Psychiatry ADVISOR

November 22, 2019

Rationale Behind the Transdermal Delivery of Antipsychotic Medications

Sheila Jacobs

The transdermal drug route could potentially increase treatment compliance in patients with schizophrenia.

Future advancements in delivery technologies, along with their evaluation in clinical trials, might help to broaden the clinical use of transdermal drug formulations for the treatment of psychiatric disorders. The current study was designed to evaluate progress regarding the use of transdermal antipsychotic drug formulations by conducting a search of papers, patents, and clinical trials that have been published on the topic in the last 10 years. Results of the analysis were published in CNS Drugs.

The investigators sought to offer a rationale for the development of transdermal formulations of antipsychotic agents that are currently on the market. Data on antipsychotic transdermal formulations are reported and discussed, with the focus of this analysis being on the characteristics of the dosage forms in use, along with their ability to promote drug absorption. Although a large number of antipsychotic medications are currently available, only a few of these agents (aripiprazole, asenapine, blonanserin, chlorpromazine, haloperidol, olanzapine, prochlorperazine, quetiapine, and risperidone) have actually been developed as transdermal delivery systems.

According to some of the papers and patents that were evaluated, such transdermal formulations as patches, gels, creams, solutions, sprays, films, and nanosystems have been assessed, with the objective being expanded to the clinical utility of antipsychotic agents. Specifically, the use of a variety of strategies, including nanoparticles/vesicles, permeation enhancers, and microneedles with iontophoresis, may help improve the absorption of antipsychotic medications through the skin.

Study findings showed that with few clinical trials available on transdermal delivery of antipsychotic agents, only those delivery systems that contain asenapine, blonanserin, and risperidone have demonstrated noteworthy clinical results with respect to pharmacokinetic data, efficacy, and tolerability. The transdermal patch formulation of blonanserin has recently been approved in Japan for the treatment of schizophrenia.

The investigators concluded that future advancements in delivery technologies of antipsychotics and their evaluation in clinical trials could help increase the number of available antipsychotic formulations for the treatment of psychiatric disorders such as schizophrenia. Future studies on this topic are warranted, with microneedles possibly representing an attractive option for improving the delivery of antipsychotic agents through the skin.

Reference Abruzzo A, Cerchiara T, Luppi B, Bigucci F. Transdermal delivery of antipsychotics: rationale and current status. CNS Drugs. 2019;33(9):849-865.