Influences on therapeutic drug monitoring of psychotropic drugs – analyst's perspective

 

Introduction Therapeutic drug monitoring (TDM) of psychotropic drugs is an essential tool for therapy management. A lot of different analytical methods are in use. Does the determination method used influence the results? Which other factors are decisive?

Methods An overview of Methods reported in the German External Quality Assessment (EQA) schemes for psychotropic drugs is given and different methods discussed. The general principle of the methods will be presented including significant advantages and disadvantages. In additions, analytical challenges for the determination of enantiomeric pure drugs such as escitalopram are discussed. Various influences and interfering factors for TDM are reflected.

Results The spectrum of methods used range from atomic absorption to chromatography-based methods (HPLC-UV or LC/MS-MS), and immunoassays. Variances of the individual methods in EQA are similar. Discrepancies are seen for Lithium. However, humans exert significant influences, whether during blood collection, sample processing, or by the patient themselves through individual metabolism or compliance.

Conclusion Most analytical procedures work very well. TDM of psychotropic drugs is substantially influenced by correct blood collection and processing as well as the patient.

Conflict of Interest No conflict of interest exists

Publication History

Article published online:
16 May 2022

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