Commentary: therapeutic monitoring of antipsychotic drugs.
Commentary: therapeutic monitoring of antipsychotic drugs.
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评论：抗精神病药物的治疗监测。
DOI：
10.1097/00004714-199704000-00015
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发表时间：
1997
影响因子：
2.9
通讯作者：
S. Curry
中科院分区：
文献类型：
--
作者：
S. Curry
Markowitz及其同事在本期杂志上发表的这封信[1]提供了关于精神病学标准实践或“护理标准”发展的有趣见解，当科学观察转移到临床实践时。大约在1966年，伯纳德博士B。布罗迪是药物代谢研究的先驱，1967年赢家拉斯克奖，当时的国家心脏研究所化学药理学实验室主任，他刺激了对镇静剂和抗抑郁药血浆浓度的研究。[2，3]布罗迪注意到，人们对发现越来越多的药物代谢物（如氯丙嗪）有浓厚的研究兴趣，但对血液或血液成分中的浓度或药代动力学没有明显的兴趣，并且存在检测尿液依从性而不检查血液中氯丙嗪的临床实践。布罗迪认为，重点应转向所有药物活性物质的血浆浓度，这通常意味着未代谢的母体药物，特别是精神病患者，如果通过剂量变化将其血浆浓度调整到尚未确定的治疗范围，可能会得到更好的控制。在氯丙嗪的案例中，气相色谱与电子捕获检测提供了分析方法，[4]我有幸作为访问研究员参与了早期的探索工作，当时这是一个全新的研究领域。很快，在与约翰·马歇尔、约翰·戴维斯和大卫·贾诺夫斯基的合作下，氯丙嗪在患者之间和患者体内的血浆浓度的巨大差异变得明显起来，在浓度和效应之间的倒U形关系中间的治疗范围的概念诞生了。[5-7]现在已经有许多关于抗精神病药物的效果与血浆浓度之间关系的研究。根据Shriqui的说法，[8]超过100项临床研究试图确定剂量，精神抑制剂“血液”（我的引号）水平和临床反应之间的相关程度，以寻找精神分裂症治疗药物监测（TDM）实践的基础。作为证据，Shriqui列出了1972年至1993年进行的27项固定剂量研究，试图确定三种化合物的治疗范围。
The letter by Markowitz and colleagues published in this issue of the Journal [1] provides interesting insights into the development of standard practices or" standards of care" in psychiatric medicine when scientific observations are transferred to clinical practice. It was in approximately 1966 that Dr. Bernard B. Brodie, pioneer in drug metabolism research and Lasker Award winner in 1967, Director of the Laboratory of Chemical Pharmacology at the then National Heart Institute, stimulated research into plasma concentrations of tranquilizers and antidepressants.[2, 3] Brodie had noticed the intense research interest in discovery of more and more metabolites of drugs such as chlorpromazine, with no apparent interest in concentrations in blood or blood fractions, or in pharmacokinetics, and the existence of the clinical practice of testing urine for compliance without checking for chlorpromazine in the blood. Brodie considered that emphasis should switch to plasma concentrations of the active species of all drugs, which usually meant the unmetabolized parent drug, and that psychiatric patients in particular might be better controlled if their plasma concentrations were adjusted, by means of dosage changes, to as-yet undetermined therapeutic ranges. In the case of chlorpromazine, gas chromatography with electron capture detection provided the analytical method,[4] and I was privileged as a visiting fellow to be involved in the early exploratory work in what was then a brand new field of research. Quite quickly, in collaboration with John Marshall, John Davis, and David Janowsky, wide variations between and within patients in plasma concentrations of chlorpromazine became evident, and the notion of a therapeutic range in the middle of an inverted U-shaped relationship between concentration and effect was born.[5-7]There have now been many studies of the relationship between effect and plasma concentrations of antipsychotic drugs. According to Shriqui,[8] more than 100 clinical studies have attempted to determine the degree of correlation between dosage, neuroleptic" blood"(my quotation marks) levels, and clinical response, in the search for a basis for a practice of therapeutic drug monitoring (TDM) in schizophrenia. As evidence, Shriqui tabulated 27 fixed-dose studies conducted from 1972 to 1993 in an attempt to define the therapeutic ranges for just three compounds.
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氟哌啶醇血浆水平和临床反应：治疗窗口关系。
DOI：
10.1176/ajp.149.4.500
发表时间：
1992
期刊：
The American journal of psychiatry
影响因子：
--
作者：
VanPutten,T;Marder,SR;Mintz,J;Poland,RE
通讯作者：
Poland,RE
影响因子：
--
作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
通讯作者：
Jan Volavka;Thomas B. Cooper;P. Czobor;Morris Meisner
影响因子：
17.7
作者：
Hegarty Jd;R. Baldessarini;M. Tohen;C. Waternaux;G. Oepen
通讯作者：
Hegarty Jd;R. Baldessarini;M. Tohen;C. Waternaux;G. Oepen
迟发性运动障碍患者血浆氯氮平水平升高。
影响因子：
--
作者：
Pollack,S;Lieberman,J;Kleiner,D;Szymanski,S;Kane,J;Borenstein,M;Cooper,T
通讯作者：
Cooper,T