The Clinical Use of Antipsychotic Plasma Levels

Jonathan M. Meyer is a Clinical Professor of Psychiatry at the University of California, San Diego, and a Psychopharmacology Consultant to the California Department of State Hospitals. Stephen M. Stahl is Adjunct Professor of Psychiatry at the University of California, San Diego, Clinical Professor of Psychiatry and Neuroscience at the University of California, Riverside, and Honorary Visiting Senior Fellow in Psychiatry at the University of Cambridge.

Preface; 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.