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Abstract
This review provides specific information concerning the interpretation and usefulness of antidepressant drug monitoring. Fifteen antidepressants (ADs) were selected based on their importance in the 7 major markets (Japan, USA, France, United Kingdom, Italy, Spain, Germany) according to the Cognos Plus Study #11. Literature data were reviewed concerning monitoring of the tricyclic ADs amitriptyline, clomipramine, imipramine, and new generation antidepressants such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, mianserin, mirtazapine, bupropion, and milnacipran. In addition, St.-John's Wort was added as this natural antidepressant is very popular in Europe. The objectives of therapeutic drug monitoring (TDM) for old and new generation ADs differs, as older ADs have narrow therapeutic windows with higher risks of severe drug interactions, while the new ADs have a wide therapeutic range, but an unclear plasma concentration-effect relationship. Therefore, the purpose of TDM for new-generation ADs leads more to the monitoring of patient compliance and special patient groups such as the elderly, patients with liver and kidney impairment, patients with poor metabolism by CYP 450 and comedication with inhibitors and inducers of those enzymes.
Key words :
- Depression
- monoamine oxidase inhibitors
- noradrenergic and specific serotonergic antidepressants
- serotonin-antagonist and reuptake inhibitors
- selective noradrenaline reuptake inhibitors
- selective serotonin reuptake enhancer
- selective serotonin reuptake inhibitors
- serotonin and noradrenaline reuptake inhibitors
- tricyclic antidepressants
- therapeutic drug monitoring
- analytical methods
- St. John's Wort
| Abbreviations | ||
| ADs, | = | antidepressants; |
| AMP, | = | adenosine monophosphate; |
| APCI, | = | atmospheric pressure chemical ionization; |
| AUC, | = | area-under-the-curve; |
| BDNF, | = | brain-derived neurotrophic factor; |
| CRE, | = | calcium-responsive element; |
| CREB, | = | cAMP/ Ca2+-responsive element binding protein; |
| CRH, | = | corticotrophin-releasing hormone; |
| CYP 450, | = | cytochrome P450; |
| DAD, | = | diode array detector; |
| DRI, | = | dopamine reuptake inhibitor; |
| DUAG, | = | The Danish University Antidepressant Group; |
| DNA, | = | deoxyribonucleic acid; |
| ECD, | = | electron capture detector; |
| ESI, | = | electro-spray ionisation; |
| FDA, | = | Food and Drug Administration; |
| GABA, | = | γ-aminobutyric acid; |
| GC, | = | gas chromatography; |
| HPA, | = | hypothalamic-pituitary-adrenal; |
| HPLC, | = | high pressure liquid chromatography; |
| 5-HT, | = | 5-hydroxytryptamine (serotonin); |
| LC, | = | liquid chromatography; |
| LOQ, | = | limit of quantitation; |
| MAO, | = | monamine oxidase; |
| MAOI, | = | monoamine oxidase inhibitors; |
| MS, | = | mass spectrometry; |
| NARI, | = | selective noradrenalin reuptake inhibitors; |
| NaSSA, | = | noradrenergic and specific serotonergic antidepressants; |
| NPD, | = | nitrogen phosphorus detector; |
| RSK1–3, | = | ribosomal S6 kinases; |
| SARI, | = | serotonin-2 antagonists and reuptake inhibitors; |
| SNRI, | = | serotonin and noradrenalin reuptake inhibitors; |
| SPE, | = | solid-phase extraction; |
| SPME, | = | solid-phase microextraction; |
| SSC, | = | steady-state concentration; |
| SSRE, | = | selective serotonin reuptake enhancer; |
| SSRI, | = | selective serotonin reuptake inhibitor; |
| TCA, | = | tricyclic antidepressant; |
| TDM, | = | therapeutic drug monitoring; |
| TIAFT, | = | The International Association of Forensic Toxicologists; |
| TLC, | = | thin-layer chromatography; |
| trkB, | = | tyrosine kinase B receptor; |
| UV, | = | ultraviolet |
| Abbreviations | ||
| ADs, | = | antidepressants; |
| AMP, | = | adenosine monophosphate; |
| APCI, | = | atmospheric pressure chemical ionization; |
| AUC, | = | area-under-the-curve; |
| BDNF, | = | brain-derived neurotrophic factor; |
| CRE, | = | calcium-responsive element; |
| CREB, | = | cAMP/ Ca2+-responsive element binding protein; |
| CRH, | = | corticotrophin-releasing hormone; |
| CYP 450, | = | cytochrome P450; |
| DAD, | = | diode array detector; |
| DRI, | = | dopamine reuptake inhibitor; |
| DUAG, | = | The Danish University Antidepressant Group; |
| DNA, | = | deoxyribonucleic acid; |
| ECD, | = | electron capture detector; |
| ESI, | = | electro-spray ionisation; |
| FDA, | = | Food and Drug Administration; |
| GABA, | = | γ-aminobutyric acid; |
| GC, | = | gas chromatography; |
| HPA, | = | hypothalamic-pituitary-adrenal; |
| HPLC, | = | high pressure liquid chromatography; |
| 5-HT, | = | 5-hydroxytryptamine (serotonin); |
| LC, | = | liquid chromatography; |
| LOQ, | = | limit of quantitation; |
| MAO, | = | monamine oxidase; |
| MAOI, | = | monoamine oxidase inhibitors; |
| MS, | = | mass spectrometry; |
| NARI, | = | selective noradrenalin reuptake inhibitors; |
| NaSSA, | = | noradrenergic and specific serotonergic antidepressants; |
| NPD, | = | nitrogen phosphorus detector; |
| RSK1–3, | = | ribosomal S6 kinases; |
| SARI, | = | serotonin-2 antagonists and reuptake inhibitors; |
| SNRI, | = | serotonin and noradrenalin reuptake inhibitors; |
| SPE, | = | solid-phase extraction; |
| SPME, | = | solid-phase microextraction; |
| SSC, | = | steady-state concentration; |
| SSRE, | = | selective serotonin reuptake enhancer; |
| SSRI, | = | selective serotonin reuptake inhibitor; |
| TCA, | = | tricyclic antidepressant; |
| TDM, | = | therapeutic drug monitoring; |
| TIAFT, | = | The International Association of Forensic Toxicologists; |
| TLC, | = | thin-layer chromatography; |
| trkB, | = | tyrosine kinase B receptor; |
| UV, | = | ultraviolet |