Kasperk, Nicholas and Haen, Ekkehard and Hiemke, Christoph and Frodl, Thomas and Schoretsanitis, Georgios and Paulzen, Michael and Kuzo, Nazar (2024) Pharmacokinetic correlates of clinical response in a naturalistic sample of escitalopram-treated patients. EXPERT REVIEW OF CLINICAL PHARMACOLOGY, 17 (3). pp. 247-253. ISSN 1751-2433, 1751-2441
Full text not available from this repository. (Request a copy)Abstract
Objective We assessed pharmacokinetic correlates of treatment response to escitalopram using a large therapeutic drug monitoring database. Methods A large naturalistic sample of patients receiving escitalopram was analyzed. Responders were defined as 'very much improved' or 'much improved' based on the Clinical Global Impression - Improvement score, CGI-I. We compared responders (n = 83) vs. non-responders (n = 388) with the primary outcome being the escitalopram plasma concentration and concentration corrected by the daily dose (C/D ratio). Effects of age, sex, body-mass-index (BMI), and C/D ratio were assessed in a multivariate logistic regression model predicting response. Results There were no statistically significant differences in clinical and demographic characteristics between responders vs. non-responders. There were also no differences between escitalopram daily doses or plasma concentrations, while C/D ratios were significantly higher in non-responders than in responders (1.6 +/- 1.7 vs. 1.2 +/- 0.9 (ng/mL)/(mg/day), p = 0.007); C/D ratios (odds ratio 0.52, 95% confidence interval 0.34-0.80, p < 0.003) were associated with response to escitalopram, after controlling for age, sex, and BMI. Conclusions Patients with low clearance of escitalopram as reflected upon high C/D ratios may be less likely respond to escitalopram. Identifying these patients during dose titration may support clinical decision-making, including switching to a different antidepressant instead of increasing daily dose.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ANTIDEPRESSANT RESPONSE; METABOLITES; PREDICTORS; SERUM; Antidepressants; escitalopram; pharmacokinetics; Therapeutic drug monitoring; treatment response |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Jan 2026 10:58 |
| Last Modified: | 16 Jan 2026 10:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64864 |
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