Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews

Background: For many psychotropic drugs, monitoring of drug concentrations in the blood (Therapeutic Drug Monitoring; TDM) has been proven useful to individualize treatments and optimize drug effects. Clinicians hereby compare individual drug concentrations to population-based reference ranges for a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Xenia M. Hart, Luzie Eichentopf, Xenija Lense, Thomas Riemer, Katja Wesner, Christoph Hiemke, Gerhard Gründer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	psychotropic drugs drug monitoring therapeutic reference range concentration/effect relationship systematic review Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/9c2559bab1ee4d849d3f9c62798725a5
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9c2559bab1ee4d849d3f9c62798725a5
record_format	dspace
spelling	oai:doaj.org-article:9c2559bab1ee4d849d3f9c62798725a52021-11-30T19:46:11ZTherapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews1664-064010.3389/fpsyt.2021.787043https://doaj.org/article/9c2559bab1ee4d849d3f9c62798725a52021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.787043/fullhttps://doaj.org/toc/1664-0640Background: For many psychotropic drugs, monitoring of drug concentrations in the blood (Therapeutic Drug Monitoring; TDM) has been proven useful to individualize treatments and optimize drug effects. Clinicians hereby compare individual drug concentrations to population-based reference ranges for a titration of prescribed doses. Thus, established reference ranges are pre-requisite for TDM. For psychotropic drugs, guideline-based ranges are mostly expert recommendations derived from a conglomerate of cohort and cross-sectional studies. A systematic approach for identifying therapeutic reference ranges has not been published yet. This paper describes how to search, evaluate and grade the available literature and validate published therapeutic reference ranges for psychotropic drugs.Methods/Results: Following PRISMA guidelines, relevant databases have to be systematically searched using search terms for the specific psychotropic drug, blood concentrations, drug monitoring, positron emission tomography (PET) and single photon emission computed tomography (SPECT). The search should be restricted to humans, and diagnoses should be pre-specified. Therapeutic references ranges will not only base upon studies that report blood concentrations in relation to clinical effects, but will also include implications from neuroimaging studies on target engagement. Furthermore, studies reporting concentrations in representative patient populations are used to support identified ranges. Each range will be assigned a level of underlying evidence according to a systematic grading system.Discussion: Following this protocol allows a comprehensive overview of TDM literature that supports a certain reference range for a psychotropic drug. The assigned level of evidence reflects the validity of a reported range rather than experts' opinions.Xenia M. HartLuzie EichentopfXenija LenseThomas RiemerKatja WesnerChristoph HiemkeGerhard GründerFrontiers Media S.A.articlepsychotropic drugsdrug monitoringtherapeutic reference rangeconcentration/effect relationshipsystematic reviewPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	psychotropic drugs drug monitoring therapeutic reference range concentration/effect relationship systematic review Psychiatry RC435-571
spellingShingle	psychotropic drugs drug monitoring therapeutic reference range concentration/effect relationship systematic review Psychiatry RC435-571 Xenia M. Hart Luzie Eichentopf Xenija Lense Thomas Riemer Katja Wesner Christoph Hiemke Gerhard Gründer Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
description	Background: For many psychotropic drugs, monitoring of drug concentrations in the blood (Therapeutic Drug Monitoring; TDM) has been proven useful to individualize treatments and optimize drug effects. Clinicians hereby compare individual drug concentrations to population-based reference ranges for a titration of prescribed doses. Thus, established reference ranges are pre-requisite for TDM. For psychotropic drugs, guideline-based ranges are mostly expert recommendations derived from a conglomerate of cohort and cross-sectional studies. A systematic approach for identifying therapeutic reference ranges has not been published yet. This paper describes how to search, evaluate and grade the available literature and validate published therapeutic reference ranges for psychotropic drugs.Methods/Results: Following PRISMA guidelines, relevant databases have to be systematically searched using search terms for the specific psychotropic drug, blood concentrations, drug monitoring, positron emission tomography (PET) and single photon emission computed tomography (SPECT). The search should be restricted to humans, and diagnoses should be pre-specified. Therapeutic references ranges will not only base upon studies that report blood concentrations in relation to clinical effects, but will also include implications from neuroimaging studies on target engagement. Furthermore, studies reporting concentrations in representative patient populations are used to support identified ranges. Each range will be assigned a level of underlying evidence according to a systematic grading system.Discussion: Following this protocol allows a comprehensive overview of TDM literature that supports a certain reference range for a psychotropic drug. The assigned level of evidence reflects the validity of a reported range rather than experts' opinions.
format	article
author	Xenia M. Hart Luzie Eichentopf Xenija Lense Thomas Riemer Katja Wesner Christoph Hiemke Gerhard Gründer
author_facet	Xenia M. Hart Luzie Eichentopf Xenija Lense Thomas Riemer Katja Wesner Christoph Hiemke Gerhard Gründer
author_sort	Xenia M. Hart
title	Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
title_short	Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
title_full	Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
title_fullStr	Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
title_full_unstemmed	Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews
title_sort	therapeutic reference ranges for psychotropic drugs: a protocol for systematic reviews
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9c2559bab1ee4d849d3f9c62798725a5
work_keys_str_mv	AT xeniamhart therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT luzieeichentopf therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT xenijalense therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT thomasriemer therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT katjawesner therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT christophhiemke therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews AT gerhardgrunder therapeuticreferencerangesforpsychotropicdrugsaprotocolforsystematicreviews
_version_	1718406280536653824

Therapeutic Reference Ranges for Psychotropic Drugs: A Protocol for Systematic Reviews

Ejemplares similares