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Urinary detection of olanzapine and its limitations

Published online by Cambridge University Press:  02 January 2018

John W. Coates
John W. Coates*
Affiliation:
Mental Health Services, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD
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Information
Psychiatric Bulletin , Volume 25 , Issue 5 , May 2001 , pp. 195
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © 2001, The Royal College of Psychiatrists

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, Reference Coates1999, Reference Coates2000). 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 (Reference Callaghan, Bergstrom and PtakCallaghan 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.Google Scholar
Coates, J.W. (1999) Urinary detection of olanzapine – an aid to compliance. British Journal of Psychiatry, 175, 591–592.Google Scholar
Coates, J.W. (2000) Urinary detection of olanzapine – an aid to compliance confirmed. Psychiatric Bulletin, 24, 316.Google Scholar
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