精神科治疗药物监测的现状及发展方向.ppt

*浓效关系的研究浓度血清浓度、血浆浓度、全血浓度、红细胞浓度游离浓度-总浓度活性旋光异构体浓度代谢产物浓度代谢产物/原药浓度/剂量（C/Dratio）效应临床疗效副作用不良反应毒性反应受体结合率心电图脑电图*常用抗抑郁药的参考治疗浓度及警戒浓度（1）中文名英文名血浆半衰期参考治疗浓度警戒浓度阿米替林+去甲替林Amitriptyline+nortriptyline10–28h30h80–200ng/mL300ng/mL多塞平+去甲多赛平Doxepin+nordoxepin15–20h50–150ng/mL300ng/mL米帕明+地西帕明Imipramine+desipramine11–25h15–18h175–300ng/mL300ng/mL氯米帕明+去甲氯米帕明Clomipramine+norclomipramine16–60h36h230–450ng/mL450ng/mL马普替林Maprotiline20–58h75–130ng/mL220ng/mL氟西汀+去甲氟西汀Fluoxetine+norfluoxetine4–6days4–16days120–500ng/mL1000ng/mL帕罗西汀Paroxetine12–44h30–120ng/mL240ng/mL氟伏沙明Fluvoxamine20h60–230ng/mL500ng/mL西酞普兰Citalopram33h50–110ng/mL220ng/mL艾司西酞普兰Escitalopram30h15–80ng/mL160ng/mL*常用抗抑郁药的参考治疗浓度及警戒浓度（2）中文名英文名血浆半衰期参考治疗浓度警戒浓度舍曲林Sertraline26h10–150ng/mL300ng/mL米氮平Mirtazapine20–40h30–80ng/mL160ng/mL文拉法辛+去甲文拉法辛Venlafaxine+O-desmethylvenlafaxine5h11h100–400ng/mL800ng/mL瑞波西汀Reboxetine13–30h60–350ng/mL700ng/mL度洛西汀Duloxetine9–19h30–120ng/mL240ng/mL安非他酮+羟基安非他酮Bupropion+hydroxybupropion8–26h17–47h225–1500ng/mL2000ng/mL吗氯贝胺Moclobemide2–7h300–1000ng/mL2000ng/mL米安舍林Mianserine14–33h15–70ng/mL140ng/mL曲唑酮Trazodone4–11h700–1000ng/mL1200ng/mL*常用抗精神病药的参考治疗浓度及警戒浓度中文名英文名血浆半衰期参考治疗浓度警戒浓度氯丙嗪Chlorpromazine15–30h30–300ng/mL600ng/mL奋乃静Perphenazine8–12h0.6–2.4ng/mL5ng/mL氟奋乃静Fluphenazine16h1–10ng/mL15ng/mL氟哌啶醇Haloperidol12–36h1–10ng/mL15ng/mL甲硫哒嗪Thioridazine30h100–200ng/mL400ng/mL舒必利Sulpiride8–14h200–1000ng/mL1000ng/mL氯氮平Clozapine12–16h350–600ng/mL1000ng/mL奥氮平Olanzapine30–60h20–80ng/mL150ng/mL喹硫平Quetiapine7h100–500ng/mL1000ng/mL利培酮+9-羟利培酮Risperidone+9-hydroxyrisperidone3h24h20–60ng/mL120ng/mL阿立哌唑Aripiprazole60–80h