0000000000454673
AUTHOR
Julia C. Stingl
Tools for optimising pharmacotherapy in psychiatry (therapeutic drug monitoring, molecular brain imaging and pharmacogenetic tests): focus on antidepressants.
Contains fulltext : 238693.pdf (Publisher’s version ) (Open Access) Objectives: More than 40 drugs are available to treat affective disorders. Individual selection of the optimal drug and dose is required to attain the highest possible efficacy and acceptable tolerability for every patient.Methods: This review, which includes more than 500 articles selected by 30 experts, combines relevant knowledge on studies investigating the pharmacokinetics, pharmacodynamics and pharmacogenetics of 33 antidepressant drugs and of 4 drugs approved for augmentation in cases of insufficient response to antidepressant monotherapy. Such studies typically measure drug concentrations in blood (i.e. therapeutic …
Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017
AbstractTherapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to optimize pharmacotherapy. It considers the interindividual variability of pharmacokinetics and thus enables personalized pharmacotherapy. In psychiatry and neurology, patient populations that may particularly benefit from TDM are children and adolescents, pregnant women, elderly patients, individuals with intellectual disabilities, patients with substance abuse disorders, forensic psychiatric patients or patients with known or suspected pharmacokinetic abnormalities. Non-response at therapeutic doses, uncertain drug adherence, suboptimal tolerability, or pharmacokinetic drug…
Pharmakokinetik, Pharmakogenetik und therapeutisches Drug Monitoring
Um einen pharmakologischen Effekt zu erzeugen, muss ein Medikament den Wirkort in ausreichender Konzentration erreichen. Welche Menge den Wirkort erreicht, hangt wesentlich von der Dosis ab, aber auch von vielen weiteren Faktoren, die bestimmen, welche Mengen resorbiert werden und wie das Medikament im Korper verteilt, abgebaut und ausgeschieden wird. Diese Prozesse sind auch dafur verantwortlich, wie lange die Wirkung anhalt. Die Pharmakokinetik beschreibt und erklart diese Zusammenhange, insbesondere den zeitlichen Konzentrationsverlauf der Medikamente und ihrer Metaboliten in Flussigkeiten und Geweben des Korpers. Sie versucht auch, zu erklaren, welche biologischen Mechanismen fur diese …
CYP2D6 genotype and adjuvant tamoxifen: meta-analysis of heterogeneous study populations.
The International Tamoxifen Pharmacogenomics Consortium was established to address the controversy regarding cytochrome P450 2D6 (CYP2D6) status and clinical outcomes in tamoxifen therapy. We performed a meta-analysis on data from 4,973 tamoxifen-treated patients (12 globally distributed sites). Using strict eligibility requirements (postmenopausal women with estrogen receptor-positive breast cancer, receiving 20 mg/day tamoxifen for 5 years, criterion 1); CYP2D6 poor metabolizer status was associated with poorer invasive disease-free survival (IDFS: hazard ratio = 1.25; 95% confidence interval = 1.06, 1.47; P = 0.009). However, CYP2D6 status was not statistically significant when tamoxifen…