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Target ranges for other psychotropics Pharmacokinetics CHAPTER 11 Quetiapine has an established dose–response relationship, and appears to be well tolerated at doses well beyond the licensed dose range.115 In practice, dose adjustment should be based on patien...

References Pharmacokinetics CHAPTER 11 References Jakobsen MI, et  al. The significance of sampling time in therapeutic drug monitoring of clozapine. Acta Psychiatr Scand 2017; 135:159–169. Hiemke C. Concentration-­effect relationships of psychoactive drugs a...

Interpreting postmortem blood concentrations Pharmacokinetics CHAPTER 11 Interpreting postmortem blood concentrations Much is known about the distribution of drugs in the body during life but relatively little about these same parameters after death. A great m...

References 880 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 11 References Ferner RE. Post-­mortem clinical pharmacology. Br J Clin Pharmacol 2008; 66:430–443. Flanagan RJ, et al. Analytical toxicology: guidelines for sample collection postmortem...

Acting on clozapine plasma concentration results Pharmacokinetics CHAPTER 11 Acting on clozapine plasma concentration results In most developed countries, clozapine blood concentration monitoring is widely used. Table 11.4 gives some general advice about actio...

References 882 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 11 References Varma S, et  al. Clozapine-­related EEG changes and seizures: dose and plasma-­level relationships. Ther Adv Psychopharmacol 2011; 1:47–66. Northwood K, et al. Optimising ...

Psychotropic drugs and cytochrome (CYP) function Pharmacokinetics CHAPTER 11 Psychotropic drugs and cytochrome (CYP) function Information on the effect of drugs on CYP function helps predict or confirm ­suspected interactions that may not have been uncovered i...

Genetics of cytochrome function 888 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 11 Genetics of cytochrome function The function of CYPs is under genetic control. Each individual’s CYP function is determined by heredity and is often, but not alwa...

References Pharmacokinetics CHAPTER 11 References Baldacci A, et al. Pharmacogenetic guidelines for psychotropic drugs: optimizing prescriptions in clinical practice. Pharmaceutics 2023; 15:2540. Cojocaru A, et al. The implications of cytochrome P450 2D6/CYP2...

Smoking and psychotropic drugs 892 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 11 Smoking and psychotropic drugs Tobacco smoke contains polycyclic aromatic hydrocarbons that induce certain hepatic enzymes (CYP1A2 in particular).1 Other enzymes t...

References 894 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 11 References Kroon LA. Drug interactions with smoking. Am J Health Syst Pharm 2007; 64:1917–1921. Scherf-­Clavel M, et al. Analysis of smoking behavior on the pharmacokinetics of antid...

Drug interactions with alcohol

Pharmacokinetic interactions1–4 Pharmacokinetics CHAPTER 11 Drug interactions with alcohol Drug interactions with alcohol are complex. Many patient-­related and drug-­related factors need to be considered. It can be difficult to predict outcomes accurately bec...

Pharmacodynamic interactions2–4 Pharmacokinetics CHAPTER 11 Interactions of uncertain aetiology include increased blood alcohol concentrations in people who take verapamil and decreased metabolism of methylphenidate in people who consume alcohol. Alcohol may a...

References Pharmacokinetics CHAPTER 11 References Zakhari S. Overview: how is alcohol metabolized by the body? Alcohol Res Health 2006; 29:245–254. Tanaka E. Toxicological interactions involving psychiatric drugs and alcohol: an update. J Clin Pharm Ther 2003...

Caffeine The Maudsley® Prescribing Guidelines in Psychiatry, Fifteenth Edition. David M. Taylor, Thomas R. E. Barnes and Allan H. Young. © 2025 David M. Taylor. Published 2025 by John Wiley & Sons Ltd. Chapter 12 Caffeine Caffeine is probably the most used psy...

General effects of caffeine

Psychotropic effects of caffeine 902 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 12 General effects of caffeine ■ ■Acute use can increase systolic and diastolic blood pressure (BP) by up to 10mmHg for up to 4 hours.3 Chronic moderate use probabl...