Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.
Child Adolesc Psychiatry Ment Health. 2009 Apr 9;3(1):14. doi: 10.1186/1753-2000-3-14.
Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM) is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded 1 introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents.
大多数用于治疗儿童和青少年的精神药物都是“超适应证”使用的，这直接存在药物剂量过低或过高的风险，以及长期出现副作用的延迟风险。在儿科精神科患者中选择剂量时需要考虑药代动力学参数和中枢神经系统的发育，并需要在儿童和青少年中进行特定的研究。由于大多数应用于儿童和青少年精神病学的精神药物缺乏这些研究，治疗药物监测（TDM）是优化药物治疗的有效工具，并能够根据个体患者的特点调整药物剂量。多中心 TDM 研究能够确定与年龄和发育相关的血液浓度治疗范围，并促进儿童和青少年保健系统中高度合格的标准化记录。此外，它们将为未来儿童和青少年精神药理学治疗的研究提供数据，例如作为与各种合并药物的各种临床相关相互作用的基线。因此，成立了一个德奥瑞“儿童和青少年精神病学治疗药物监测能力网络”，引入了一个综合的互联网数据库，用于收集儿童和青少年精神药物的人口统计学、安全性和疗效数据以及血液浓度数据。
