title: Therapeutic drug monitoring of psychotropic drugs in China: a nationwide survey.
abstract: OBJECTIVE
  To understand the status of therapeutic drug monitoring (TDM) of psychotropic drugs in psychiatric facilities in mainland China and to lay the foundation for improvement of TDM in psychiatry.
  
  
  METHODS
  A cross-sectional survey was conducted with a locally developed questionnaire among psychiatric facilities in which TDM of psychotropic drugs was available. The questionnaire included laboratory situations, implementation of TDM, equipment and analytical methods, internal quality control (IQC), and external quality assessment (EQA).
  
  
  RESULTS
  Forty-seven of the 58 delivered questionnaires were collected from the psychiatric facilities involving 26 provinces in mainland China. The response rate was 81.0%. Among all facilities surveyed, lithium was the most common psychotropic drug (68.1% of the laboratories) monitored by TDM, followed by clozapine (44.7%), carbamazepine (25.5%), chlorpromazine (21.3%), norclozapine (19.1%), risperidone (19.1%), paliperidone (17.0%), valproic acid (14.9%), and quetiapine (10.6%). Only 10.2% of the laboratories had recommendations for dose adjustments based on their TDM reports. Others only provided drug concentration results with no clinical recommendations. The analytical methods used included high-performance liquid chromatography, liquid chromatography with tandem mass spectrometric detection, and immunoassay. For lithium, most hospitals used ion-selective electrode methods. IQC and EQA were still in their infancy.
  
  
  CONCLUSIONS
  This first nationwide survey showed that TDM has been available in a considerable number of psychiatric hospitals across China. Though current equipment and analytical methods meet the TDM need, much improvement is needed, particularly in new analytical method development, interpretation of results, consultation services, and quality control, including IQC and EQA. Guidance or consensus guideline for TDM of psychotropic drugs in the Chinese language is also urgently required.
authors.affiliation: *Laboratory of Clinical Psychopharmacology, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; and †Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Gui-Xin
authors.initials: GX
authors.lastname: Guo
authors.forename: Chuan
authors.initials: C
authors.lastname: Sun
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhang
authors.initials: Z
authors.lastname: Rong
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.forename: Zuo-Li
authors.initials: ZL
authors.lastname: Sun
authors.forename: Fang
authors.initials: F
authors.lastname: Yan
authors.forename: Yi-Lang
authors.initials: YL
authors.lastname: Tang
authors.forename: Chuan-Yue
authors.initials: CY
authors.lastname: Wang
authors.forename: Wen-Biao
authors.initials: WB
authors.lastname: Li
mesh_terms: D002851:Chromatography, High Pressure Liquid / Q000379:methods; D002853:Chromatography, Liquid / Q000379:methods; D003430:Cross-Sectional Studies; D016903:Drug Monitoring / Q000379:methods*; D004867:Equipment Design; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D017410:Practice Guidelines as Topic; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000032:analysis*; D011786:Quality Control; D011795:Surveys and Questionnaires; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D011619:Psychotropic Drugs