THERAPEUTIC MONITORING OF ANTIPSYCHOTIC DRUGS

Nowadays the mainstay of treatment is drug therapy. Chlorpromazine, haloperidol and other ‘first generation’ drugs are gradually being superseded by ‘second generation’ or ‘atypical’ antipsychotics that generally have fewer unpleasant side-effects than the older drugs. The most effective of these second generation drugs is clozapine. There are a number of reports that demonstrate relationships between plasma antipsychotic concentrations and in vivo binding to receptors in different regions of the brain. However, only in the case of plasma clozapine is there evidence that there is a generallyapplicable ‘target range’ associated with successful therapy making it an ideal candidate for therapeutic drug monitoring (TDM) (Flanagan, 2006; Hiemke, 2008).