Retrospective pilot study for analysis of antidepressant serum concentrations of citalopram and venlafaxine during inflammation

Pharmacopsychiatry
G HefnerC Hiemke

Abstract

Inflammation-mediated changes in drug metabolism may increase drug levels in blood and lead to intoxications. The objective of this study was to find out whether elevated serum levels of C-reactive protein (CRP) are associated with increased serum concentrations of the antidepressants citalopram and venlafaxine. Therapeutic drug monitoring request forms of psychiatric patients were screened retrospectively. The serum concentrations in relation to the daily doses [(C/D) (ng/ml/mg)] and the metabolic ratios (metabolite/drug) were compared intraindividually under normal (<5 mg/l) and pathological (>5 mg/l) condition by the Wilcoxon signed-rank test. Elevated levels of CRP were not associated with a significant (P>0.05) increase in C/D for citalopram (2.4 ng/ml/mg vs. 2.85 ng/ml/mg, N=15) or in C/D for the active moiety of venlafaxine (1.76 ng/ml/mg vs. 1.68 ng/ml/mg, N=39), compared with normal CRP serum levels. No significant difference in the metabolic ratio was observed in both groups. There was no major effect of inflammation on the metabolism of citalopram and venlafaxine. Because of the broad therapeutic indices of these 2 drugs, the drugs seem to be a good choice for the treatment of depression, even if an infection occurs.

Citations

Dec 21, 2020·Clinical Pharmacology and Therapeutics·Camille LenoirCaroline Flora Samer
Jul 14, 2020·Pharmacology & Therapeutics·Françoise Stanke-LabesqueUNKNOWN French Society of Pharmacology and Therapeutics
Oct 1, 2021·The Annals of Pharmacotherapy·C Michael White

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