Psychiatria pre prax 3/2017

Therapeutic drug monitoring in psychiatry – possibilities and use in practice

A treatment individualisation is one of basic ways to patient care improvement. A therapeutic drug monitoring (TDM) is its main tool, which uses drug concentration assessment in blood in order to achieve the maximum effect with the minimum risk of toxicity. Actually, it is to be expected that individual pharmacokinetic differences will lead to 20fold differences in steady state drug concentration at the very same doses of psychopharmacs. TDM is nowadays a routine method only in the treatment with typical mood stabilizers. Nevertheless, according to international guidelines most antipsychotics, antidepressants, but also a number of drugs for addiction treatment or donepezil belong to category of drugs “strongly recommended” or “recommended” for TDM. However, for the full use of TDM it is necessary to learn the basics of the method, its possibilities and limitations that are described in this article.

Keywords: psychoactive drugs, therapeutic monitoring, personalized pharmacotherapy