A review of a recently published guidelines' “strong recommendation” for therapeutic drug monitoring of olanzapine, haloperidol, perphenazine, and fluphenazine
Document Type
Article
Publication Date
7-2019
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.
DOI
https://doi.org/10.9740/mhc.2019.07.287
Publication Information
Noel, Christopher (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, 287-293.
Please note that the Publication Information provides general citation information and may not be appropriate for your discipline. To receive help in creating a citation based on your discipline, please visit http://libguides.sjfc.edu/citations.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License