Last update:

   11-Nov-2021
 

Arch Hellen Med, 38(6), November-December 2021, 817-832

SPECIAL ARTICLE

Greek translation of a summary of the 2017 update of the consensus guidelines
for therapeutic drug monitoring in neuropsychopharmacology

G. Schoretsanitis,1 E.G. Pallis,2 M. Paulzen,3 S. Unterecker,4 M. Schwarz,5 A. Conca,6 G. Zernig,7,8 G. Gründer,9 E. Haen,10 P. Baumann,11 N. Bergemann,12 K. Domschke,13 G. Eckermann,14 K. Egberts,15 M. Gerlach,15 C. Greiner,16 G. Hefner,17 E. Jaquenoud,18 G. Laux,19 T. Messer,20 M.J. Müller,21 P. Riederer,4 A. Saria,7 B. Stegmann,10 W. Steimer,22 J. Stingl,23 M. Uhr,24 S. Ulrich,25 R. Waschgler,26 G. Zurek,27 C. Hiemke28
1The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA, 2Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece, 3Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA – Translational Brain Medicine, Aachen, Germany, and Alexianer Hospital Aachen, Aachen, Germany, 4Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany, 5Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany, 6Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy, 7Experimental Psychiatry Unit, Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Innsbruck, Austria, 8Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria, 9Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, 10Clinical Pharmacology, Department of Psychiatry and Psychotherapy, and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany, 11Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland, 12Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany, 13Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany, 14Psychiatric Hospital, Kaufbeuren, Germany, 15Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany, 16Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany, 17Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany, 18Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland, 19Institute of Psychological Medicine, Haag in Oberbayern, Germany, 20Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany, 21Psychiatric Hospitals Oberberggruppe, Berlin, Germany, 22Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany, 23Institute of Clinical Pharmacology, University Hospital of RWTH Aachen, Aachen, Germany, 24Max Planck Institute of Psychiatry, Munich, Germany, 25Aristo Pharma GmbH, Berlin, Germany, 26Psychiatric Hospital, Feldkirch, Austria, 27Medical Laboratory Bremen, Bremen, Germany, 28Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, and Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany

The quantification and pharmacological interpretation of drug concentrations in blood (serum or plasma) is widely known as therapeutic drug monitoring (TDM). In clinical practice, TDM is an established precision tool that provides the fundamental prerequisites for personalized treatment. Specifically, in neurology and psychiatry, TDM can be used as part of the process of prescription of medications in specific patient subgroups, including children and adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance abuse disorders, individuals with pharmacokinetic idiosyncrasies and forensic patients. Clinicians may consider TDM in the case of lack of clinical response to therapeutic doses of medication, assessment of drug adherence, tolerability and drug-drug interactions. This is the Greek translation of a short summary of the updated consensus guidelines compiled by the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP). It includes therapeutic reference ranges, laboratory alert levels, recommendation levels for prescribing TDM for dosage optimization without specific indications, conversion factors, factors for calculation of dosage-related drug concentrations and metabolite-to-parent ratios.

Key words: Antidepressants, Antipsychotics, Mood stabilizers, Psychiatry, Therapeutic drug monitoring.


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