The monitoring of saliva drug levels: psychiatric applications.

An overview is presented of the status of human saliva as a clinical monitoring medium in medicine and psychiatry. Despite the present controversy about the reliability of saliva lithium levels, an evaluation of the prospects of saliva for other pharmacokinetic estimations as well is recommended. The second part of the paper outlines the authors' attempt to expand the use of saliva monitoring in a depot neuroleptic clinic and a methadone maintenance program. This technique, well accepted by the patient populations, is found useful as a screening tool for drug use and compliance can be checked. It can also be indicated prior to the evaluation of the toxicity of prescribed medication as well as the assessment of drug interaction. On humanitarian, clinical and economical grounds, further investigation of the clinical applications of saliva in psychiatric practice is warranted.