HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Coates, J. W. Search for Related Content PubMed Articles by Coates, J. W.

Urinary detection of olanzapine and its limitations

Mental Health Services, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD

Sir: Sander (Psychiatric Bulletin, January 2001, 25, 33) is correct in pointing out some of the limitations of urinary detection of olanzapine as a proxy for compliance, as previously described by myself (Coates, 1999, 2000). Currently, only a negative result shows non-compliance, whereas a positive result is open to various interpretations. I am presently studying two ways of potentially addressing these shortcomings, which may prove helpful.

First, I am investigating the quantification of the urinary levels of olanzapine, rather than just using a qualitative test. This should provide more of an indication of the actual compliance when levels are ascertained. Second, the measurement of urinary metabolites, either quantitatively or qualitatively, may lead to a more sophisticated approach in the future. In particular, 10-N-glucuronide is the most abundant metabolite but 4'-N-desmethy-lolanzapine is correlated to clearance (Callaghan et al, 1999) and this may give a better indication of a person's recent compliance.

Currently, however, non-detection of urinary olanzapine remains the best objective test of non-compliance and with these further developments it may prove to be even more valuable in clinical practice.

References

CALLAGHAN, J. T., BERGSTROM, R. F., PTAK, L. R., et al (1999) Olanzapine. Pharmacokinetic and pharmacodynamic profile. Clinical Pharmacokinetics, 37, 177-193.[CrossRef][Medline]

COATES, J. W. (1999) Urinary detection of olanzapine — an aid to compliance. British Journal of Psychiatry, 175, 591-592.

COATES, J. W. (2000) Urinary detection of olanzapine — an aid to compliance confirmed. Psychiatric Bulletin, 24, 316.[Free Full Text]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Coates, J. W. Search for Related Content PubMed Articles by Coates, J. W.