Clinical Relevance of TDM of SSRIs

Schwarz, Markus J.; Hiemke, Christoph; Baumann, Pierre

doi:10.1097/01.ftd.0000245378.87563.72

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Although TDM of SSRIs was first recommended by the AGNP in the consensus report of 2004, indications for TDM of SSRIs have been a matter of debate. 8,16,17 Despite the discussion of the usefulness of TDM of SSRIs in the general population, questions have not been raised as to the usefulness of TDM of SSRIs in elderly patients. As we have shown, both in the current and in a previous study, elderly patients are at increased risk for elevated serum concentrations and might therefore be expected to be at increased risk for adverse drug events.…”

Section: Discussionmentioning

confidence: 96%

Therapeutic Drug Monitoring of Selective Serotonin Reuptake Inhibitors in Elderly Patients

Hermann

Waade

Molden³

2015

Therapeutic Drug Monitoring

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Section: Discussionmentioning

confidence: 96%

Therapeutic Drug Monitoring of Selective Serotonin Reuptake Inhibitors in Elderly Patients

Hermann

Waade

Molden³

2015

Therapeutic Drug Monitoring

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“…It was established during the 1980s when the importance of drug concentration-effect relationships became widely recognized and simple immunoassay-based commercial drug assays were introduced. For antidepressant and other psychotropic drugs, TDM is also recommended, although it is actually not used as much as it should be (118)(119)(120). Monitoring can be used to confirm if the plasma concentration of a drug is above or below the therapeutic range, thus minimizing the time that elapses before corrective measures can be implemented in the patient.…”

Section: Therapeutic Drug Monitoring and Pharmacogenomicsmentioning

confidence: 99%

Pharmacogenomics and adverse drug reactions in diagnostic and clinical practice

Manolopoulos¹

2007

Clinical Chemical Laboratory Medicine

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Pharmacogenetics and pharmacogenomics deal with genetically determined variations in how individuals respond to drugs. They hold the potential to revolutionize drug therapy. The clinical need for novel approaches to improve pharmacotherapy stems from the high rate of adverse reactions to drugs and their lack of effectiveness in many individuals. Despite the accumulation of research findings showing the potential for clinical benefit for several drug-metabolizing enzymes and some receptors that constitute drug targets, the translation of these findings into tangible clinical applications occurs very slowly. The main steps for clinical implementation of pharmacogenomics include: a) education of clinicians and all other parties involved in the use and benefits of pharmacogenomics; b) execution of large prospective clinical and pharmacoeconomic studies showing the benefit of pharmacogenomic genotyping; c) provision of incentives to develop tests; d) development of specific clinical guidelines; and e) creation of a solid regulatory and ethical framework. Furthermore, the potential should be explored to use existing therapeutic drug monitoring laboratories to introduce pharmacogenomic testing into hospitals. Overall, our thesis is that pharmacogenomics is already a reality in clinical practice and is bound to continue gaining acceptance by clinicians in the coming years.

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“…Therapeutic drug monitoring (TDM) is a clinical tool where the concentration of a pharmaceutical drug in a biological matrix is used to optimise and individualise the treatment of a patient. TDM is applicable for drugs having a narrow therapeutic range; a correlation between the blood concentration and the therapeutic effect or adverse reactions; and where the symptoms of the disease are difficult to monitor or quantify [ 1 , 2 , 3 ]. This is particularly true for the treatment of many neurological and psychiatric disorders, but TDM is also used for monitoring immunosuppressive drugs and antibiotics [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Automated Interlaboratory Comparison of Therapeutic Drug Monitoring Data and Its Use for Evaluation of Published Therapeutic Reference Ranges

Larsen¹,

Hoffmann-Lücke

Aaslo

et al. 2023

Pharmaceutics

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Therapeutic drug monitoring is a tool for optimising the pharmacological treatment of diseases where the therapeutic effect is difficult to measure or monitor. Therapeutic reference ranges and dose-effect relation are the main requirements for this drug titration tool. Defining and updating therapeutic reference ranges are difficult, and there is no standardised method for the calculation and clinical qualification of these. The study presents a basic model for validating and selecting routine laboratory data. The programmed algorithm was applied on data sets of antidepressants and antipsychotics from three public hospitals in Denmark. Therapeutic analytical ranges were compared with the published therapeutic reference ranges by the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) and in additional literature. For most of the drugs, the calculated therapeutic analytical ranges showed good concordance between the laboratories and to published therapeutic reference ranges. The exceptions were flupentixol, haloperidol, paroxetine, perphenazine, and venlafaxine + o-desmethyl-venlafaxine (total plasma concentration), where the range was considerably higher for the laboratory data, while the calculated range of desipramine, sertraline, ziprasidone, and zuclopenthixol was considerably lower. In most cases, we identified additional literature supporting our data, highlighting the need of a critical re-examination of current therapeutic reference ranges in Denmark. An automated approach can aid in the evaluation of current and future therapeutic reference ranges by providing additional information based on big data from multiple laboratories.

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Clinical Relevance of TDM of SSRIs

Cited by 3 publications

References 18 publications

Therapeutic Drug Monitoring of Selective Serotonin Reuptake Inhibitors in Elderly Patients

Therapeutic Drug Monitoring of Selective Serotonin Reuptake Inhibitors in Elderly Patients

Pharmacogenomics and adverse drug reactions in diagnostic and clinical practice

Automated Interlaboratory Comparison of Therapeutic Drug Monitoring Data and Its Use for Evaluation of Published Therapeutic Reference Ranges

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