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A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine
INTRODUCTION: In addition to clozapine, there is a growing body of evidence that supports therapeutic drug monitoring (TDM) for additional antipsychotics commonly used in the United States. METHODS: The Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) published TDM gui...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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College of Psychiatric & Neurologic Pharmacists
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607953/ https://www.ncbi.nlm.nih.gov/pubmed/31293849 http://dx.doi.org/10.9740/mhc.2019.07.287 |
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author | Noel, Christopher |
author_facet | Noel, Christopher |
author_sort | Noel, Christopher |
collection | PubMed |
description | INTRODUCTION: In addition to clozapine, there is a growing body of evidence that supports therapeutic drug monitoring (TDM) for additional antipsychotics commonly used in the United States. METHODS: The Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) published TDM guidelines for several psychiatric medications. Sources were identified that the authors used to establish therapeutic reference ranges for haloperidol, fluphenazine, perphenazine, and olanzapine—4 antipsychotics commonly used in the United States with a “strong recommendation” for TDM. The sources were then reviewed for content and appropriateness for utilization in establishing the reference ranges. RESULTS: Olanzapine had 15 citations, haloperidol had 9, perphenazine had 4, and fluphenazine had 2. The studies' methods were reviewed along with the proposed therapeutic reference ranges. DISCUSSION: Several limitations of the guidelines were identified. Reference ranges were suggested based on studies of patients with various diagnoses; some patients had an acute exacerbation, and others were in a maintenance phase. An additional publication was identified that reviewed similar (and additional) TDM studies; those conclusions were in slight contrast with those of the AGNP guidelines. In the future, guidance should be given to those looking to conduct TDM studies to standardize methods and make meta-analysis of this data more feasible. |
format | Online Article Text |
id | pubmed-6607953 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | College of Psychiatric & Neurologic Pharmacists |
record_format | MEDLINE/PubMed |
spelling | pubmed-66079532019-07-10 A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine Noel, Christopher Ment Health Clin Literature Review INTRODUCTION: In addition to clozapine, there is a growing body of evidence that supports therapeutic drug monitoring (TDM) for additional antipsychotics commonly used in the United States. METHODS: The Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) published TDM guidelines for several psychiatric medications. Sources were identified that the authors used to establish therapeutic reference ranges for haloperidol, fluphenazine, perphenazine, and olanzapine—4 antipsychotics commonly used in the United States with a “strong recommendation” for TDM. The sources were then reviewed for content and appropriateness for utilization in establishing the reference ranges. RESULTS: Olanzapine had 15 citations, haloperidol had 9, perphenazine had 4, and fluphenazine had 2. The studies' methods were reviewed along with the proposed therapeutic reference ranges. DISCUSSION: Several limitations of the guidelines were identified. Reference ranges were suggested based on studies of patients with various diagnoses; some patients had an acute exacerbation, and others were in a maintenance phase. An additional publication was identified that reviewed similar (and additional) TDM studies; those conclusions were in slight contrast with those of the AGNP guidelines. In the future, guidance should be given to those looking to conduct TDM studies to standardize methods and make meta-analysis of this data more feasible. College of Psychiatric & Neurologic Pharmacists 2019-07-01 /pmc/articles/PMC6607953/ /pubmed/31293849 http://dx.doi.org/10.9740/mhc.2019.07.287 Text en © 2019 CPNP. The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Literature Review Noel, Christopher A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title | A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title_full | A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title_fullStr | A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title_full_unstemmed | A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title_short | A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
title_sort | review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine |
topic | Literature Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607953/ https://www.ncbi.nlm.nih.gov/pubmed/31293849 http://dx.doi.org/10.9740/mhc.2019.07.287 |
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