Journal article
Blood Levels to Optimize Antipsychotic Treatment in Clinical Practice: A Joint Consensus Statement of the American Society of Clinical Psychopharmacology and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie.
- Schoretsanitis G Department of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 75-59 263rd St, Glen Oaks, NY 11004. george.schor@gmail.com.
- Kane JM Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.
- Correll CU Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.
- Marder SR Psychiatry and Biobehavioral Sciences, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
- Citrome L Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USA.
- Newcomer JW Thriving Mind South Florida Behavioral Health Network, Miami, Florida; and Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA.
- Robinson DG Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, USA.
- Goff DC Department of Psychiatry, NYU Langone Medical Center, New York, and Nathan Kline Institute, Orangeburg, New York, USA.
- Kelly DL Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA.
- Freudenreich O Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
- Piacentino D Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, and Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA.
- Paulzen M Alexianer Hospital Aachen; and Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University; and JARA-Translational Brain Medicine, Aachen, Germany.
- Conca A Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy.
- Zernig G Experimental Psychiatry Unit, Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Innsbruck, and Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria.
- Haen E Clinical Pharmacology, Department of Psychiatry and Psychotherapy, and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany.
- Baumann P Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland.
- Hiemke C Department of Psychiatry and Psychotherapy and Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany.
- Gründer G Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Pharmakopsychiatrie TTDMTFOTAFNU
- 2020-05-21
Published in:
- The Journal of clinical psychiatry. - 2020
English
OBJECTIVE
The quantification of antipsychotic levels in blood, also known as therapeutic drug monitoring (TDM), is a potentially useful tool of modern personalized therapy that can be applied to augment antipsychotic use and dosing decisions. The application of TDM for antipsychotics can be helpful in numerous challenging clinical scenarios, such as lack of therapeutic response, relapse, or adverse drug reactions (ADRs) related to antipsychotic treatment. The benefits of TDM may be particularly evident in the treatment of highly vulnerable patient subgroups, such as children, adolescents, pregnant women, and the elderly. The main aim of this article is to aid clinicians who routinely prescribe antipsychotics to successfully apply TDM in routine clinical practice in order to help optimize the efficacy and safety of those antipsychotics.
PARTICIPANTS
Participants were clinicians and researchers, members of the American Society of Clinical Psychopharmacology, and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (Association of Neuropsychopharmacology and Pharmacopsychiatry).
EVIDENCE
TDM literature on antipsychotics was critically reviewed to provide a condensed clinical decision-making algorithm with therapeutic reference ranges for blood antipsychotic levels, within which patients are most likely to respond and tolerate treatment, although TDM is not equally recommended/supported for all antipsychotics.
CONSENSUS PROCESS
A preliminary draft was prepared and circulated to the writing group members. Consensus was achieved in all cases, and resulting recommendations focused on following areas: steady-state and sampling time, levels of recommendations, indications, therapeutic reference ranges and laboratory alert levels, practical issues, and interpretation, as well as limitations.
CONCLUSIONS
The utilization of TDM as a tool for problem solving in antipsychotic treatment offers a unique method to improve safety and efficacy. This consensus statement summarizes essential information on the routine use of TDM for antipsychotics and encourages clinicians to perform TDM with the appropriate indications as part of the clinical decision-making process.
The quantification of antipsychotic levels in blood, also known as therapeutic drug monitoring (TDM), is a potentially useful tool of modern personalized therapy that can be applied to augment antipsychotic use and dosing decisions. The application of TDM for antipsychotics can be helpful in numerous challenging clinical scenarios, such as lack of therapeutic response, relapse, or adverse drug reactions (ADRs) related to antipsychotic treatment. The benefits of TDM may be particularly evident in the treatment of highly vulnerable patient subgroups, such as children, adolescents, pregnant women, and the elderly. The main aim of this article is to aid clinicians who routinely prescribe antipsychotics to successfully apply TDM in routine clinical practice in order to help optimize the efficacy and safety of those antipsychotics.
PARTICIPANTS
Participants were clinicians and researchers, members of the American Society of Clinical Psychopharmacology, and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (Association of Neuropsychopharmacology and Pharmacopsychiatry).
EVIDENCE
TDM literature on antipsychotics was critically reviewed to provide a condensed clinical decision-making algorithm with therapeutic reference ranges for blood antipsychotic levels, within which patients are most likely to respond and tolerate treatment, although TDM is not equally recommended/supported for all antipsychotics.
CONSENSUS PROCESS
A preliminary draft was prepared and circulated to the writing group members. Consensus was achieved in all cases, and resulting recommendations focused on following areas: steady-state and sampling time, levels of recommendations, indications, therapeutic reference ranges and laboratory alert levels, practical issues, and interpretation, as well as limitations.
CONCLUSIONS
The utilization of TDM as a tool for problem solving in antipsychotic treatment offers a unique method to improve safety and efficacy. This consensus statement summarizes essential information on the routine use of TDM for antipsychotics and encourages clinicians to perform TDM with the appropriate indications as part of the clinical decision-making process.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.4088/JCP.19cs13169
- PMID 32433836
- Persistent URL
- https://folia.unifr.ch/global/documents/24812
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