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Therapeutic drug monitoring of selective serotonin reuptake inhibitors influences clinical dosing strategies and reduces drug costs in depressed elderly patients
Author(s) -
Lundmark J.,
Bengtsson F.,
Nordin C.,
Reis M.,
Wålinder J.
Publication year - 2000
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1034/j.1600-0447.2000.101005354.x
Subject(s) - citalopram , sertraline , paroxetine , antidepressant , fluoxetine , therapeutic drug monitoring , reuptake inhibitor , drug , medicine , dosing , serotonin reuptake inhibitor , pharmacology , serotonin , receptor , hippocampus
Objective: This study was initiated in order to describe and evaluate the effects of a therapeutic drug monitoring (TDM) routine of selective serotonin reuptake inhibitors (SSRIs) on treatment strategies and drug costs in depressed elderly patients. Method: Blood samples were drawn from elderly depressed patients and analysed for steady‐state trough serum concentrations of citalopram ( n =48), paroxetine ( n =48) or sertraline ( n =39). A global efficacy evaluation was made at baseline and after 6–9 months. Antidepressant drug costs before and after TDM were estimated. Results: Eight samples were excluded due to technical problems or non‐compliance. In 65 of the 127 (51.2%) remaining cases, the treatment strategy was changed according to the TDM outcome, in most a reduction of the prescribed dose. Bioanalytical TDM costs included the antidepressant drug costs after TDM were reduced by 10.2%. Conclusion: The results support the utility of TDM in the search for the individual minimum effective SSRI dose in the elderly.