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Therapeutic Drug Monitoring of Common Antipsychotics

Patteet, Lisbeth Pharm*; Morrens, Manuel MD, PhD†,‡; Maudens, Kristof E. PhD*; Niemegeers, Peter MD; Sabbe, Bernard MD, PhD†,§; Neels, Hugo PhD*,¶

doi: 10.1097/FTD.0b013e3182708ec5.
Review Article

Abstract: The aim of this review is to provide information for interpreting outcome results from monitoring of antipsychotics in biological samples. A brief overview of the working mechanisms, pharmacological effects, drug interactions, and analytical methods of classical and atypical antipsychotics is given. Nineteen antipsychotics were selected based on their importance in the worldwide market as follows: amisulpride, aripiprazole, asenapine, bromperidol, clozapine, flupenthixol, haloperidol, iloperidone, lurasidone, olanzapine, paliperidone, perphenazine, pimozide, pipamperone, quetiapine, risperidone, sertindole, sulpiride, and zuclopenthixol. A straightforward relationship between administered dose, plasma or serum concentration, clinical outcome, or adverse effects is often lacking. Nowadays, focus lies on therapeutic drug monitoring and individualized therapy to find adequate treatment, to explain treatment failure or nonresponse, and to check patient compliance. However, extensive research in this field is still mandatory.

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*Toxicological Centre, University of Antwerp, Universiteitsplein 1, Antwerp, Belgium

Faculty of Medicine, Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, Antwerp, Belgium

Psychiatric Hospital Broeders Alexianen, Provinciesteenweg, Boechout, Belgium

§Psychiatric Centre Sint-Norbertushuis, Stationstraat, Duffel, Belgium

Laboratory for TDM and toxicology, ZNA Stuivenberg, Lange Beeldekensstraat, Antwerpen, Belgium.

Correspondence: Lisbeth Patteet, Toxicological Centre, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Antwerp, Belgium (e-mail:

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (

Received April 27, 2012

Accepted August 15, 2012

© 2012 Lippincott Williams & Wilkins, Inc.