The AGNP-TDM Expert Group Consensus Guidelines: focus on therapeutic monitoring of antidepressants.

摘要: Therapeutic drug monitoring (TDM) of psychotropic drugs such as antidepressants has been widely introduced for optimization pharmacotherapy in psychiatric patients. The interdisciplinary TDM group the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) worked out consensus guidelines with aim providing psychiatrists and laboratories a tool to optimize use TDM. Five research-based levels recommendation were defined regard routine plasma concentrations: (i) strongly recommended; (ii) (iii) useful; (iv) probably (v) not recommended. In addition, list indications that justify is presented, eg, control compliance, lack clinical response or adverse effects at recommended doses, interactions, pharmacovigilance programs, presence genetic particularity concerning metabolism, children, adolescents, elderly For some drugs, studies on therapeutic ranges are lacking, but target clinically relevant concentrations presented most based pharmacokinetic reported literature. many antidepressants, thorough analysis literature dealing concentration-clinical effectiveness relationship allowed inclusion concentrations. recommendations made combination pharmacogenetic (phenotyping genotyping) tests Finally, practical instructions given laboratory practitioners treating physicians how TDM: preparation TDM, analysis, reporting interpretation results, adequate information patient treatment complex process needs optimal coordination procedure implicating patients, physicians, pharmacologists, specialists. These should be helpful optimizing antidepressants.