Relevant issues in the monitoring and the toxicology of antidepressants.

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Wille SM, Cooreman SG, Neels HM, Lambert WE

Relevant issues in the monitoring and the toxicology of antidepressants.

Crit Rev Clin Lab Sci. 2008;45(1):25-89. doi: 10.1080/10408360701713112 .

PubMed ID

18293180 [ View in PubMed

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Abstract

This review provides specific information concerning the interpretation and usefulness of antidepressant drug monitoring. Fifteen antidepressants (ADs) were selected based on their importance in the 7 major markets (Japan, USA, France, United Kingdom, Italy, Spain, Germany) according to the Cognos Plus Study #11. Literature data were reviewed concerning monitoring of the tricyclic ADs amitriptyline, clomipramine, imipramine, and new generation antidepressants such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine, mianserin, mirtazapine, bupropion, and milnacipran. In addition, St.-John's Wort was added as this natural antidepressant is very popular in Europe. The objectives of therapeutic drug monitoring (TDM) for old and new generation ADs differs, as older ADs have narrow therapeutic windows with higher risks of severe drug interactions, while the new ADs have a wide therapeutic range, but an unclear plasma concentration-effect relationship. Therefore, the purpose of TDM for new-generation ADs leads more to the monitoring of patient compliance and special patient groups such as the elderly, patients with liver and kidney impairment, patients with poor metabolism by CYP 450 and comedication with inhibitors and inducers of those enzymes.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Dosulepin	Sodium-dependent noradrenaline transporter	Protein	Humans	Yes	Inhibitor	Details
Dosulepin	Sodium-dependent serotonin transporter	Protein	Humans	Yes	Inhibitor	Details