Home > Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017.

Hiemke, C and Bergemann, N and Clement, H W and Conca, A and Deckert, J and Domschke, K and Eckermann, G and Egberts, K and Gerlach, M and Greiner, C and Gründer, G and Haen, E and Havemann-Reinecke, U and Hefner, G and Helmer, R and Janssen, G and Jaquenoud, E and Laux, G and Messer, T and Mössner, R and Müller, M J and Paulzen, M and Pfuhlmann, B and Riederer, P and Saria, A and Schoppek, B and Schoretsanitis, G and Schwarz, M and Gracia, M Silva and Stegmann, B and Steimer, W and Stingl, J C and Uhr, M and Ulrich, S and Unterecker, S and Waschgler, R and Zernig, G and Zurek, G and Baumann, P (2018) Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry, 51, (01-02), pp. 9-62. doi: 10.1055/s-0043-116492.

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Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to optimize pharmacotherapy. It considers the interindividual variability of pharmacokinetics and thus enables personalized pharmacotherapy. In psychiatry and neurology, patient populations that may particularly benefit from TDM are children and adolescents, pregnant women, elderly patients, individuals with intellectual disabilities, patients with substance abuse disorders, forensic psychiatric patients or patients with known or suspected pharmacokinetic abnormalities. Non-response at therapeutic doses, uncertain drug adherence, suboptimal tolerability, or pharmacokinetic drug-drug interactions are typical indications for TDM. However, the potential benefits of TDM to optimize pharmacotherapy can only be obtained if the method is adequately integrated in the clinical treatment process. To supply treating physicians and laboratories with valid information on TDM, the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued their first guidelines for TDM in psychiatry in 2004. After an update in 2011, it was time for the next update. Following the new guidelines holds the potential to improve neuropsychopharmacotherapy, accelerate the recovery of many patients, and reduce health care costs.

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