Therapeutic Drug Monitoring (TDM) has until now become a routine procedure for many
psychopharmacotherapeutical interventions. Its aim is to optimize treatment with antidepressants,
neuroleptics and mood stabilizers in the sense of a maximization of the therapeutic
effect and a minimization of the toxicity risk. However, data about existing „therapeutic
windows“ of psychotropic medications are often obtained from study samples comprised
of highly cooperative and selected individuals. Such probands may not be representative
for the „average psychiatric patient“ and such studies may thus provide only limited
information for the everyday use of psychotropic drugs. Therefore studies with sufficient
numbers of unselected patients in a naturalistic clinical setting are of primary importance
to clarify the full clinical relevance of TDM in psychopharmacotherapy. To obtain
more information about the benefits of TDM under naturalistic conditions, we investigated
therapeutic effects and adverse reactions of typical and atypical neuroleptic agents
as well as antidepressants in relation to plasma concentrations measured in an unselected
collective of patients of a psychiatric university clinic in a standard therapeutical
setting. We also examined the influence of gender and age on the clinical response
as well as on the frequency of side effects in relation to the plasma levels of the
psychotropic drugs. The results of these investigations will be discussed in view
of existing data about „therapeutic windows“ in neuroleptics and antidepressants.
