Schoretsanitis, Georgios and Haen, Ekkehard and Gruender, Gerhard and Hiemke, Christoph and Endres, Katharina and Ridders, Florian and Correll, Christoph U. and Paulzen, Michael (2019) Pharmacokinetics of venlafaxine in treatment responders and non-responders: a retrospective analysis of a large naturalistic database. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 75 (8). pp. 1109-1116. ISSN 0031-6970, 1432-1041
Full text not available from this repository. (Request a copy)Abstract
PurposeTo assess in a large naturalistic sample, whether clinical response to a treatment with venlafaxine is associated with different patterns of plasma concentrations of active moiety, AM (sum of venlafaxine (VEN) and its active metabolite O-desmethylvenlafaxine (ODVEN)).MethodsApplying a regression model, plasma concentrations and plasma concentrations corrected-by-dosage (C/D) for AM were included as independent variable with Clinical Global Impressions-Improvement (CGI-I) scale ratings as dependent variable. Moreover, AM, VEN, and ODVEN were compared between treatment responders and non-responders, defining response as much or very much improved on the CGI-I scale based on the non-parametric Mann-Whitney U (M-W-U) test with a significance level of 0.05.ResultsNo correlations were found between AM and C/D AM plasma concentrations and CGI-I ratings (regression coefficient 0.0, CI 0.000, 0.001, p=0.492 for AM and 0.047, CI -0.065, 0.159, p=0.408 for C/D AM). Venlafaxine daily dosage did not differ between responders and non-responders (217.776.9 vs. 222.0 +/- 72.7mg/day, p=0.45 for M-W-U). Responders displayed lower ODVEN (p=0.033) and AM (p=0.031) plasma concentrations than non-responders (p=0.033 and 0.031, respectively for M-W-U). No other differences were detected. Using a cut-off level of 400ng/mL for AM concentrations, a higher percentage of responders was reported in the group of patients with AM<400ng/mL (13.04%) compared to patients with AM>400ng/mL (8%) (p=0.038).Conclusions Higher ODVEN and AM concentrations in non-responders than in responders indicate that treatment escalation above upper thresholds of therapeutic reference ranges of venlafaxine is not promising. Hence, the therapeutic reference range for venlafaxine can help in improving outcomes in a measurement-based care model that takes advantage of therapeutic drug monitoring.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ANTIDEPRESSANT RESPONSE; CLINICAL PREDICTORS; SERUM-LEVELS; DRUG; RISPERIDONE; METABOLITES; PHENOTYPE; AGE; Venlafaxine; Therapeutic drug monitoring; Plasma concentration; CGI; Treatment response |
| Subjects: | 500 Science > 570 Life sciences 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie Chemistry and Pharmacy > Institute of Pharmacy > Pharmacology and Toxicology (Prof. Schlossmann, formerly Prof. Seifert) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Apr 2020 08:23 |
| Last Modified: | 01 Apr 2020 08:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26561 |
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