TDM in psychiatry and neurology: A comprehensive summary of the consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology, update 2017; a tool for clinicians

被引：86

作者：

Schoretsanitis, Georgios ^{[1
,2
]}

Paulzen, Michael ^{[2
,3
]}

Unterecker, Stefan ^{[4
]}

Schwarz, Markus ^{[5
]}

Conca, Andreas ^{[6
]}

Zernig, Gerald ^{[7
]}

Gruender, Gerhard ^{[8
]}

Haen, Ekkerhard ^{[9
,10
]}

Baumann, Pierre ^{[11
]}

Bergemann, Niels ^{[12
]}

Clement, Hans Willi ^{[13
]}

Domschke, Katharina ^{[14
]}

Eckermann, Gabriel ^{[15
]}

Egberts, Karin ^{[16
]}

Gerlach, Manfred ^{[16
]}

Greiner, Christine ^{[17
]}

Havemann-Reinecke, Ursula ^{[18
]}

Hefner, Gudrun ^{[19
]}

Helmer, Renate ^{[20
]}

Janssen, Ger ^{[21
]}

Jaquenoud-Sirot, Eveline ^{[22
]}

Laux, Gerd ^{[23
]}

Messer, Thomas ^{[24
]}

Moessner, Rainald ^{[25
]}

Mueller, Matthias J. ^{[26
]}

Pfuhlmann, Bruno ^{[27
]}

Riederer, Peter ^{[4
]}

Saria, Alois ^{[7
]}

Schoppek, Bernd ^{[28
]}

Gracia, Margarete Silva ^{[9
,10
]}

Stegmann, Benedikt ^{[9
,10
]}

Steimer, Werner ^{[29
]}

Stingl, Julia C. ^{[17
]}

Uhr, Manfred ^{[30
]}

Ulrich, Sven ^{[31
]}

Waschgler, Roland ^{[32
]}

Zurek, Gabriela ^{[33
]}

Hiemke, Christoph ^{[34
,35
]}

机构：

[1] Univ Bern, Dept Psychiat, Bern, Switzerland

[2] Rhein Westfal TH Aachen, Dept Psychiat Psychotherapy & Psychosomat, JARA Translat Brain Med, Pauwelsstr 30, D-52074 Aachen, Germany

[3] Alexianer Hosp Aachen, Aachen, Germany

[4] Univ Hosp Wurzburg, Dept Psychiat Psychosomat & Psychotherapy, Wurzburg, Germany

[5] Ludwig Maximilians Univ Munchen, Dept Lab Med, Munich, Germany

[6] Serv Psichiatr Comprensorio Sanit Bolzano, Bolzano, Italy

[7] Med Univ Innsbruck, Dept Psychiat & Psychotherapy, Expt Psychiat Unit, Innsbruck, Austria

[8] Heidelberg Univ, Med Fac Mannheim, Cent Inst Mental Hlth, Dept Mol Neuroimaging, Mannheim, Germany

[9] Univ Regensburg, Dept Psychiat & Psychotherapy, Clin Pharmacol, Regensburg, Germany

[10] Univ Regensburg, Dept Pharmacol & Toxicol, Regensburg, Germany

[11] Univ Lausanne, Dept Psychiat, Lausanne, Switzerland

[12] Kitzberg Hosp, Ctr Psychosomat Med & Psychotherapy, Bad Mergentheim, Germany

[13] Univ Freiburg, Dept Child & Adolescent Psychiat, Freiburg, Germany

[14] Univ Freiburg, Dept Psychiat & Psychotherapy, Med Ctr, Fac Med, Freiburg, Germany

[15] Hosp Psychiat, Kaufbeuren, Germany

[16] Univ Hosp Wurzburg, Dept Child & Adolescent Psychiat Psychosomat & Ps, Ctr Mental Hlth, Wurzburg, Germany

[17] Fed Inst Drugs & Med Devices BfArM, Bonn, Germany

[18] Univ Gottingen, Dept Psychiat & Psychosomat, Gottingen, Germany

[19] Vitos Klin Hochtaunus, Psychiat Hosp, Friedrichsdorf, Germany

[20] Ctr Epilepsy, Bielefeld, Germany

[21] Limbach Grp, Med Lab Stein, Monchengladbach, Germany

[22] Psychiat Hosp, Brugg, Switzerland

[23] Inst Med Psychol, Haag In Oberbayern, Germany

[24] Psychiat Hosp, Danuviuskliniken, Pfaffenhofen, Germany

[25] Univ Tubingen, Dept Psychiat & Psychotherapy, Tubingen, Germany

[26] Psychiat Hosp Oberberggrp, Berlin, Germany

[27] Psychiat Hosp Weisser Hirsch, Dresden, Germany

[28] Psychiat Hosp, Kbo Isar Amper Klinikum Munchen Ost, Munich, Germany

[29] Tech Univ Munich, Inst Clin Chem & Pathobiochem, Munich, Germany

[30] Max Planck Inst Psychiat, Munich, Germany

[31] Aristo Pharma GmbH, Berlin, Germany

[32] Psychiat Hosp, Feldkirch, Austria

[33] Med Lab Bremen, Bremen, Germany

[34] Univ Med Ctr Mainz, Dept Psychiat & Psychotherapy, Mainz, Germany

[35] Univ Med Ctr Mainz, Inst Clin Chem & Lab Med, Mainz, Germany

来源：

WORLD JOURNAL OF BIOLOGICAL PSYCHIATRY | 2018年 / 19卷 / 03期

关键词：

Therapeutic drug monitoring; pharmacokinetics; neuropsychopharmacology; drug therapy; pharmacovigilance; PHARMACOKINETICS; SCHIZOPHRENIA; RISPERIDONE;

D O I：

10.1080/15622975.2018.1439595

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

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 fur 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.

引用

页码：162 / 174

页数：13

共 19 条

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