Therapeutic drug monitoring of SSRIs in elderly depressed patients led to a change in treatment strategy in 51.2% of cases and reduced overall antidepressant drug costs by 10.2%.
Observational (n=135)
Does therapeutic drug monitoring of SSRIs influence clinical dosing strategies and reduce drug costs in depressed elderly patients?
Therapeutic drug monitoring of SSRIs in elderly patients frequently leads to dose reductions and lowers overall drug costs.
OBJECTIVE: This study was initiated in order to describe and evaluate the effects of a therapeutic drug monitoring (TDM) routine of selective serotonin reuptake inhibitors (SSRIs) on treatment strategies and drug costs in depressed elderly patients. METHOD: Blood samples were drawn from elderly depressed patients and analysed for steady-state trough serum concentrations of citalopram (n = 48), paroxetine (n = 48) or sertraline (n = 39). A global efficacy evaluation was made at baseline and after 6-9 months. Antidepressant drug costs before and after TDM were estimated. RESULTS: Eight samples were excluded due to technical problems or noncompliance. In 65 of the 127 (51.2%) remaining cases, the treatment strategy was changed according to the TDM outcome, in most a reduction of the prescribed dose. Bioanalytical TDM costs included the antidepressant drug costs after TDM were reduced by 10.2%. CONCLUSION: The results support the utility of TDM in the search for the individual minimum effective SSRI dose in the elderly.
Lundmark et al. (2000) conducted an observational in Depression (n=135). Therapeutic drug monitoring (TDM) of SSRIs vs. Before TDM was evaluated on Change in treatment strategy according to TDM outcome. Therapeutic drug monitoring of SSRIs in elderly depressed patients led to a change in treatment strategy in 51.2% of cases and reduced overall antidepressant drug costs by 10.2%.