Long term efficacy of paroxetine in major depression: A study with plasma levels

Mauri, Massimo C.; Laini, V.; Bitetto, Antonella; Boscati, L.; Scalvini, Marta E.; Mapelli, L.; Rudelli, Renata

doi:10.3109/13651509909024771

Cited by 7 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In conclusion this study, assessed in a naturalistic, observational setting, confirm the good efficacy and tolerability of SRT at low dosages in the long-term treatment of major depression. According to our data, drug plasma level monitoring of SRT, like other SSRIs (Mauri et al, 1999;Lundmark et al, 2000), could be useful in optimizing the response in non-or partialresponders, but this requires a separate examination.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, many studies suggest that the risk of depression increases with each past episode, subsequent episodes often occur sooner, they are of longer duration, more severe, less responsive to treatment and they carry renewed risks of psychosocial impairment and suicide (Keller, 1999;Mauri et al, 1999;Zajecka, 2000). Therefore, a 3-6 months' continuation therapy after acute stabilization should be considered for all depressed patients and maintenance therapy should be considered for many of them (Hirschfeld, 2000).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long‐term efficacy and therapeutic drug monitoring of sertraline in major depression

Mauri

Fiorentini

Cerveri

et al. 2003

Human Psychopharmacology

Self Cite

View full text Add to dashboard Cite

Maintenance treatment for depression should be considered as a chronic disease management programme. Several studies have reported that sertraline (SRT) can be useful in preventing relapses and recurrent episodes of major depression.Twenty-three outpatients, 14 males and 9 females, affected by major depressive disorder, recurrent (DSM-IV criteria) were included. The patients were prescribed 25-150 mg of SRT for 12 months and were evaluated at baseline (T(0)), after 15 days (T(0.5)), 30 days (T(1)), 6 months (T(6)) and 12 months (T(12)) by using the brief psychiatric rating scale (BPRS), Hamilton rating scale for anxiety (HRS-A) and Hamilton rating scale for depression (HRS-D). Plasma samples for SRT level determination were collected at T(0.5), T(1), T(6) and T(12). There was a positive relationship between SRT oral dose and drug plasma levels. Lower plasma levels, 25-50 ng/ml, were adequate for clinical maintenance treatment. Our data suggest that SRT seems to be effective and well tolerated at low dosages both in the acute and maintenance treatment of recurrent depression. Monitoring the SRT plasma level, even though not strictly necessary from a clinical point of view, can be useful in optimizing treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term efficacy and therapeutic drug monitoring of sertraline in major depression

Mauri

Fiorentini

Cerveri

et al. 2003

Human Psychopharmacology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Taking these findings into account, it is plausible that the plasma paroxetine levels play a role in deciding the time to treatment response, but that the levels are independent of the final response to the paroxetine treatment. In contrast, Mauri et al (1999) reported that a therapeutic window of paroxetine is 70 ng/ml. Lundmark et al (2000) have also demonstrated that a serum paroxetine concentration of 25-50 ng/ml appears to be adequate for efficacy based on therapeutic drug monitoring.…”

Section: Discussionmentioning

confidence: 95%

“…Gilles et al (2005) reported that the ideal paroxetine concentration at 2 weeks was 43 ng/ml, with poor outcomes being observed at either higher or lower concentrations. Mauri et al (1999) paroxetine levels in treatment for chronic symptoms should be between 20 and 70 ng/ml. These results suggest that a therapeutic window might exist in paroxetine treatment in depressed patients.…”

Section: Introductionmentioning

confidence: 99%

Rapid response to paroxetine is associated with plasma paroxetine levels at 4 but not 8 weeks of treatment, and is independent of serotonin transporter promoter polymorphism in Japanese depressed patients

Yoshimura

Umene-Nakano

Suzuki

et al. 2009

Human Psychopharmacology

View full text Add to dashboard Cite

In the present study, we investigated the relationship between the serotonin transporter gene linked polymorphic regions (5-HTTLPR) or plasma paroxetine levels and clinical response to paroxetine in depressed patients. Sixty patients who met the DSM-IV criteria for major depressive disorder were enrolled in the study. Twenty-two were male and 38 were female, with ages ranging from 25 to 71 (mean +/- SD = 42 +/- 16) years. The clinical improvement of patients was assessed using the Hamilton rating scale for depression (Ham-D) before and every week after paroxetine administration. According to the data reported previously, patients with an at least 50% decrease in their Ham-D score were classified as responders. The results showed that the plasma paroxetine levels at 4 weeks were significantly higher in responders (rapid responders) than in nonresponders. On the other hand, no significant associations were found between the L genotype (L/L, L/S) or S genotype (S/S) and the response rates either at 4 weeks or 8 weeks. These results suggest that patients with higher plasma levels at 4 weeks might respond rapidly to paroxetine treatment, but the final response rate at 8 weeks will be independent of the plasma paroxetine levels and the 5-HTTLPR L/S genotype.

show abstract

“…Plasma level determination can be an useful tool to allow adjusting the dose in each individual patient [52].…”

Section: Paroxetinementioning

confidence: 99%

Pharmacokinetics of Antidepressants in Patients with Hepatic Impairment

et al. 2014

Self Cite

View full text Add to dashboard Cite

Appropriate use of antidepressant in patients with hepatic impairment requires careful consideration of how the hepatic illness may affect pharmacokinetics. This review aims to analyze pharmacokinetic profile, plasma level variations so as the metabolism of several antidepressants relating to their use in patients with an hepatic impairment. Due to the lack of data regarding hepatic impairment itself, the review is focused mainly on studies investigating pharmacokinetics in hepatic cirrhosis or alcohol-related conditions. More data on reduced hepatic metabolism can be extrapolated by drug studies conducted in elderly populations. Dose adjustment of antidepressants in these patients is important as most of these drugs are predominantly metabolized by the liver and many of them are associated with dose-dependent adverse reactions. As no surrogate parameter is available to predict hepatic metabolism of drugs, dose adjustment according to pharmacokinetic properties of the drugs is proposed. There is a need for a more balanced assessment of the benefits and risks associated with antidepressants use in patients with hepatic impairment, particularly considering pharmacokinetic profile of the drugs to ensure that patients, who would truly benefit from these agents, are not denied appropriate treatment. In conclusion, kinetic studies for centrally acting drugs including antidepressants with predominant hepatic metabolism should be carried out in patients with liver disease to allow precise dose recommendations for enhanced patient safety.

show abstract

Long term efficacy of paroxetine in major depression: A study with plasma levels

Cited by 7 publications

References 18 publications

Long‐term efficacy and therapeutic drug monitoring of sertraline in major depression

Long‐term efficacy and therapeutic drug monitoring of sertraline in major depression

Rapid response to paroxetine is associated with plasma paroxetine levels at 4 but not 8 weeks of treatment, and is independent of serotonin transporter promoter polymorphism in Japanese depressed patients

Pharmacokinetics of Antidepressants in Patients with Hepatic Impairment

Contact Info

Product

Resources

About