TY - JOUR
T1 - TDM in psychiatry and neurology
T2 - A comprehensive summary of the consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology, update 2017; a tool for clinicians*
AU - Schoretsanitis, Georgios
AU - Paulzen, Michael
AU - Unterecker, Stefan
AU - Schwarz, Markus
AU - Conca, Andreas
AU - Zernig, Gerald
AU - Gründer, Gerhard
AU - Haen, Ekkerhard
AU - Baumann, Pierre
AU - Bergemann, Niels
AU - Clement, Hans Willi
AU - Domschke, Katharina
AU - Eckermann, Gabriel
AU - Egberts, Karin
AU - Gerlach, Manfred
AU - Greiner, Christine
AU - Havemann-Reinecke, Ursula
AU - Hefner, Gudrun
AU - Helmer, Renate
AU - Janssen, Ger
AU - Jaquenoud-Sirot, Eveline
AU - Laux, Gerd
AU - Messer, Thomas
AU - Mössner, Rainald
AU - Müller, Matthias J.
AU - Pfuhlmann, Bruno
AU - Riederer, Peter
AU - Saria, Alois
AU - Schoppek, Bernd
AU - Silva Gracia, Margarete
AU - Stegmann, Benedikt
AU - Steimer, Werner
AU - Stingl, Julia C.
AU - Uhr, Manfred
AU - Ulrich, Sven
AU - Waschgler, Roland
AU - Zurek, Gabriela
AU - Hiemke, Christoph
PY - 2018/4/3
Y1 - 2018/4/3
N2 - Objectives: Therapeutic drug monitoring (TDM) combines the quantification of drug concentrations in blood, pharmacological interpretation and treatment guidance. TDM introduces a precision medicine tool in times of increasing awareness of the need for personalized treatment. In neurology and psychiatry, TDM can guide pharmacotherapy for patient subgroups such as children, adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance use disorders, individuals with pharmacokinetic peculiarities and forensic patients. Clear indications for TDM include lack of clinical response in the therapeutic dose range, assessment of drug adherence, tolerability issues and drug–drug interactions. Methods: Based upon existing literature, recommended therapeutic reference ranges, laboratory alert levels, and levels of recommendation to use TDM for dosage optimization without specific indications, conversion factors, factors for calculation of dose-related drug concentrations and metabolite-to-parent ratios were calculated. Results: This summary of the updated consensus guidelines by the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie offers the practical and theoretical knowledge for the integration of TDM as part of pharmacotherapy with neuropsychiatric agents into clinical routine. Conclusions: The present guidelines for TDM application for neuropsychiatric agents aim to assist clinicians in enhancing safety and efficacy of treatment.
AB - Objectives: Therapeutic drug monitoring (TDM) combines the quantification of drug concentrations in blood, pharmacological interpretation and treatment guidance. TDM introduces a precision medicine tool in times of increasing awareness of the need for personalized treatment. In neurology and psychiatry, TDM can guide pharmacotherapy for patient subgroups such as children, adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance use disorders, individuals with pharmacokinetic peculiarities and forensic patients. Clear indications for TDM include lack of clinical response in the therapeutic dose range, assessment of drug adherence, tolerability issues and drug–drug interactions. Methods: Based upon existing literature, recommended therapeutic reference ranges, laboratory alert levels, and levels of recommendation to use TDM for dosage optimization without specific indications, conversion factors, factors for calculation of dose-related drug concentrations and metabolite-to-parent ratios were calculated. Results: This summary of the updated consensus guidelines by the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie offers the practical and theoretical knowledge for the integration of TDM as part of pharmacotherapy with neuropsychiatric agents into clinical routine. Conclusions: The present guidelines for TDM application for neuropsychiatric agents aim to assist clinicians in enhancing safety and efficacy of treatment.
KW - drug therapy
KW - neuropsychopharmacology
KW - pharmacokinetics
KW - pharmacovigilance
KW - Therapeutic drug monitoring
U2 - 10.1080/15622975.2018.1439595
DO - 10.1080/15622975.2018.1439595
M3 - Journal article
C2 - 29493375
AN - SCOPUS:85043516004
SN - 1562-2975
VL - 19
SP - 162
EP - 174
JO - The World Journal of Biological Psychiatry
JF - The World Journal of Biological Psychiatry
IS - 3
ER -