Therapeutic Drug Monitoring
In their article, our colleagues Hirsch and Steinert (1) provide an important overview of the emergency medical treatment of psychomotor agitation and aggressive behavior. Another important aspect in this context is therapeutic drug monitoring (TDM) of antipsychotics and antidepressants. This is especially true, as the authors list problems such as the low potency, adverse drug reactions, and dose adjustments for geriatric patients, as well as drug–drug interactions, pharmacokinetic peculiarities, and individual enzyme features. Furthermore, individualized TDM is an important component of emergency medical treatment and follow-up treatment. TDM is performed according to the latest developments using liquid chromatography tandem mass spectrometry (LC-MS/MS), to obtain the best possible sensitivity and specificity while avoiding cross-reactivity in the analysis. Recommendations for TDM can be found in the currently valid version of the guideline of the working group on neuropsychopharmacology and pharmacopsychiatry (Arbeitsgemeinschaft fuer Neuropsychopharmakologie und Pharmakopsychiatrie) (2).
Dr. med. Ramona Dolscheid-Pommerich
Prof. Dr. med. Dipl. Biol. Birgit Stoffel-Wagner
Institut für Klinische Chemie und Klinische Pharmakologie
Conflict of interest statement
Dr. Dolscheid-Pommerich has received speaking honoraria from Siemens Healthineers and Roche Diagnostics.
Prof. Stoffel-Wagner declares that no conflict of interest exists.
|1.||Hirsch S, Steinert T: The use of rapid tranquilization in aggressive behavior. Dtsch Arztebl Int 2019; 116: 445–52 VOLLTEXT|
|2.||Hiemke C, Bergemann N, Clement HW, et al.: AGNP consensus guidelines for therapeutic drug monitoring in psychiatry: Update 2017; Pharmacopsychiatry 51: 9–62 CrossRef MEDLINE|