Pharmacopsychiatry 2024; 57(02): 90
DOI: 10.1055/s-0044-1779571
Abstracts │ XVth Symposium of the Task Force Therapeutic Drug Monitoring of the AGNP
Poster Abstracts

Systematic review on blood concentrations of ADHD medications in children and adolescents

S. S. Hagenkötter
1   Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
K. Egberts
2   Department Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
,
S. Fekete
2   Department Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
,
M. Gerlach
2   Department Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
,
C. Hiemke
3   Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany
,
R. Rauh
1   Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
H.W. Clement
1   Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
M. Biscaldi
1   Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
C. Fleischhaker
1   Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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We present the current results of a systematic review of studies about the use of therapeutic drug monitoring (TDM) for methylphenidate, amphetamine, atomoxetine and guanfacine in the treatment of ADHD and the calculation of the respective preliminary therapeutic reference ranges in children and adolescents.

The study analyzed all TDM studies published until April 2023 (Medline) using the following inclusion criteria: Age under 18 years, assessment of responder status and measurement of maximum blood concentrations (Cmax). Cmax was used to determine potential therapeutic reference ranges by calculating the mean and SD and the median and 25th/75th percentiles.

For methylphenidate, a mean ± SD of (9.2 [± 8.7] ng/ml) and a 25th/75th IQR of 7-12 ng/ml was calculated. For d-amphetamine, mean concentration was 31.9 ± 15.2 and the IQR 25th/75th [18.4 ; 32.5] ng/ml. Mean concentration of atomoxetine was 118.6 ng/ml ± 496.1 and the 25th/75th IQR was [65.5 ;144.0] ng/ml. Only one study was eligible for guanfacine, with a mean concentration of 7.5 ng/ml in responders.

The results on these four ADHD medications provide preliminary recommendations for therapeutic reference ranges that can be used as a reference for TDM in children and adolescents with ADHD.



Publication History

Article published online:
12 March 2024

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