Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017

Author:

Hiemke C.12,Bergemann N.3,Clement H.4,Conca A.5,Deckert J.6,Domschke K.7,Eckermann G.8,Egberts K.9,Gerlach M.9,Greiner C.10,Gründer G.11,Haen E.12,Havemann-Reinecke U.13,Hefner G.14,Helmer R.15,Janssen G.16,Jaquenoud E.17,Laux G.18,Messer T.19,Mössner R.20,Müller M.21,Paulzen M.11,Pfuhlmann B.22,Riederer P.6,Saria A.23,Schoppek B.24,Schoretsanitis G.25,Schwarz M.26,Gracia M.12,Stegmann B.12,Steimer W.27,Stingl J.10,Uhr M.28,Ulrich S.29,Unterecker S.6,Waschgler R.30,Zernig G.2331,Zurek G.32,Baumann P.33

Affiliation:

1. Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany

2. Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany

3. Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany

4. Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany

5. Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy

6. Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany

7. Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

8. Psychiatric Hospital, Kaufbeuren, Germany

9. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany

10. Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany

11. Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA – Translational Brain Medicine, Aachen, Germany

12. Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany

13. Department of Psychiatry and Psychosomatics, University of Göttingen, Göttingen, Germany

14. Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany

15. Center of Epilepsy, Bielefeld, Germany

16. Medical Laboratory Stein, Limbach Group, Mönchengladbach, Germany

17. Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland

18. Institute of Psychological Medicine, Haag in Oberbayern, Germany

19. Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany

20. Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany

21. Psychiatric Hospitals Oberberggruppe, Berlin, Germany

22. Psychiatric Hospital Weisser Hirsch, Dresden, Germany

23. Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria

24. kbo-Isar-Amper Klinikum München-Ost, Psychiatric Hospital, Munich-Haar, Germany

25. Department of Psychiatry, University of Bern, Bern, Switzerland

26. Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany

27. Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany

28. Max Planck Institute of Psychiatry, Munich, Germany

29. Aristo Pharma GmbH, Berlin, Germany

30. Psychiatric Hospital, Feldkirch, Austria

31. Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria

32. Medical Laboratory Bremen, Bremen, Germany

33. Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland

Abstract

AbstractTherapeutic 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.

Publisher

Georg Thieme Verlag KG

Subject

Pharmacology (medical),Psychiatry and Mental health,General Medicine

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