Precise treatments for schizophrenia: where is the way forward?

Schizophrenia is a kind of chronic mental disorder that leads to disability,and it is characterized by the incoordination of perception, mind,emotion and behaviour, and the disconnection between mental activities and reality. It is recurrent and hard to cure. Schizophrenia has caused both agony to patients and their families, and heavy economic burden to their families and society.The appearance of chlorpromazine,the first antipsychotic drug in the1950s, brought about a revolutionary change in the treatment of schizophrenia. Even though the first-generation antipsychotic drug's effectiveness for schizophrenia (especially the positive symptoms) was absolutely positive, it did not

Determination of venlafaxine and its active metabolite O-desmethylvenlafaxine in human plasma by HPLC fluorescence

Background Therapeutic drug monitoring guides clinical individualised medication by measuring plasma concentration, which could improve the curative effect, avoid drug overdose and reduce the incidence of adverse reactions. At present, there are few reports on the clinical detection of venlafaxine and its active metabolite O-desmethylvenlafaxine. In this paper, the detection method of venlafaxine and O-desmethylvenlafaxine in blood plasma was established, which provides an effective and convenient means for guiding clinical application of medication.Aim To establish a method for determination of venlafaxine and its active metabolite O-desmethylvenlafaxine in human plasma by highperformance liquid chromatography with fluorescence detection.Methods Chromatographic separation was achieved on an Agilent Eclipse XDB-C18 Column(4.6 × 150 mm, 5 μm) with water containing sodium dihydrogen phosphate(0.05 mol/L) and acetonitrile(72:28) as the mobile phases. The following parameters were employed: flow rate 0.5 mL/min, column temperature 30°C, fluorescence excitation wavelength 276 nm and emission wavelength 598 nm.Results The method showed good linearity in the concentration range 10–1000 ng/mL. The regression equation for venlafaxine was R=0.0054 C+0.0264, r2=0.99991. The regression equation for O-desmethylvenlafaxine was R=0.0034 C+0.0272, r2=0.99969. The intraday and interday precisions(relative SD) were less than 10%, and the quantitative limit was 10 ng/mL.Conclusion We established a sensitive, specific and simple method for the detection of venlafaxine and O-desmethylvenlafaxine. This method fully meets the needs of clinical trials of venlafaxine and the requirements of relevant guidelines. It provided a reference for the clinical detection of venlafaxine and O-desmethylvenlafaxine plasma concentrations and pharmacokinetic study.