PMID: 15228156Jul 2, 2004Paper

Therapeutic monitoring of antidepressants in the era of pharmacogenetics studies

Therapeutic Drug Monitoring
C B EapP Baumann

Abstract

As for other drugs, there is a large interindividual variability of the plasma concentrations of antidepressants for a given dose. Within the last 2 decades, a very large number of pharmacogenetic studies have made it possible to understand the importance of genetic factors on the disposition of drugs in the organism, many of them at the levels of drug metabolism. Polymorphism of CYP2D6 and of other drug-metabolizing enzymes may thus lead to very large differences in drug exposure between patients and possibly also to toxicity or ineffective drug concentrations in some subjects. In consequence, dose recommendations of antidepressants based on genotypes, justified by the principle of administering bioequivalent individualized drug doses, are now proposed. However, blood (and thus possibly brain) concentrations also depend on other factors than the genetic makeup of the patients. Therapeutic drug monitoring of antidepressants allows us to take into account the influence of factors such as comedications, diet, smoking habit, impaired organ function, and compliance. Therapeutic drug monitoring and genotyping are thus complementary, and their combined use contributes to improve pharmacotherapy with antidepressants and other drugs.

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Citations

Feb 21, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·B Gomez-MancillaM E Schmidt
Jul 9, 2011·Expert Opinion on Drug Metabolism & Toxicology·Stefano PorcelliDiana De Ronchi
Jul 10, 2007·Clinical Chemistry and Laboratory Medicine : CCLM·Vangelis G Manolopoulos
Oct 20, 2006·Journal of Clinical Pharmacology·Jenny E Kootstra-RosJan van der Weide
Sep 9, 2006·Journal of Clinical Pharmacy and Therapeutics·M E E ShamsS Härtter
May 17, 2005·Clinica Chimica Acta; International Journal of Clinical Chemistry·Maria Shipkova, Eberhard Wieland
Jan 12, 2007·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Young Mi KimIn Ja Son
May 1, 2005·Personalized Medicine·David Gurwitz

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