Antidepressant efficacy is correlated with plasma levels

• Verfasst von: Cellini, Lorenzo [VerfasserIn]
• Verfasst von: De Donatis, Domenico [VerfasserIn]
• Verfasst von: Zernig, Gerald [VerfasserIn]
• Verfasst von: De Ronchi, Diana [VerfasserIn]
• Verfasst von: Giupponi, Giancarlo [VerfasserIn]
• Verfasst von: Serretti, Alessandro [VerfasserIn]
• Verfasst von: Hart, Xenia Marlene [VerfasserIn]
• Verfasst von: Conca, Andreas [VerfasserIn]
• Verfasst von: Florio, Vincenzo [VerfasserIn]
• Titel: Antidepressant efficacy is correlated with plasma levels
• Titelzusatz: mega-analysis and further evidence
• Verf.angabe: Lorenzo Cellini, Domenico De Donatis, Gerald Zernig, Diana De Ronchi, Giancarlo Giupponi, Alessandro Serretti, Hart Xenia, Andreas Conca and Vincenzo Florio
• E-Jahr: 2022
• Jahr: March 2022
• Umfang: 9 S.
• Fussnoten: Gesehen am 17.09.2024 ; Vor- und Nachname von Xenia Hart sind in der Verfasserangabe fälschlich vertauscht worden
• Titel Quelle: Enthalten in: International clinical psychopharmacology
• Ort Quelle: Philadelphia, Pa. : Lippincott Williams & Wilkins, 1986
• Jahr Quelle: 2022
• Band/Heft Quelle: 37(2022), 2 vom: März, Seite 29-37
• ISSN Quelle: 1473-5857
• DOI: doi:10.1097/YIC.0000000000000386
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1902699548

Abstract

The debate around optimal target dose for first-line antidepressants (ADs) is still ongoing. Along this line, therapeutic drug monitoring (TDM) represents one of the most promising tools to improve clinical outcome. Nevertheless, a few data exist regarding the concentration-effect relationship of first-line ADs which limits TDM implementation in routine clinical practice. We conducted the first patient-level concentration-response mega-analysis including data acquired by us previously and explored the concentration dependency of first-line AD (206 subjects). Further, new data on mirtazapine are reported (18 subjects). Hamilton Depression Rating Scale-21 administered at baseline, at month 1 and month 3 was used as the measure of efficacy to assess antidepressant response (AR). When pooling all four first-line ADs together, normalized plasma levels and AR significantly fit a bell-shaped quadratic function with a progressive increase of AR up to around the upper normalized limit of the therapeutic reference range with a decrease of AR at higher serum levels. Our results complement the available evidence on the issue and the recent insights gained from dose-response studies. A concentration-dependent clinical efficacy, such as previously demonstrated for tricyclic compounds, also emerge for first-line ADs. Our study supports a role for TDM as a tool to optimize AD treatment to obtain maximum benefit.