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A review of a recently published guidelines' "strong recommendation" for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine.
Ment Health Clin 2019; 9(4):287-293MH

Abstract

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.

Authors

No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31293849

Citation

Noel, Christopher. "A Review of a Recently Published Guidelines' "strong Recommendation" for Therapeutic Drug Monitoring of Olanzapine, Haloperidol, Perphenazine, and Fluphenazine." The Mental Health Clinician, vol. 9, no. 4, 2019, pp. 287-293.
Noel C. A review of a recently published guidelines' "strong recommendation" for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine. Ment Health Clin. 2019;9(4):287-293.
Noel, C. (2019). A review of a recently published guidelines' "strong recommendation" for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine. The Mental Health Clinician, 9(4), pp. 287-293. doi:10.9740/mhc.2019.07.287.
Noel C. A Review of a Recently Published Guidelines' "strong Recommendation" for Therapeutic Drug Monitoring of Olanzapine, Haloperidol, Perphenazine, and Fluphenazine. Ment Health Clin. 2019;9(4):287-293. PubMed PMID: 31293849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of a recently published guidelines' "strong recommendation" for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine. A1 - Noel,Christopher, Y1 - 2019/07/01/ PY - 2019/7/12/entrez PY - 2019/7/12/pubmed PY - 2019/7/12/medline KW - TDM KW - fluphenazine KW - haloperidol KW - olanzapine KW - perphenazine KW - plasma concentrations KW - therapeutic drug monitoring SP - 287 EP - 293 JF - The mental health clinician JO - Ment Health Clin VL - 9 IS - 4 N2 - 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. SN - 2168-9709 UR - https://www.unboundmedicine.com/medline/citation/31293849/A_review_of_a_recently_published_guidelines'_"strong_recommendation"_for_therapeutic_drug_monitoring_of_olanzapine,_haloperidol,_perphenazine,_and_fluphenazine L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31293849/ DB - PRIME DP - Unbound Medicine ER -