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Consensus guidelines for therapeutic drugmonitoring in neuropsychopharmacology: update 2026 : pharmacokinetic, pharmacogenetic and clinical aspects

TDM involves measuring and interpreting drug concentrations in blood plasma or serum to optimize pharmacotherapy. In psychiatry and neurology, TDM is a well-established tool for personalized drug treatments. The AGNP-TDM task force initially published guidelines for best practice TDM in 2004, 2011,...

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Main Authors: Hart, Xenia Marlene (Author) , Gründer, Gerhard (Author) , Hiemke, Christoph (Author) , Adamovic, Ivana (Author) , Amann, Friederike (Author) , Baumann, Pierre (Author) , Bergemann, Niels (Author) , Brandt, Christian (Author) , Clement, Hans-Willi (Author) , Conca, Andreas (Author) , Deckert, Jürgen (Author) , Dietmaier, Otto (Author) , Eckermann, Gabriel (Author) , Egberts, Karin (Author) , Endres, Katharina (Author) , Erlacher, Nicole (Author) , Fekete, Stefanie (Author) , Ferrea, Stefano (Author) , Florio, Vincenzo (Author) , Gerlach, Manfred (Author) , Haen, Ekkehard (Author) , Hahn, Martina (Author) , Havemann-Reinecke, Ursula (Author) , Hefner, Gudrun (Author) , Jost, Wolfgang H. (Author) , Kuzin, Maxim (Author) , Laux, Gerd (Author) , Leucht, Stefan (Author) , Maniscalco, Ignazio (Author) , Menke, Andreas (Author) , Messer, Thomas (Author) , Moessner, Rainald (Author) , Müller, Daniel J. (Author) , Müller, Thomas (Author) , Paulzen, Michael (Author) , Petri, Holger (Author) , Pfeifer, Philippe (Author) , Pfuhlmann, Bruno (Author) , Riederer, Peter (Author) , Roll, Sibylle C. (Author) , Scherf-Clavel, Maike (Author) , Schwarz, Markus (Author) , Steimer, Werner (Author) , Stingl, Julia (Author) , Toto, Sermin (Author) , Ulrich, Sven (Author) , Zernig, Gerald (Author) , Zurek, Gabriela (Author) , Unterecker, Stefan (Author) , Schoretsanitēs, Geōrgios (Author)
Format: Article (Journal)
Language:English
Published: Juli 2026
In: Pharmacopsychiatry
Year: 2026, Volume: 59, Issue: 4, Pages: 166-295
ISSN:1439-0795
DOI:10.1055/a-2860-7861
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1055/a-2860-7861
Verlag, kostenfrei, Volltext: http://www.thieme-connect.de/DOI/DOI?10.1055/a-2860-7861
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Author Notes:Xenia M. Hart, Gerhard Gründer, Christoph Hiemke, Ivana Adamovic, Friederike Amann, Pierre Baumann, Niels Bergemann, Christian Brandt, Hans-Willi Clement, Andreas Conca, Jürgen Deckert, Otto Dietmaier, Gabriel Eckermann, Karin Egberts, Katharina Endres, Nicole Erlacher, Stefanie Fekete, Stefano Ferrea, Vincenzo Florio, Manfred Gerlach, Ekkehard Haen, Martina Hahn, Ursula Havemann-Reinecke, Gudrun Hefner, Wolfgang H. Jost, Maxim Kuzin, Gerd Laux, Stefan Leucht, Ignazio Maniscalco, Andreas Menke, Thomas Messer, Rainald Moessner, Daniel J. Müller, Thomas Müller, Michael Paulzen, Holger Petri, Philippe Pfeifer, Bruno Pfuhlmann, Peter Riederer, Sibylle C. Roll, Maike Scherf-Clavel, Markus Schwarz, Werner Steimer, Julia C. Stingl, Sermin Toto, Sven Ulrich, Gerald Zernig, Gabriela Zurek, Stefan Unterecker, Georgios Schoretsanitis
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Summary:TDM involves measuring and interpreting drug concentrations in blood plasma or serum to optimize pharmacotherapy. In psychiatry and neurology, TDM is a well-established tool for personalized drug treatments. The AGNP-TDM task force initially published guidelines for best practice TDM in 2004, 2011, and 2017. A fundamental methodological revision has now been carried out on how to determine therapeutic reference ranges and dose-related reference ranges transparently and systematically. In the current edition, 50 experts in neuropsychopharmacology offer a complete update of both ranges for each substance following an evidence-based approach. Various types of data were considered for reference range determination, ranging from meta-analyses to drug concentrations expected under recommended doses. Therapeutic reference ranges are now listed for 160 neuropsychiatric drugs, newly included for 30 drugs and revised for 88 drugs. Expected drug concentrations can be calculated based on a revised formula for 162 drugs. Obligatory TDM (i.e. for dose titration) is strongly recommended for 15 neuropsychiatric drugs and recommended for 39 drugs. TDM is classified as useful for 49 drugs and potentially useful for 62 drugs, indicating that it is recommended in specific clinical situations, such as suspected non-adherence, insufficient clinical response despite recommended doses, relapse during maintenance treatment, and many more. The 2026 update includes practical pharmacogenetic recommendations that are directly relevant to TDM. This work integrates a combination of strategies to guide drug treatments in clinical practice using all available tools. A consistent implementation of TDM and pharmacogenetic recommendations will enhance neuropsychopharmacotherapy, improve patient outcomes, and reduce healthcare costs.
Item Description:Artikel online veröffentlicht: 02. Juli 2026
Gesehen am 30.07.2026
Physical Description:Online Resource
ISSN:1439-0795
DOI:10.1055/a-2860-7861

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