Kuzin, Maxim and Haen, Ekkehard and Kuzo, Nazar and Endres, Katharina and Hiemke, Christoph and Paulzen, Michael and Schoretsanitis, Georgios (2024) Assessing Pharmacokinetic Correlates of Escitalopram-Related Adverse Drug Reactions. THERAPEUTIC DRUG MONITORING, 46 (2). pp. 246-251. ISSN 0163-4356, 1536-3694
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Background: To assess the pharmacokinetic correlates of reported adverse drug reactions (ADRs) under antidepressant treatment with escitalopram (ESC) using a large therapeutic drug monitoring database. Methods: A large naturalistic sample of inpatients and outpatients prescribed ESC was analyzed. ADRs were classified using the Udvalg for Kliniske Undersogelser side effect rating scale. We compared ESC-treated patients with (n = 35) and without ADRs (n = 273) using ESC plasma concentrations as the primary outcome. We also compared ADR rates in the 2 groups based on 2 cut-off ESC levels reflecting the recommended upper thresholds of the therapeutic reference range of 80 ng/mL, suggested by the consensus therapeutic drug monitoring guidelines, and 40 ng/mL, based on recent meta-analysis data. The effects of age, sex, smoking, daily ESC dose, plasma concentrations, and concentrations corrected for daily dose were included in a binary logistic regression model to predict ADRs. Results: No differences in clinical, demographic, or pharmacokinetic parameters were observed between patients with and without ADRs (P > 0.05). Patients with ESC-related ADRs were more frequently diagnosed with psychotic disorders than those without (25% vs. 7.1%, P = 0.004). None of the variables was associated with ADR risk. Overall, ADR rates were not significantly different in patients above versus below thresholds of ESC concentrations (ESC concentrations >40 [n = 59] vs. <= 40 ng/mL [n = 249] and >80 [n = 8] vs. <= 80 ng/mL [n = 300]; P = 0.56 and P = 1.0, respectively). Conclusions: No distinct pharmacokinetic patterns underlying ESC-associated ADRs were observed. Further studies with more specific assessments of ADRs in larger cohorts are required to better identify potential underlying patterns.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GENERALIZED ANXIETY DISORDER; DEPRESSION; METABOLISM; escitalopram; antidepressant; therapeutic drug monitoring; adverse drug reactions; pharmacokinetics |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Psychiatrie und Psychotherapie > Molekulare Neurowissenscahften |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jan 2026 08:50 |
| Last Modified: | 15 Jan 2026 08:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64976 |
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