Influencing CYP Enzymes to Boost Psychiatric Treatment: A Review on Clinical Evidence

Hasselt, F. M. van; Coehorst, Y.; Wilffert, Bob; Loonen, Antonius

doi:10.1055/s-0032-1323752

Cited by 1 publication

(1 citation statement)

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“…When combining compounds that are inhibitors or inducers of drug metabolizing enzymes (▶Table 2, 3) with a drug that is a substrate of the inhibited or induced enzyme (▶ Table 1), dosing should be guided by TDM to avoid loss of action, poor tolerability or intoxication due to a pharmacokinetic drug-drug interaction [364,412,1081,1236]. Effects of smoking should be considered when patients are under therapy with a CYP1A2 substrate such as clozapine, duloxetine, mirtazapine, olanzapine, rasagiline or ropinirol (▶ Table 1).…”

Section: Recommendationmentioning

confidence: 99%

Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017

Bergemann²,

et al. 2017

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Therapeutic 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-drug interactions are typical indications for TDM. However, the potential benefits of TDM to optimize pharmacotherapy can only be obtained if the method is adequately integrated in the clinical treatment process. To supply treating physicians and laboratories with valid information on TDM, the TDM task force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued their first guidelines for TDM in psychiatry in 2004. After an update in 2011, it was time for the next update. Following the new guidelines holds the potential to improve neuropsychopharmacotherapy, accelerate the recovery of many patients, and reduce health care costs.

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Section: Recommendationmentioning

confidence: 99%