Sigurdsson, H. P. and Hefner, G. and Ben-Omar, N. and Koestlbacher, A. and Wenzel-Seifert, K. and Hiemke, C. and Haen, E. (2015) Steady-state serum concentrations of venlafaxine in patients with late-life depression. Impact of age, sex and BMI. JOURNAL OF NEURAL TRANSMISSION, 122 (5). pp. 721-729. ISSN 0300-9564, 1435-1463
Full text not available from this repository. (Request a copy)Abstract
Diagnosis of late-life depression is given when depressive symptoms emerge in persons older than 65 years. Great care is needed when elderly patients receive psychopharmacotherapy due to altered pharmacokinetic status. As a consequence, age is considered to have a significant effect on serum concentrations of antidepressant drugs. The magnitudes of age-dependent changes, however, are uncertain. By utilizing a large therapeutic drug monitoring (TDM) database, this cross-sectional study aimed to retrospectively assess pharmacotherapy in elderly patients in comparison with their younger counterparts, when treated with venlafaxine, which is widely used to treat late-life depression. In addition, the influence of sex and body mass index (BMI) was evaluated. Serum concentrations of venlafaxine and its active metabolite O-desmethylvenlafaxine requested during routine TDM in two University Medical Centers in Germany were analyzed. Patients with concomitant CYP2D6 inhibiting drugs as co-medication were excluded. In total, 1,417 samples were available for the analysis. Elderly patients had by average 42 % higher dose-adjusted serum concentrations (ng/mL/mg) of the active moiety (venlafaxine plus O-desmethylvenlafaxine) than younger patients. In addition, our study demonstrated that the difference between age groups is independent of sex and BMI. However, age groups only explain 4.5 % of the total dose-adjusted serum concentration variation of the venlafaxine active moiety. Dose adjustments for venlafaxine are recommended in patients aged 65 years or older, particularly in elderly female patients who are exceptionally vulnerable to high serum concentrations of venlafaxine. TDM is recommended during venlafaxine pharmacotherapy.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NATURALISTIC CONDITIONS; O-DESMETHYLVENLAFAXINE; MAJOR DEPRESSION; ANTIDEPRESSANTS; PHARMACOKINETICS; PHARMACODYNAMICS; RECOMMENDATIONS; PHARMACOLOGY; INHIBITORS; EFFICACY; Venlafaxine; Pharmacokinetics; Therapeutic drug monitoring; Late-life depression |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 Jul 2019 11:16 |
| Last Modified: | 18 Jul 2019 11:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5549 |
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