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

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serval:BIB_1C6A9B332BCE
Type
Article: article from journal or magazin.
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Publications
Institution
Title
The AGNP-TDM Expert Group Consensus Guidelines: focus on therapeutic monitoring of antidepressants
Journal
Dialogues in Clinical Neuroscience
Author(s)
Baumann Pierre, Ulrich Sven, Eckermann Gabriel, Gerlach Manfred, Kuss Hans-Joachim, Laux Gerd, Müller-Oerlinghausen Bruno, Rao Marie Luise, Riederer Peter, Zernig Gerald, Hiemke Christoph
ISSN
1294-8322
Publication state
Published
Issued date
2005
Peer-reviewed
Oui
Volume
7
Number
3
Pages
231-247
Language
english
Notes
SAPHIRID:61388 --- Old url value: http://www.dialogues-cns.org/brochures/26/htm/26_45.asp
Abstract
Therapeutic drug monitoring (TDM) of psychotropic drugs such as antidepressants has been widely introduced for optimization of pharmacotherapy in psychiatric patients. The interdisciplinary TDM group of the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) has worked out consensus guidelines with the aim of providing psychiatrists and TDM laboratories with a tool to optimize the use of TDM. Five research-based levels of recommendation were defined with regard to routine monitoring of drug plasma concentrations: (i) strongly recommended; (ii) recommended; (iii) useful; (iv) probably useful; and (v) not recommended. In addition, a list of indications that justify the use of TDM is presented, eg, control of compliance, lack of clinical response or adverse effects at recommended doses, drug interactions, pharmacovigilance programs, presence of a genetic particularity concerning drug metabolism, and children, adolescents, and elderly patients. For some drugs, studies on therapeutic ranges are lacking, but target ranges for clinically relevant plasma concentrations are presented for most drugs, based on pharmacokinetic studies reported in the literature. For many antidepressants, a thorough analysis of the literature on studies dealing with the plasma concentration-clinical effectiveness relationship allowed inclusion of therapeutic ranges of plasma concentrations. In addition, recommendations are made with regard to the combination of pharmacogenetic (phenotyping or genotyping) tests with TDM. Finally, practical instructions are given for the laboratory practitioners and the treating physicians how to use TDM: preparation of TDM, drug analysis, reporting and interpretation of results, and adequate use of information for patient treatment TDM is a complex process that needs optimal interdisciplinary coordination of a procedure implicating patients, treating physicians, clinical pharmacologists, and clinical laboratory specialists. These consensus guidelines should be helpful for optimizing TDM of antidepressants
Pubmed
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10/03/2008 11:37
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20/08/2019 13:52
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