P02-74 - Medical and economic benefit of therapeutic drug monitoring (TDM) in the treatment of major depressive disorder (MDD) with citalopram - 05/05/11
Résumé |
Introduction |
In the treatment of MDD, insufficient treatment outcome and the delayed onset of action still remain major problems.
Measuring plasma concentrations, i.e. TDM is a possible option to improve therapeutic outcomes.
Aim |
The aim of this prospective and naturalistic study was to evaluate the economic and clinical benefit of TDM for depressed inpatients treated with citalopram.
Methods |
Inpatients with MDD according to ICD-10 were included and treated with citalopram. Psychopathology was assessed by the 17-item Hamilton Depression (HAMD-17) rating scale in weekly intervals for five weeks. In parallel, serum concentrations of citalopram were measured.
Results |
55 patients were included (27f). 84% of the patients with citalopram plasma concentrations below 50ng/ml (n=36) were non-responders in week five. Among patients who achieved plasma concentrations ≥50ng/ml (n=19) on day 7, 47% became responder at week five (p=0.025). Patients with plasma levels ≥50ng/ml had a significantly shorter duration of hospitalization (49±20) than patients below 50ng/ml (72±37; p=0.033).
Conclusion |
Our results show that citalopram plasma levels above 50ng/ml are predictive for later treatment outcome and that TDM is cost effective due to reduced duration of hospitalization.
Le texte complet de cet article est disponible en PDF.Vol 26 - N° S1
P. 669 - 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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