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 (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.