Greensboro key to Ameritox’s new strategy for antipsychotic medicine monitoring

May 7, 2014

Keeping mental health patients on a medication regime is a stubborn challenge in psychiatry, but the analysts in Ameritox’ Greensboro testing laboratory are taking a new approach to helping them stay on track.
The Baltimore-based company, which opened its Gallimore Dairy Road facility in 2010, has launched a new division called Ingenuity Health that will use urine samples to give caregivers better insight into whether and how patients prescribed antipsychotic drugs such as Abilify are sticking to them.

Research has found that as many as half of patients with serious mental disorders don’t take their medications properly, said Jerry Vaccaro, the president of the new division, which can lead to relapses and dangerous behavior. Doctors often have to rely on “make-do” methods of medication monitoring with mental health patients such as counting pills, and those strategies can be unreliable or easily manipulated.

“By eliminating the historical guesswork about whether a patient is taking their prescribed medication, Ingenuity Health aims to free clinicians to focus on helping patients lead full and healthy lives,” Vaccaro said.
The monitoring approach developed by Ameritox is based on the fact that administered drugs are eliminated from the human body as waste, with each drug leaving a particular signature of metabolites in urine, according to Dr. Kathryn Bronstein, the company’s vice president for medical affairs.

It’s possible to look for evidence of medication consumption in the blood or elsewhere, but that is a more invasive testing procedure and the data can be less precise, she said.

“Urine monitoring for drugs and metabolites allows you to examine a broader window of detection,” she said. “In other words, it reflects what a patient has taken in the past few days versus tests of blood or oral fluids, which indicate what the patient has taken most recently.”

So far, Ingenuity Health’s monitoring process has only been fully tested and launched for Abilify, the top-selling prescription treatment for schizophrenia and bipolar disorders in the U.S., though testing for other medications is taking place now. The urine screening can already determine whether other kinds of antipsychotics are in the patient’s system at all, but it takes more research to identify markers that can tell if they are likely there at the prescribed dose.
All of Ingenuity Health’s tests are being done at the Greensboro lab, Bronstein said, though there probably won’t be significant hiring in that lab related to the new service. Ameritox said when it opened in 2010 that that lab would have about 228 employees at full capacity, but officials declined to provide a current count.

The success of the new initiative and the amount of work it brings to Greensboro will depend on whether and how physicians choose to make use of the service. Bronstein said because the technology is brand new there are no established norms for how often caregivers will test their patients.

Doctors may choose to test patients who aren’t showing any signs of medication-related problems only once or twice a year, and those with a history of skipping meds may need much more frequent monitoring.
In between those extremes, “when you can’t determine if a patient isn’t doing well because they’re not on the right medicine or because they’re not taking the medicine they were prescribed, that can be a trigger point where you’d say, ‘let’s do a urine test so we can see what’s happening,’” she said.