Psychotropic Drug Metabolism and Clinical Monitoring

  • A. E. Balant-Gorgia
  • L. P. Balant
Conference paper
Part of the Psychopharmacology Series book series (PSYCHOPHARM, volume 10)


The major causes of variability in blood concentrations of psychoactive substances are presystemic and systemic hepatic clearances, with a few exceptions such as lithium or sulpiride. The main reason for this variability is to be found in the lipophilic nature of most psychotropes which favors elimination by metabolism rather than by renal excretion of the unchanged drug. The nature of this variability is, in part, of defined genetic origin (see Brøsen et al., this volume) and, in part, of undefined genetic or poorly controlled environment factors, which interfere with aging, or pathological conditions. Analysis of the interplay of drug metabolism and therapeutic monitoring would thus imply a review of all the aspects of biotransformation which may induce intra- and interindividual variability. Confronted with this (almost) insuperable task, we have decided to concentrate on selected aspects of metabolism. The criteria behind these choices are summarized by three questions: (1) which substances (parent drug and/or metabolite) should be mentioned? (2) how should they be determined? and (3) which approach should be adopted for the interpretation of the concentration data? For each area of interest, we have tried to summarize current knowledge and to express an opinion, which is not necessarily the result of a general consensus.


High Pressure Liquid Chromatography Therapeutic Drug Monitoring Clinical Monitoring Fluphenazine Decanoate Plasma Level Monitoring 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • A. E. Balant-Gorgia
    • 1
  • L. P. Balant
    • 2
  1. 1.Therapeutic Drug Monitoring UnitInstitutions Universitaires de PsychiatrieChêne-BourgSwitzerland
  2. 2.Clinical Research UnitInstitutions Universitaires de PsychiatrieGenevaSwitzerland

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