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

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.