Abstract

Objective: It is essential for the patient health that the physician reaches the data that will help with proper drug treatment in cases when Therapeutic Drug Monitoring (TDM) can not be applied. This study aims at examining the change on the plasma levels related to three antidepressants including to escitalopram (S-CT), fluoxetine (FLU), and sertraline (SRT) widely used in depression therapy and given in different daily doses, and offering prior knowledge to physicians through the obtained data in situations where TDM is not applicable.

Method: Plasma samples of the patients treated with antidepressant drugs were analyzed on TDM requests by physicians at the Clinical Pharmacogenetic Laboratory, Üsküdar University, Istanbul, Turkey. In our study, the TDM reports were obtained retrospectively from the computerized database of the laboratory for the period 2017 - 2019. The TDM reports included daily drug dose, drug plasma level, patient characteristics like gender, age.

Results: In total, 468 TDM analyses of S-CT, 803 of FLU, 730 of SRT were registered. In this study, the most commonly prescribed drug doses in the treatment were found 10 - 20 mg S-CT, 20 mg FLU and 50 mg SRT. The mean plasma levels in the samples for S-CT, FLU and SRT were about 24.03 ± 18.40 ng/mL, 110.09 ± 92.11 ng/mL, 31.49 ± 30.31 ng/mL, respectively. Also, The mean daily dose for S-CT, FLU, and SRT was about 15.31 ± 6.33 mg/d, 34.25 ± 15.78 mg/d, 86.34 ± 46.86 mg/d, respectively. For each drug on each daily dose, variability in the resulting plasma level was observed.

Conclusion: In this study, S-CT, FLU, and SRT plasma levels have been analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) for TDM analysis. Obtained data can assist in the interpretation of TDM in various daily drug doses for each patient and it can be a valuable reference. In particular, this study may also offer prior knowledge including the relationship between drug daily dose and drug plasma level to physicians through the obtained data in situations where TDM is not applicable.

Keywords: Therapeutic Drug Monitoring; Plasma level; Escitalopram; Fluoxetine; Sertraline

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Citation

Citation: Fadime Canbolat., et al. “Considering Therapeutic Drug Monitoring (TDM) Data for a Good Dose Strategy in Intake of Escitalopram, Fluoxetine, and Sertraline". Acta Scientific Pharmacology 1.8 (2020): 15-23.

Copyright

Copyright: © 2020 Fadime Canbolat., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.