Abstract
A major factor determining response to pharmacotherapy is the quantity of drug (and sometimes active metabolite) that is available to be taken up into the brain. Drug and metabolite measurements in blood are necessary to determine this bioavailability. This chapter is concerned with issues relevant to the measurement and clinical utility of blood concentrations of psychotropic drugs and their metabolites in mentally retarded persons. Much of the discussion addresses several confounding factors that can adversely affect the relationship between blood levels and behavioral outcome. However, despite technical and theoretical difficulties inherent in blood level measurements, such studies may improve pharmacotherapy by (a) establishing “therapeutic windows” for specific behavioral or psychiatric disorders, (b) preventing behavioral toxicity, (c) identifying non-responders or negative responders, and (d) ascertaining compliance. Relatively little research has been done quantifying drug concentrations with mentally retarded subjects as compared with other clinical populations, and many basic questions remain to be answered. The application of pharmacokinetics to drug treatment of retarded persons (who often cannot relate toxic effects or subjective indices of improvement) can only improve clinical practice and provide rational empirical criteria for treatment decisions in this field.
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Lewis, M.H., Mailman, R.B. (1988). Psychotropic Drug Blood Levels: Measurement and Relation to Behavioral Outcome in Mentally Retarded Persons. In: Aman, M.G., Singh, N.N. (eds) Psychopharmacology of the Developmental Disabilities. Disorders of Human Learning, Behavior, and Communication. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8774-9_3
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