Blood Levels to Optimize Antipsychotic Treatment in Clinical Practice: A Joint Consensus Statement of the ASCP and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie

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Overview

The quantification of antipsychotic levels in blood, or therapeutic drug monitoring (TDM), could aid clinicians in numerous challenging scenarios. Learn more about using TDM for dosing decisions in this journal CME activity that describes expert consensus.


Read the whole article at psychiatrist.com here:
Blood Levels to Optimize Antipsychotic Treatment in Clinical Practice: A Joint Consensus Statement of the ASCP and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie

© Copyright 2020 Physicians Postgraduate Press, Inc.

Target Audience

Psychiatrists

Learning Objectives

Use therapeutic drug monitoring with appropriate indications as part of the clinical decision-making process to help optimize the efficacy and safety of antipsychotics

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
05/19/2020
Activity expires: 
06/30/2022
Cost:
$10.00
Rating: 
0

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Use therapeutic drug monitoring with appropriate indications as part of the clinical decision-making process to help optimize the efficacy and safety of antipsychotics

Statement of Need and Purpose

Despite the general call for personalized therapy, available relevant tools in standard psychiatric care are scarce.  TDM is an evidence-based method that measures interindividual pharmacokinetic variability, which can be leveraged to enhance safety and efficacy of antipsychotic treatment. The use of TDM with antipsychotics might guide clinicians to reduce the risk of under- or overdosing and of side effects, thereby offering an ability to improve efficacy, safety/tolerability, and adherence.

Release, Expiration, and Review Dates

This educational activity was published in May 2020 and is eligible for AMA PRA Category 1 Credit™ through June 30, 2022. The latest review of this material was April 2020.

Disclosure of off-label usage

The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.

Author contributions

Drs Hiemke, Goff, Gründer, Paulzen, Correll, Citrome, Kelly, Schoretsanitis, and Kane wrote the first article draft. All the authors critically read and revised the manuscript.

Funding/support

No commercial organizations had any role in the completion of this work.

 

Faculty Affiliation

Georgios Schoretsanitis, MD, PhD*
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York

John M. Kane, MD
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, and Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York

Christoph U. Correll, MD
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, and Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany

Stephen R. Marder, MD
Psychiatry and Biobehavioral Sciences, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California

Leslie Citrome, MD, MPH
Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York

John W. Newcomer, MD
Thriving Mind South Florida Behavioral Health Network, Miami, Florida; and Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri

Delbert G. Robinson, MD
Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, and Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York, and Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York

Donald C. Goff, MD
Department of Psychiatry, NYU Langone Medical Center, New York, and Nathan Kline Institute, Orangeburg, New York

Deanna L. Kelly, PhD
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland

Oliver Freudenreich, MD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Daria Piacentino, MD, PhD
Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, and Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland

Michael Paulzen, MD
Alexianer Hospital Aachen; and Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University; and JARA–Translational Brain Medicine, Aachen, Germany

Andreas Conca, MD
Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy

Gerald Zernig, MD
Experimental Psychiatry Unit, Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Innsbruck, and Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria

Ekkehard Haen, MD, PhD
Clinical Pharmacology, Department of Psychiatry and Psychotherapy, and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany

Pierre Baumann, PhD
Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland

Christoph Hiemke, PhD
Department of Psychiatry and Psychotherapy and Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany

Gerhard Gründer, MD
Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

For the American Society of Clinical Psychopharmacology and the Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrier (members listed below)

*Corresponding author: Georgios Schoretsanitis, MD, PhD, Department of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 75-59 263rd St, Glen Oaks, NY 11004 (george.schor@gmail.com).

Financial Disclosure

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief of The Journal of Clinical Psychiatry, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.

