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Psychotropic Drug Metabolism and Clinical Monitoring

  • Conference paper
Book cover Clinical Pharmacology in Psychiatry

Part of the book series: Psychopharmacology Series ((PSYCHOPHARM,volume 10))

Abstract

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.

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Authors and Affiliations

  1. Therapeutic Drug Monitoring Unit, Institutions Universitaires de Psychiatrie, 1225, Chêne-Bourg, Switzerland

    A. E. Balant-Gorgia

  2. Clinical Research Unit, Institutions Universitaires de Psychiatrie, 47 rue du XXXI Décembre, 1207, Geneva, Switzerland

    L. P. Balant

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  1. A. E. Balant-Gorgia
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  2. L. P. Balant
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Editor information

Editors and Affiliations

  1. Dept. of Clinical Pharmacology, Odense University, Winsløwparken 19, 5000, Odense C, Denmark

    Lars F. Gram

  2. I.U.P.G., Unité de Recherche Clinique, 47, Rue du XXXI Décembre, 1207, Genève, Switzerland

    Luc P. Balant

  3. Department of Psychiatry, Case Western Res. Univ., 2040 Abington Road, Cleveland, Ohio, 44106, USA

    Herbert Y. Meltzer

  4. Institute of Medicinal Biology, University of Tromsø, P.O. Box 977, 9037, Tromsø, Norway

    Svein G. Dahl

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© 1993 Springer-Verlag Berlin Heidelberg

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Balant-Gorgia, A.E., Balant, L.P. (1993). Psychotropic Drug Metabolism and Clinical Monitoring. In: Gram, L.F., Balant, L.P., Meltzer, H.Y., Dahl, S.G. (eds) Clinical Pharmacology in Psychiatry. Psychopharmacology Series, vol 10. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78010-3_20

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  • DOI: https://doi.org/10.1007/978-3-642-78010-3_20

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