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Medications Stay in Brain Longer Than Blood Tests Indicate

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:TORONTO (CP) - How often should patients with psychiatric disorders take their medications? It's a question that may need to be re-examined following a new study by the Centre for Addiction and Mental Health.

Decisions on how often drugs need to be taken have traditionally be based on tests that measure medication levels in the blood. But the study, published in the journal Molecular Psychiatry, suggests drugs remain in the brain longer than blood levels indicate.

A single pill taken on Monday had lingering effects in the brain on Friday, even though no traces of the drug could be found in the blood, the study says.

Since the therapeutic effects of such drugs result from their effect on the brain, the study questions the sole use of blood levels to determine doses.

Researchers might come up with more efficient dosing schedules, with fewer side-effects, if they tested for drug levels in the brain instead.

"This is the first study that systematically compared the activity of medications in the brain versus the blood using brain imaging," said Dr. Shitij Kapur, an associate professor at the University of Toronto and one of the authors of the study. "These findings could have significant impact on how physicians prescribe medication for their patients in the future."

The researchers used positron emission tomography, or PET, to track drug action in the brain. They measured the levels of two common anti-psychotic medications, olanzapine and risperidone, after giving single doses to healthy volunteers and after continuous treatment with schizophrenics.

The scans showed that with both groups, drug levels remained significantly higher in the brain than in the blood. The study suggests some dosing schedules could be made less frequent, which would be "good news for patients, who generally don't enjoy having to take many pills during the course of a day," said Dr. Gary

Remington, another study author and director of the Toronto centre's schizophrenia assessment program. Remington is now looking at whether prescribing oral medications once every two or three days is just as effective as daily dosages.

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