Comparison of plasma,saliva, and hair lamotrigine concentrations |
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| Institution: | 1. Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland;2. 1st Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland;3. 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland;4. Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland;1. Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;2. Affiliated Hangzhou First People''s Hospital, Zhejiang University School of Medicine, Hangzhou, China;3. The First Hospital of Lanzhou, Lanzhou, China;4. Chaohu Hospital of Anhui Medical University, Anhui, China;5. Nanjing Medical University, Nanjing, China;1. Service d’anatomie pathologique, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France;2. Service de neurochirurgie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France;1. Department of Diagnostic Medicine, Clinical and Public Health, Division of Legal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy;2. Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi, 103, 41125 Modena, Italy;3. Department of Diagnostic Medicine, Clinical and Public Health, Division of Toxicology and Clinical Pharmacology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy;1. Dept. of Clinical Pharmacology, St. Olavs University Hospital, Trondheim, Norway;2. Dept. of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;3. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;4. Dept. of Neurology, The Neuroscience Center, Copenhagen University Hospital, Copenhagen, Denmark;5. Dept. of Neurology, Stavanger University Hospital, Stavanger, Norway;6. Dept. of Neurology, Drammen Hospital, Drammen, Norway;7. Dept. of Neurohabilitation, Oslo University Hospital, Ullevål, Norway;8. Dept. of Neurology, Aarhus University Hospital, Aarhus, Denmark;9. The National Center for Epilepsy, Oslo University Hospital, Sandvika, Norway;10. Dept. of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway;1. Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China;2. Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China;3. Shanghai AB Sciex Analytical Instrument Trading Co., Ltd., Shanghai 200050, China |
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| Abstract: | BackgroundIn some clinical situations (pregnancy, aging, drug resistance, toxicity), measurements of lamotrigine plasma levels may be reliable. Limited studies indicate that saliva and hair could be alternative sources for monitoring lamotrigine therapy. The drug content in hair can also be used to assess the history of drug therapy and to ascertain long-term patient compliance. The aims of this study were to 1) determine the correlations among plasma, saliva, and hair lamotrigine concentrations, 2) evaluate saliva as an alternative matrix for monitoring drug levels and 3) evaluate hair as a source of information on adherence to antiepileptic treatment and on the correlation of hair concentrations with clinical outcomes in patients with epilepsy.MethodsPlasma, saliva, and hair lamotrigine concentrations were measured by liquid chromatography–tandem mass spectrometry in positive ionization mode. The study group (n = 85) was recruited among the epileptic patients at the Institute of Psychiatry and Neurology, Warsaw, Poland.ResultsPlasma concentrations were not influenced by sex, age, or the concomitant use of other antiepileptic drugs. Lamotrigine saliva and plasma concentrations were strongly correlated (r = 0.82, p < 0.001). Lamotrigine hair concentrations were correlated with the plasma concentrations (r = 0.53, p < 0.001) and daily dose in mg/kg (r = 0.23, p = 0.024). The analysis revealed no significant correlation between lamotrigine hair levels and the number of seizures in the previous 3 months (r = -0.1, p > 0.05).ConclusionsThe lamotrigine saliva concentration is strongly correlated with its plasma level, and saliva can be used as an alternative matrix to plasma for monitoring. Lamotrigine can also be successfully measured in hair, and the drug levels in hair tend to be correlated with the levels in plasma. However, lamotrigine levels in hair may not correspond to clinical outcomes (i.e., seizure episodes). |
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| Keywords: | Epilepsy Lamotrigine Plasma Saliva Hair |
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