Alternate Routes of Administration of Antidepressant and Antipsychotic Medications

@article{Kaminsky2015AlternateRO,
  title={Alternate Routes of Administration of Antidepressant and Antipsychotic Medications},
  author={Bonnie M Kaminsky and Jolene R. Bostwick and Sally K. Guthrie},
  journal={Annals of Pharmacotherapy},
  year={2015},
  volume={49},
  pages={808 - 817}
}
Objective: To review the administration of antidepressant and antipsychotic medications via inhaled, intranasal, buccal, sublingual, transdermal, and rectal routes. Data Sources: A PubMed search was conducted for all data through March 31, 2015 to identify pertinent literature. Search terms included the generic name of each antidepressant and antipsychotic medication in combination with the following terms: alternate routes of administration, inhaled, intranasal, buccal, sublingual, transdermal… 

Tables from this paper

Transdermal Delivery of Antipsychotics: Rationale and Current Status

The aim of this article is to provide the rationale for the development of transdermal formulations of antipsychotics by highlighting their main advantages, starting with an overview of the

Intranasal delivery of antipsychotic drugs

The promise and pitfalls of intranasally administering psychopharmacological agents for the treatment of psychiatric disorders

The current state of the art in intranasal psychopharmacological agent delivery research and current challenges using this administration route are described, and important aspects of nose-to-brain delivery that may improve the efficacy of these new therapies in future research are discussed.

The Gut Microbiome and Treatment-Resistance in Schizophrenia

  • M. Seeman
  • Medicine, Psychology
    Psychiatric Quarterly
  • 2019
The results are suggestive of the premise that there is a drug refractory form of psychosis for which the composition of gut bacteria is responsible, and that parenteral drug administration could overcome the problem.

Rectal Bioavailability of Sertraline Tablets in a Critically Ill Patient With Bowel Compromise.

The case of a 55-year-old woman in whom sertraline tablets were administered rectally for depression and anxiety and where PK monitoring was performed is described.

Transdermal Asenapine in Schizophrenia: A Systematic Review

Transdermal asenapine was superior to placebo at week 6 with nearly one-third of patients experiencing >30% improvement in total PANSS score which translates in a number needed to treat (NNT) of 9.

The Role of Inhaled Loxapine in the Treatment of Acute Agitation in Patients with Psychiatric Disorders: A Clinical Review

The efficacy and tolerability of inhaled loxapine in the treatment of acute agitation in patients with psychiatric disorders is evaluated and it is found that it is effective and generally well tolerated when administered to agitated patients with schizophrenia and bipolar disorder.

Absorption behavior of etilefrine after buccal administration in rats

Intravenous Delivery of a D1-D2 Interfering Peptide with Antidepressant-like Effects

This study finds that the D1-D2 interfering peptide has antidepressantlike effects compared to saline in rats in the forced swimming test at doses greater than 1.5nmol/g.

References

SHOWING 1-10 OF 43 REFERENCES

Nonenteral routes of administration for psychiatric medications. A literature review.

New Formulations of Existing Antidepressants

While there do not appear to be major clinical advantages for the new formulations of existing antidepressant medications in terms of antidepressant efficacy, none of them is less efficacious than their older counterpart.

Pharmacokinetics of Rectal Drug Administration, Part I

Rectal drug delivery in a site- and rate-controlled manner using osmotic pumps or hydrogel formulations may provide opportunities for manipulating systemic drug concentrations and drug effects, and local irritation is increasingly being acknowledged as a possible complication of rectal drug therapy.

A review of the literature on the selegiline transdermal system: an effective and well-tolerated monoamine oxidase inhibitor for the treatment of depression.

The selegiline transdermal system provides several advantages compared to orally administered MAOIs, including minimal interaction with dietary tyramine and prolonged exposure to the parent compound, while offering a favorable side effect profile.

Relative Rectal Bioavailability of Fluoxetine in Normal Volunteers

Although rectal bioavailability of fluoxetine capsules is considerably less than oral, the rectal route of administration might be an option in patients who cannot take oral medications.

Chlorpromazine bioavailability from a topical gel formulation in volunteers.

Chlorpromazine in PLO gel may not be an effective treatment option since blood levels were undetectable at 1, 2, and 4 hours after topical application.

Alternative Delivery Systems for Agents to Treat Acute Agitation: Progress to Date

These novel formulations used to deliver medications to treat agitation require at least some cooperation but have the potential to prevent escalation and improve the experience of patients and could be considered when negotiation is possible.

Non-invasive systemic drug delivery: developability considerations for alternate routes of administration.

The various delivery route options are outlined with their pros and cons; key criteria and physicochemical attributes that would make a drug a suitable candidate are discussed; approaches to assess delivery feasibility, toxicity at the site of delivery, and overall developability potential are described.

Intranasal drug delivery to the central nervous system: present status and future outlook.

Whether nasal delivery of selected CNS drugs could improve their pharmacokinetics and patient compliance is explored and this route offers attractive advantages, and pharmaceutical scientists and anatomists should collaborate to improve CNS drug compliance and to increase the number of compounds that can be administered intranasally.