Key result
Lower serum paroxetine levels are linked to clinical response in depressed patients taking 40 mg.
Why the study?
There is no established relationship between serum concentration of SSRIs and clinical response in depressed patients.
Is paroxetine serum concentration associated with clinical response in depressed patients?
Observational (n=46)
Is paroxetine serum concentration associated with clinical response in depressed patients?
In depressed patients treated with paroxetine 40 mg, high serum concentrations are associated with a lack of clinical response.
High paroxetine concentrations associated with nonresponse; leaves open whether monitoring improves outcomes in depression.
INTRODUCTION: There is no established relationship between the serum concentration of selective serotonin reuptake inhibitors (SSRIs) and clinical response in depressed patients. METHODS: We analyzed paroxetine concentrations in serum of 46 depressed patients during treatment with a fixed dosage of 40 mg paroxetine. RESULTS: After 5 weeks 29 patients responded to treatment, while 17 did not. Analysis of variance with repeated measures (ANOVA-rm) revealed a significant effect of "response" with responders having lower serum concentrations throughout the treatment period, when compared to non-responders. After 2, 3, and 4 weeks of treatment, we could define an upper threshold of paroxetine serum concentrations (week 1 : 22.7 ng/mL; week 2 : 43 ng/mL; week 3 : 53.4 ng/mL; week 4 : 39.1 ng/mL) above which response to treatment was unlikely. CONCLUSION: We conclude that -- in contrast to other pharmacological approaches -- high rather than low drug serum concentrations may be associated with non-response in paroxetine treatment of depressed patients.
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Gilles et al. (2005) conducted an observational in Depression (n=46). Paroxetine serum concentration vs. High vs low serum concentration was evaluated on Clinical response to treatment. Lower paroxetine serum concentrations were significantly associated with clinical response in depressed patients treated with 40 mg paroxetine over 5 weeks.
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