Psychiatria pre prax 4/2011

Would therapeutic drug monitoring improve adherence and efficaccy of treatment in schizophrenia?

Therapeutic drug monitoring (TDM) is considered to be a valid tool for optimization of pharmacotherapy, however, in clinical practice is rarely used. TDM may help to answer the questions important for a choice of treatment strategy, e.g. whether the patient takes the drug and whether the drug is taken in a sufficient dose. The most common causes of nontherapeutic range of plasma levels include non-adherence and pharmacokinetic interaction. Clozapine still represents the gold standard in the treatment of pharmacoresistant schizophrenia and optimal plasma levels for acute and maintenance clozapine treatment are well known. Literature and our experience show that TMD in clinically defined patients subgroups is clinically advantageous.

Keywords: therapeutic drug monitoring, pharmacoresistance, schizophrenia, clozapine, plasma levels.