We aimed to investigate the effects of infection on serum concentrations of different antipsychotics in inpatients with respiratory tract infections treated with psychiatric drugs, including risperidone, clozapine, quetiapine, and aripiprazole. All patients underwent therapeutic drug monitoring (TDM) and routine blood tests during infection and noninfection periods. The Wilcoxon signed-rank test was used to analyze intra-individual differences in dose-corrected serum concentrations (C/D) levels in infection and noninfection periods. To study the effects of infection intensity on drug concentrations, white blood cells (WBCs) parameters and C/D levels were analyzed by Spearman's correlation analysis using all samples. The median C/D levels of risperidone (risperidone + 9-OH, n = 36) and clozapine (n = 42) were significantly higher (P < 0.001), whereas the median C/D levels of quetiapine (n = 21) and aripiprazole (n = 13) were slightly significantly higher (P < 0.01) in infection than in noninfection period. A significant positive association between C/D levels and WBC parameters was observed for risperidone, clozapine, and quetiapine. These results indicated reduced clearance of all drugs evaluated, especially clozapine and risperidone, due to infection. Therefore, during infection in patients receiving risperidone, clozapine, quetiapine, or aripiprazole, TDM should be performed to minimize the possible adverse effects associated with elevated drug concentrations.

中文翻译：

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感染与抗精神病药物血清浓度升高有关。

我们旨在研究感染对接受精神科药物（包括利培酮、氯氮平、喹硫平和阿立哌唑）治疗的呼吸道感染住院患者血清中不同抗精神病药物浓度的影响。所有患者在感染和非感染期间均接受治疗药物监测 (TDM) 和常规血液检查。Wilcoxon 符号秩检验用于分析感染和非感染期间剂量校正血清浓度 (C/D) 水平的个体内差异。为了研究感染强度对药物浓度的影响，使用所有样本通过 Spearman 相关分析来分析白细胞 (WBC) 参数和 C/D 水平。利培酮（利培酮 + 9-OH，n = 36）和氯氮平（n = 42）的中位 C/D 水平显着更高（P < 0.001），而喹硫平 (n = 21) 和阿立哌唑 (n = 13) 的中位 C/D 水平在感染期间略高于非感染期间 (P < 0.01)。对于利培酮、氯氮平和喹硫平，观察到 C/D 水平与 WBC 参数之间存在显着的正相关。这些结果表明，由于感染，所有评估的药物，尤其是氯氮平和利培酮的清除率降低。因此，在接受利培酮、氯氮平、喹硫平或阿立哌唑的患者感染期间，应进行 TDM 以尽量减少与药物浓度升高相关的可能不良反应。对于利培酮、氯氮平和喹硫平，观察到 C/D 水平与 WBC 参数之间存在显着的正相关。这些结果表明，由于感染，所有评估的药物，尤其是氯氮平和利培酮的清除率降低。因此，在接受利培酮、氯氮平、喹硫平或阿立哌唑的患者感染期间，应进行 TDM 以尽量减少与药物浓度升高相关的可能不良反应。对于利培酮、氯氮平和喹硫平，观察到 C/D 水平与 WBC 参数之间存在显着的正相关。这些结果表明，由于感染，所有评估的药物，尤其是氯氮平和利培酮的清除率降低。因此，在接受利培酮、氯氮平、喹硫平或阿立哌唑的患者感染期间，应进行 TDM 以尽量减少与药物浓度升高相关的可能不良反应。