Dr Kane has been a consultant for or received honoraria from Alkermes, Dainippon Sumitomo, Eli Lilly, Forum, Allergan, Genentech, H. Lundbeck, Intracellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, LB Pharmaceuticals, Merck, Minerva, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva; has received grant support from Otsuka, Lundbeck, and Janssen; has participated in advisory boards for Alkermes, Dainippon Sumitomo, Intracellular Therapies, Lundbeck, Neurocrine, Otsuka, Pierre Fabre, Takeda, and Teva; and is a shareholder in Vanguard Research Group and LB Pharmaceuticals, Inc. Dr Correll has been a consultant and/or advisor to or has received honoraria from Alkermes, Allergan, Angelini, Boehringer-Ingelheim, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular Therapies, Janssen/J&J, LB Pharma, Lundbeck, MedAvante-ProPhase, Medscape, Merck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Rovi, Servier, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; has provided expert testimony for Bristol-Myers Squibb, Janssen, and Otsuka; has served on a data safety monitoring board for Boehringer-Ingelheim, Lundbeck, Rovi, Supernus, and Teva; has received royalties from UpToDate and grant support from Janssen and Takeda; and is a shareholder of LB Pharma. Dr Marder has received consulting fees from Boehringer-Ingelheim, Lundbeck, Otsuka, Takeda, Teva, Roche, Genentech, Targacept, Forum, Abbvie, Allergan, and Neurocrine and has received research support from Boehringer-Ingelheim, Takeda, and Neurocrine. Dr Citrome has been a consultant in the past 12 months for Acadia, Alkermes, Allergan, Impel, Indivior, Intra-Cellular Therapies, Janssen, Lundbeck, Merck, Neurocrine, Noven, Osmotica, Otsuka, Pfizer, Shire, Sunovion, Takeda, Teva, and Vanda; has in the past 12 months also been a speaker for Acadia, Alkermes, Allergan, Janssen, Lundbeck, Merck, Neurocrine, Otsuka, Pfizer, Shire, Sunovion, Takeda, and Teva; holds stocks (small number of shares of common stock) of Bristol-Myers Squibb, Eli Lilly, J & J, Merck, and Pfizer purchased > 10 years ago; and has received royalties from Wiley (Editor-in-Chief, International Journal of Clinical Practice), UpToDate (reviewer), and Springer Healthcare (book). Dr Newcomer has served on a data safety monitoring board for Amgen and acted as a consultant for Alkermes, Otsuka, Intracellular Therapies, Auris, and Sunovion and for litigation. Dr Robinson served as a consultant for Asubio, Otsuka, and Shire and has received grants from Bristol-Myers Squibb, Janssen, and Otsuka. Dr Goff has received research support from the National Institutes of Health, Stanley Medical Research Foundation, and Avanir Pharmaceuticals and has participated in advisory boards for Avanir Pharmaceuticals and Takeda for which he accepted travel reimbursement but has not accepted honoraria. Dr Kelly has served on the advisory board for Lundbeck and as a consultant for HLS Therapeutics and Alkermes. Dr Freudenreich has served on advisory boards or as a consultant to Alkermes, Neurocrine, Janssen, Novartis, and Roche; received research grants from Avanir, Janssen, Otsuka, and Saladax; served as a content developer for Global Medical Education; and received royalties from Wolters Kluwer and UpToDate. Dr Conca has served as a consultant for Lilly, Bristol-Myers Squibb, and Pfizer and has served on the speakers’ bureau of Lilly, BMS, Astra Zeneca, Lundbeck, Italfarma, and Janssen. Dr Zernig has received speaker’s or consultancy fees or educational grants from AlcaSynn, AstraZeneca, Bio-Rad, Bristol-Myers Squibb, Eli Lilly, Lundbeck, Mundipharma, Novartis, Pfizer, and Wyeth. Dr Haen is chairman and managing director of the AGATE (www.amuep-agate.de) that supports reasonable and economic drug therapy and is shareholder of the psiac GmbH (www.psiac.de), which provides an Internet-based drug-drug interaction program. Dr Baumann has received speaker’s or consultancy fees from almost all pharmaceutical companies selling psychotropic drugs in Switzerland. Dr Hiemke has received speaker’s and consultancy fees from Janssen, Stada, and Servier and is editor of an Internet-based drug-drug interaction program (www.psiac.de). Dr Gründer has served as consultant and advisory board member during the last three years for the following companies and institutions: Allergan, Boehringer Ingelheim, Eli Lilly, IQWiG, Janssen-Cilag, Lundbeck, Otsuka, Recordati, SAGE and Takeda; has received honoraria as a speaker for Gedeon-Richter, Janssen-Cilag, Lundbeck, Neuraxpharma, Otsuka, and Recordati; has received funding for clinical trials from Boehringer Ingelheim, Lundbeck, and Saladax; and is the founder and a shareholder of Brainfoods GmbH, InMedicon GmbH, and Mind and Brain Institute GmbH. Drs SchoretsanitisPiacentino, and Paulzen have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article.

Group Information

The Therapeutic Drug Monitoring Task Force of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie: Niels Bergemann, MD, PhD; Hans-Willi Clement, PhD; Jürgen Deckert, MD; Gabriel Eckermann, MD; Karin Egberts, MD; Manfred Gerlach, PhD; Christine Greiner, PhD; Ursula Havemann-Reinecke, MD, PhD; Gudrun Hefner, PhD; Renate Helmer, PhD; Gerd Laux, MD; Thomas Messer, MD; Rainald Mössner, MD; Matthias J. Müller, MD, PhD; Bruno Pfuhlmann, MD; Peter Riederer, PhD; Alois Saria, MD; Bernd Schoppek, PhD; Markus Schwarz, MD; Margarete Silva Gracia, PhD; Benedikt Stegmann, PhD; Werner Steimer, MD; Manfred Uhr, MD, PhD; Sven Ulrich, PhD; Stefan Unterecker MD, Roland Waschgler, MSc; and Gabriela Zurek, PhD. The ASCP members who were involved with this consensus statement are listed as authors.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

 

 

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation

Price

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