Book contents
- The Clinical Use of Antipsychotic Plasma Levels
- Reviews
- The Clinical Use of Antipsychotic Plasma Levels
- Copyright page
- Half title page
- Contents
- Foreword
- Preface: How to Use This Handbook and Useful Tables for Handy Reference
- Introduction
- 1 Sampling Times for Oral and Long-Acting Injectable Agents
- 2 The Therapeutic Threshold and the Point of Futility
- 3 Level Interpretation Including Laboratory Reporting Issues, Responding to High Plasma Levels, Special Situations (Hepatic Dysfunction, Renal Dysfunction and Hemodialysis, Bariatric Surgery)
- 4 Tracking Oral Antipsychotic Adherence
- 5 What Is an Adequate Antipsychotic Trial? Using Plasma Levels to Optimize Psychiatric Response and Tolerability
- 6 Important Concepts about First-Generation Antipsychotics
- 7 Haloperidol and Haloperidol Decanoate
- 8 Fluphenazine and Fluphenazine Decanoate
- 9 Perphenazine and Perphenazine Decanoate
- 10 Zuclopenthixol and Zuclopenthixol Decanoate; Flupenthixol and Flupenthixol Decanoate
- 11 Chlorpromazine, Loxapine, Thiothixene, Trifluoperazine
- 12 Important Concepts about Second-Generation Antipsychotics
- 13 Clozapine
- 14 Risperidone Oral and Long-Acting Injectable; Paliperidone Oral and Long-Acting Injectable
- 15 Olanzapine and Olanzapine Pamoate
- 16 Aripiprazole, Aripiprazole Monohydrate, and Aripiprazole Lauroxil
- 17 Amisulpride, Asenapine, Lurasidone, Brexpiprazole, Cariprazine
- Appendix Therapeutic Threshold, Point of Futility, AGNP/ASCP Laboratory Alert Level, and Average Oral Concentration–Dose Relationships
- Index
- References
3 - Level Interpretation Including Laboratory Reporting Issues, Responding to High Plasma Levels, Special Situations (Hepatic Dysfunction, Renal Dysfunction and Hemodialysis, Bariatric Surgery)
Published online by Cambridge University Press: 19 October 2021
- The Clinical Use of Antipsychotic Plasma Levels
- Reviews
- The Clinical Use of Antipsychotic Plasma Levels
- Copyright page
- Half title page
- Contents
- Foreword
- Preface: How to Use This Handbook and Useful Tables for Handy Reference
- Introduction
- 1 Sampling Times for Oral and Long-Acting Injectable Agents
- 2 The Therapeutic Threshold and the Point of Futility
- 3 Level Interpretation Including Laboratory Reporting Issues, Responding to High Plasma Levels, Special Situations (Hepatic Dysfunction, Renal Dysfunction and Hemodialysis, Bariatric Surgery)
- 4 Tracking Oral Antipsychotic Adherence
- 5 What Is an Adequate Antipsychotic Trial? Using Plasma Levels to Optimize Psychiatric Response and Tolerability
- 6 Important Concepts about First-Generation Antipsychotics
- 7 Haloperidol and Haloperidol Decanoate
- 8 Fluphenazine and Fluphenazine Decanoate
- 9 Perphenazine and Perphenazine Decanoate
- 10 Zuclopenthixol and Zuclopenthixol Decanoate; Flupenthixol and Flupenthixol Decanoate
- 11 Chlorpromazine, Loxapine, Thiothixene, Trifluoperazine
- 12 Important Concepts about Second-Generation Antipsychotics
- 13 Clozapine
- 14 Risperidone Oral and Long-Acting Injectable; Paliperidone Oral and Long-Acting Injectable
- 15 Olanzapine and Olanzapine Pamoate
- 16 Aripiprazole, Aripiprazole Monohydrate, and Aripiprazole Lauroxil
- 17 Amisulpride, Asenapine, Lurasidone, Brexpiprazole, Cariprazine
- Appendix Therapeutic Threshold, Point of Futility, AGNP/ASCP Laboratory Alert Level, and Average Oral Concentration–Dose Relationships
- Index
- References
Summary
It is rare that clinicians ordering psychotropic levels must concern themselves with the details of laboratory assay methods, or how the results are reported. For example, knowledge of lithium kinetics has existed for nearly 50 years, and lithium is preferentially administered as a single bedtime dose to minimize the renal dysfunction associated with multiple daily doses, to improve adherence, and to facilitate obtaining levels as 12h troughs in the morning [1–4]. Nearly all commercial laboratories use a standard assay method (ion-selective electrode), and there is limited variation in the laboratory reported therapeutic range: the lower limit is typically 0.5 or 0.6 mEq/l, and the upper limit 1.2 mEq/l, with alerts for levels > 1.2, 1.5 or 1.6 mEq/l [3, 5, 6].
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- Information
- The Clinical Use of Antipsychotic Plasma LevelsStahl's Handbooks, pp. 60 - 86Publisher: Cambridge University PressPrint publication year: 2021