François T, Bonin B, Vandel S, Sechter D, Bizouard P
Service de psychiatrie et psychologie médicale, Centre hospitalier universitaire, hôpital Saint-Jacques, Besançon.
Rev Prat. 1994 Nov 1;44(17):2336-40.
An increased use of determinations of psychotropic drug levels has been noted during recent years. The contribution of "biological techniques" has led to a change in the relationship between physician and patient by rationalizing medical prescription and by augmenting the medical nature of this relationship. Follow-up of plasma levels is of interest for psychotropic drugs having therapeutic and (or) side effects that are linked to blood concentrations. Such drugs include the imipraminic antidepressants and regulators of thymic function. There is no consensus concerning the benzodiazepines and neuroleptic drugs. Their clinical effect does not seem to be strictly linked to plasma levels and the range of dosages is greater. Such determinations have proved to be particularly interesting in "resistant" cases, in surveillance of drug interactions and to evaluate treatment compliance.
近年来,精神药物水平测定的应用有所增加。“生物技术”的贡献通过使药物处方合理化以及增强医患关系的医学性质,改变了医患之间的关系。对于那些治疗和(或)副作用与血药浓度相关的精神药物,监测血浆水平很有意义。这类药物包括丙咪嗪类抗抑郁药和胸腺功能调节剂。对于苯二氮䓬类药物和抗精神病药物,目前尚无共识。它们的临床效果似乎与血浆水平没有严格关联,而且剂量范围更大。在“难治性”病例、药物相互作用监测以及评估治疗依从性方面,这类测定已被证明特别有意义。