Therapeutic Drug Monitoring (TDM) should not only mean therapeutic drug measurement in blood and making the decision to which concentration range: therapeutic, subtherapeutic or toxic the result could be included. Monitored pharmacotherapy should mean the method of the optimalization of treatment concerning a particular patient which is realized according to the principles of the accepted model of management. During the process of TOM many factors are analyzed but the most important of them is the clinical status of the patient. Qualitative assessment of the efficacy and adverse side effects severity is provided to ascertain as quickly as possible the appropriate drug dosage.
Realization of TOM goals requires foundation or an interdisciplinary team. TDM service requires skillfulness to make use of various evaluation tools (as clinical as laboratory) and the art of the accurate interpretation.
On the basis of a sample of 15 patients with diagnosis of major depression treated with TCA a model of TDM is proposed.