Preskorn S H, Burke M J, Fast G A
Psychiatric Research Institute, St. Francis Regional Medical Center, Wichita, Kansas.
Psychiatr Clin North Am. 1993 Sep;16(3):611-45.
TDM represents an important tool in the optimal use of selected psychiatric medications. Its role in therapy varies depending on the drug being prescribed. For some medications, such as lithium and tricyclic antidepressants, it should be a standard aspect of care. For other drugs, such as benzodiazepines, it is not helpful. Unfortunately, the use of TDM often follows an "all or none" pattern. Some clinicians rarely use it even for drugs like TCAs where it is critical to optimal care. Others use it excessively; repeating levels when it is not necessary or for drugs for which it is not necessary. It is hoped that this article has provided a basis for the thoughtful application of TDM in psychiatry as well as a review of the available data.
治疗药物监测是优化使用某些精神科药物的一项重要工具。其在治疗中的作用因所开药物而异。对于某些药物，如锂盐和三环类抗抑郁药，它应是标准治疗的一部分。对于其他药物，如苯二氮䓬类药物，则没有帮助。不幸的是，治疗药物监测的使用往往遵循“全有或全无”的模式。一些临床医生即使对于像三环类抗抑郁药这类对优化治疗至关重要的药物也很少使用它。另一些人则过度使用；在不必要时重复检测血药浓度，或者对不需要进行治疗药物监测的药物进行检测。希望本文为在精神病学中合理应用治疗药物监测提供了依据，并对现有数据进行了综述。
