Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
Xenia M Hart1, Luzie Eichentopf1, Xenija Lense1
1Department of Molecular Neuroimaging, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.
Frontiers in Psychiatry
|December 13, 2021
Summary
This study outlines a systematic method for finding and validating blood concentration reference ranges for psychotropic medications. This approach ensures reliable Therapeutic Drug Monitoring (TDM) for personalized patient treatment.
Area of Science:
- Pharmacology
- Psychiatry
- Evidence-based Medicine
Background:
- Therapeutic Drug Monitoring (TDM) uses blood drug concentrations to personalize psychotropic medication treatment.
- Current reference ranges for TDM are often expert recommendations lacking systematic validation.
- Established reference ranges are crucial for effective TDM and dose titration.
Purpose of the Study:
- To describe a systematic protocol for searching, evaluating, and grading literature on psychotropic drug reference ranges.
- To outline a method for validating published therapeutic reference ranges for psychotropic drugs.
- To introduce a systematic approach for TDM in psychiatric pharmacotherapy.
Main Methods:
- Systematic literature search following PRISMA guidelines, using drug-specific terms, blood concentrations, and neuroimaging (PET, SPECT).
- Inclusion of studies reporting blood concentrations linked to clinical effects and neuroimaging-based target engagement.
- Evaluation of studies reporting concentrations in representative patient populations.
Main Results:
- A structured protocol for comprehensive TDM literature review is presented.
- A systematic grading system is proposed to assign levels of evidence to reference ranges.
- The method allows for the validation of therapeutic reference ranges beyond expert opinion.
Conclusions:
- This protocol facilitates a thorough overview of TDM literature for psychotropic drugs.
- The assigned evidence levels enhance the reliability and validity of therapeutic reference ranges.
- This systematic approach supports evidence-based TDM for optimizing psychiatric treatment.
Keywords:
concentration/effect relationshipdrug monitoringpsychotropic drugssystematic reviewtherapeutic reference rangeMore Related Videos
08:33Experimental Protocol for Examining Behavioral Response Profiles in Larval Fish: Application to the Neuro-stimulant Caffeine
Published on: July 24, 2018
11.4K
06:37Using Reference Reagents to Confirm Robustness of Cytokine Release Assays for the Prediction of Monoclonal Antibody Safety
Published on: September 15, 2023
775
Related Concept Videos
01:26Therapeutic Drug Monitoring: Drug Analysis Methods
10
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
10
01:24Dosage Regimen: Individualization
11
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
11
01:16Therapeutic Drug Monitoring: Overview and Classification
24
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
24
01:01Dosage Regimens: Partial Pharmacokinetic Parameters
17
It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
17
01:29Therapeutic Drug Monitoring: Affecting Factors
15
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
15
01:28Drug Therapy
114
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
114