release osmotic system-methylphenidate (OROS-MPH) doses and plasma methylphenidate (MPH) concentrations in children and adolescents. The aim of this study was to investigate the relationship between the doses of OROS-MPH and the plasma levels of the drug. We also examined the effects of the other drugs including aripiprazole, risperidone, fluoxetine, and sertraline on the levels of the MPH in the plasma. Methods: The files of 100 attention deficit hyperactivity disorder (ADHD) subjects (76 male, 24 female) who were diagnosed as ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria, were screened. The ages of subjects were between 6 and 18 years (mean 11.5 ± 3.8 years). Plasma MPH levels were determined by high-performance liquid chromatography-tandem mass spectrometry assay. Results: Daily mean OROS-MPH dose used in ADHD children was 0.7 ± 0.2 mg/kg (range: 0.3-1.3 mg/kg). The mean plasma OROS-MPH was 11.6 ± 7.3 ng/mL (range: 0.5-43.4 ng/mL). There was no group difference in the mean plasma MPH and dose-related MPH levels between the groups that used any additional drug including aripiprazole (n 25), risperidone (n 10), fluoxetine (n 16), sertraline (n 10), and did not use these drugs (P > 0.05). There was a positive correlation between the OROS-MPH doses (mg/kg) and the blood MPH levels (Pearson correlation 0.40; P < 0.001). The plasma levels of MPH were found to be less than 13 ng/mL in 65% of the subjects. Conclusions: Our findings point to the fact that plasma levels of MPH show a wide range of changes at similar doses, correlate positively with the doses and, as expected, are not affected by using risperidone, sertraline, fluoxetine, and aripiprazole. Therapeutic drug monitoring may help to optimize MPH dose in patients not responding to treatment or in those experiencing serious side effects, but not in routine clinical practice. The presence of intermediate dose formulations such as 45-mg tablets for OROS-MPH may contribute to the optimization. © © 2014 Wolters Kluwer Health, Inc. All rights reserved.
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    Serotonin and gastrointestinal system [Serotonin ve gastrointestinal sistem]
    (2003) Saglam E.; Yariş E.; Bilge S.S.
    Eighty percentage of serotonin in the body is found in enterochromaffin cells (EC) of gastrointestinal system (GIS). Serotonin plays an important role in regulating GIS functions as a constituent of nonadrenergic-non cholinergic (NANC) system. There are many types of serotonergic receptors in GIS and many drugs affecting these receptors are clinically used as an antiemetic or prokinetic drugs. The effects of serotonin on the gastrointestinal system and classification of 5-HT receptors, as well as their putative role in regulating the functions in the GIS will be briefly discussed in this paper.