Aim and Objective: Escitalopram (SCT) shows an antidepressant effect due to its mechanism of increasing the serotonin level by inhibiting the serotonin transporter protein (5HTT). 5HTT is encoded by solute carrier family 6 member 4 gene (SLC6A4) in the brain. Recognition of SCT plasma level of patients and pharmacodynamics of individuals during SCT treatment will increase the expected response to the treatment and reduce the adverse effects. This study aims to determine the effect of SLC6A4 promoter long/short polymorphism and the SCT plasma level of patients on the response to treatment during the SCT drug therapy. Materials and Methods: Blood and plasma samples of 30 major depressive patients using 20 mg SCT for 8 weeks between the ages of 18 and 65 were analyzed to determine SCT plasma level and SLC6A4 promoter polymorphism. The treatment response level was determined by using the Hamilton Depression Rating Scale at patient files. Results: SCT plasma level of the nine patients with LL polymorphism was found to be in the range of 13.40–63.36 ng/mL. For 13 patients with LS polymorphism, SCT plasma level was found to be in the range of 2.93–57.48 ng/mL. For eight patients with SS polymorphism, the SCT plasma level was found to be in the range of 0.95–49.32 ng/mL. Conclusion: When the association between SCT plasma level and response to the drug treatment was examined, we had significant results to show that SCT level affected the response to treatment, especially in the LS group, as well as the SLC6A4 promoter variation. This study may lead to a more profound understanding of rational drug therapy as well as to a careful application of pharmacogenetics in psychiatry..

Therapeutic drug monitoring (TDM) is used to determine the concentration of drug in plasma/serum to adjust the dose of the therapeutic drug. Selective and sensitive analytical methods are used to determine drug and metabolite levels for the successful application of TDM. The aim of the study was to develop and validate using LC-MS/MS to analyse quantitative assay of escitalopram (S-CT) and metabolites in human plasma samples. In order to provide a convenient and safe treatment dose, it was aimed to determine the levels of S-CT and its metabolites in the patients' plasma. A new method with short sample preparation and analysis time was developed and validated using LC-MS/MS to analyse quantitative assay of S-CT and its metabolites in plasma. Also, plasma samples of 30 patients using 20 mg S-CT between the ages of 18 and 65 years were analysed by the validated method. The mean values of S-CT, demethyl escitalopram and didemethyl escitalopram in plasma of patients were 27.59, 85.52 and 44.30 ng/mL, respectively. At the end of the analysis, the metabolic ratio of S-CT and metabolites was calculated. It is considered that the method for the quantitative analysis of S-CT and its metabolites in human plasma samples may contribute to the literature on account of its sensitive and easy application. Additionally, the use of our data by physicians will contribute to the effective drug treatment for their patients who take S-CT.

Conclusions: The national prevalence of kratom use in the past 12 months in the US was estimated at 0.9% which represents 2,138,148 adults. Those who used kratom had high rates of use of other drugs and high DAST-10 scores, which puts kratom users at higher risk of polysubstance complications. Emergency medicine providers should be aware of the prevalence and patterns of kratom use.

No abstract

Colchicine (C22H25NO6) reduces the frequency of attacks of Familial Mediterranean Fever (FMF) patients and is effective in preventing and arresting renal amyloidosis in most patients. Colchicine has narrow therapeutic window. The blood concentration to achieve therapeutic effects can be determined by running Therapeutic Drug Monitoring (TDM). However, the use of selective and sensitive analytical methods is necessary for achieving success with TDM. The purpose of this study is to develop and validate using Liquid Chromatograph- Tandem Mass Spectrometry (LC-MS/MS) to analyse quantitative assay of colchicine in human plasma samples for achieving a succesful TDM. In our study, to 1ml plasma sample, 0.25 ml internal standard solution was added. The solution was extracted by liquid-liquid extraction. The method was validated according to the EMEA. Total run time was 8 min in LC-MS/MS system. The method has been validated over the 0.25 - 8.0 ng/mL calibration range for colchicine. It was seen that the method has been validated since the results of the analysis meet the EMEA criteria. In our study colchicine plasma levels were found to be approximately 1.097±0.42ng/ml in FMF patients using an oral dose of 1.5-2 mg/day. A validated, rapid, simple, cost-effective and accurate LC-MS/MS method was developed and optimized for quantitation of colchicine in plasma. It is also a practical and easy method for pharmacokinetic studies involving the evaluation of TDM of colchicine.