Mirtazapine blood levels and antidepressant response.

IF 2.9 4区医学 Q2 PSYCHIATRY

International Journal of Psychiatry in Clinical Practice Pub Date : 2024-09-28 DOI:10.1080/13651501.2024.2409654

Domenico De Donatis, Marco Verrastro, Giuseppe Fanelli, Chiara Fabbri, Ignazio Maniscalco, Xenia Hart, Georgios Schoretsanitis, Laura Mercolini, Raffaele Ferri, Bartolo Lanuzza, Alessandro Serretti, Andreas Conca, Vincenzo Florio

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引用次数: 0

Abstract

Objective: Therapeutic drug monitoring (TDM) is an important tool for treatment optimisation. Its usefulness has recently been demonstrated for some first-line antidepressants; however, few studies have been reported on the relationship between blood levels of mirtazapine and its antidepressant effects. The aim of this study was to investigate the association between blood concentration of mirtazapine and antidepressant response.

Methods: 59 outpatients treated with mirtazapine for depression were recruited and followed up for three months in a naturalistic setting. Hamilton Depression Rating Scale-21 (HAMD-21) was administered at baseline, month 1, and month 3 to assess antidepressant response. Mirtazapine serum concentration was measured at steady state. Linear regression analysis and nonlinear least-squares regression were used to estimate association between serum concentration of mirtazapine and antidepressant response.

Results: Our results showed no overall association between serum concentration of mirtazapine and symptom improvement at month 1 and month 3. A marginally significantly higher serum concentration of mirtazapine was found in responders vs non-responders at month 3.

Conclusions: The study suggests that serum concentration of mirtazapine is not strongly associated with the antidepressant efficacy of mirtazapine. This is probably attributed to its pharmacodynamic profile, even though higher blood levels seem to be marginally more effective.

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米氮平的血药浓度和抗抑郁反应。

目的：治疗药物监测（TDM）是优化治疗的重要工具。最近，一些一线抗抑郁药物的疗效已得到证实；然而，有关米氮平血药浓度与其抗抑郁效果之间关系的研究报告却寥寥无几。本研究旨在探讨米氮平的血药浓度与抗抑郁反应之间的关系。方法：在自然环境中招募了 59 名接受米氮平治疗的抑郁症门诊患者，并对其进行了为期三个月的随访。在基线、第 1 个月和第 3 个月使用汉密尔顿抑郁评定量表-21（HAMD-21）评估抗抑郁反应。米氮平血清浓度在稳定状态时进行测量。线性回归分析和非线性最小二乘回归用于估计米氮平血清浓度与抗抑郁反应之间的关系：结果表明，米氮平的血清浓度与第1个月和第3个月的症状改善之间总体上没有关联。在第3个月，米氮平的血清浓度在有反应者与无反应者之间略有显著升高：研究表明，米氮平的血清浓度与米氮平的抗抑郁疗效并无密切关系。这可能归因于其药效学特征，尽管血药浓度越高，疗效似乎越好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Psychiatry in Clinical Practice 医学-精神病学

CiteScore

6.00

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Psychiatry in Clinical Practice provides an international forum for communication among health professionals with clinical, academic and research interests in psychiatry. The journal gives particular emphasis to papers that integrate the findings of academic research into realities of clinical practice. Focus on the practical aspects of managing and treating patients. Essential reading for the busy psychiatrist, trainee and interested physician. Includes original research papers, comprehensive review articles and short communications. Key words: Psychiatry, Neuropsychopharmacology, Mental health, Neuropsychiatry, Clinical Neurophysiology, Psychophysiology, Psychotherapy, Addiction, Schizophrenia, Depression, Bipolar Disorders and Anxiety.