Pharmacopsychiatry 2018; 51(01/02): 9-62
DOI: 10.1055/s-0043-116492
Review
© Georg Thieme Verlag KG Stuttgart · New York

Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017

C. Hiemke
Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany
Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany
,
N. Bergemann
Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany
,
H. W. Clement
Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany
,
A. Conca
Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy
,
J. Deckert
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
,
K. Domschke
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
G. Eckermann
Psychiatric Hospital, Kaufbeuren, Germany
,
K. Egberts
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
,
M. Gerlach
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
,
C. Greiner
Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
,
G. Gründer
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA – Translational Brain Medicine, Aachen, Germany
,
E. Haen
Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
,
U. Havemann-Reinecke
Department of Psychiatry and Psychosomatics, University of Göttingen, Göttingen, Germany
,
G. Hefner
Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany
,
R. Helmer
Center of Epilepsy, Bielefeld, Germany
,
G. Janssen
Medical Laboratory Stein, Limbach Group, Mönchengladbach, Germany
,
E. Jaquenoud
Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland
,
G. Laux
Institute of Psychological Medicine, Haag in Oberbayern, Germany
,
T. Messer
Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany
,
R. Mössner
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
,
M. J. Müller
Psychiatric Hospitals Oberberggruppe, Berlin, Germany
,
M. Paulzen
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA – Translational Brain Medicine, Aachen, Germany
,
B. Pfuhlmann
Psychiatric Hospital Weisser Hirsch, Dresden, Germany
,
P. Riederer
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
,
A. Saria
Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria
,
B. Schoppek
kbo-Isar-Amper Klinikum München-Ost, Psychiatric Hospital, Munich-Haar, Germany
,
G. Schoretsanitis
Department of Psychiatry, University of Bern, Bern, Switzerland
,
M. Schwarz
Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany
,
M. Silva Gracia
Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
,
B. Stegmann
Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
,
W. Steimer
Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany
,
J. C. Stingl
Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
,
M. Uhr
Max Planck Institute of Psychiatry, Munich, Germany
,
S. Ulrich
Aristo Pharma GmbH, Berlin, Germany
,
S. Unterecker
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
,
R. Waschgler
Psychiatric Hospital, Feldkirch, Austria
,
G. Zernig
Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria
Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria
,
G. Zurek
Medical Laboratory Bremen, Bremen, Germany
,
P. Baumann
Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

received  15 May 2017
revised  + 08 July 2017

accepted 10 July 2017

Publication Date:
14 September 2017 (eFirst)

Abstract

Therapeutic 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.