Early Improvement and Serum Concentrations of Citalopram to Predict Antidepressant Drug Response of Patients with Major Depression

Abstract

It is concluded that treatment with citalopram should be guided by symptom rating at baseline and on day 14 and serum concentration determination on day 7.

Serum N-Desmethylcitalopram Concentrations are Associated with the Clinical Response to Citalopram of Patients with Major Depression

“…Previous studies have revealed that the steady-state concentrations of CITA predict the antidepressant response of CITA in MDD patients. Although Ostad Haji et al suggested that achieving approximately 50 ng/mL serum concentrations for CITA on day 7 is necessary for clinical improvement [ 11 , 12 ], an earlier study concluded that the lower limit of effective serum CITA concentrations was 30 ng/mL after day 7 [ 10 ]. In contrast to previous results, in this study, only 1 patient had a serum CITA concentration below 50 ng/mL (42 ng/mL), and we did not observe any relationship between the efficacy and serum CITA concentrations according to the patient groups with low (<86.0 ng/mL), expected (86.0–136.0 ng/mL), and high (>136.0 ng/mL) CITA concentrations at the 4th week.…”

“…As for most SSRIs, the therapeutic window of CITA hasn’t been established yet. Although an earlier study recommended a 30 ng/mL steady-state serum concentration as a lower limit [ 10 ], two recent studies suggested that 50 ng/mL of serum CITA concentrations are required at steady state for efficient therapy [ 11 , 12 ]. However, studies that examine the effects of serum NDCITA concentrations on the clinical response to CITA are lacking in the literature.…”

Liquid chromatography/mass spectrometry‐based plasma metabolic profiling study of escitalopram in subjects with major depressive disorder

“…Apart from these studies, a body of previous work has utilized LC/MS‐based metabolomic approaches to support the treatment of a variety of neuropsychiatric disorders including stroke, bipolar disorder, and autism . Very few studies, however, have ECTP blood plasma concentration and response prediction . One previous study demonstrated that early improvement and ECTP serum concentration could be used to predict the effectiveness of antidepressant drug response in MDD patients .…”

“…Very few studies, however, have ECTP blood plasma concentration and response prediction . One previous study demonstrated that early improvement and ECTP serum concentration could be used to predict the effectiveness of antidepressant drug response in MDD patients . In another study, it was also demonstrated that the 17‐item Hamilton Depression Rating Scale (HAMD‐17) sum scores decrease in patients with high ECTP serum concentrations compared with patients with low blood plasma drug levels…”

Hamilton depression rating subscales to predict antidepressant treatment outcome in the early course of treatment

“…EI is usually defined as a symptom reduction from baseline of at least 20% after two weeks of treatment. Many retrospective studies with virtually all groups of antidepressants (Bares et al, 2012;Gorwood et al, 2013;Henkel et al, 2009;Kim et al, 2011;Lam, 2012;Ostad Haji et al, 2013;Papakostas et al, 2006;Posternak and Zimmerman, 2005;Stassen et al, 2007;Szegedi et al, 2009;Tadić et al, 2010;Taylor et al, 2006) and even psychotherapy (Keller and Hautzinger, 2000;Tadić et al, 2010;van Calker et al, 2009;Van et al, 2008) form a substantial body of evidence that EI is a highly sensitive predictor for later treatment response, which can be used for decision making regarding the treatment strategy (continuation vs. treatment change) early in the treatment course (Bauer et al, 2013).…”