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Yasui-Furukori, N. et al.

Norio Yasui-Furukori, Taku Nakagami, Ayako Kaneda, Yoshimasa Inoue, Akihito Suzuki, Koichi Otani, Sunao Kaneko,

Inverse correlation between clinical response to paroxetine and plasma drug concentration in patients with major depressive disorders.

OBJECTIVE: There are few data concerning a clear relationship between the clinical effect of paroxetine and plasma drug concentrations, although therapeutic ranges have been established for some tricyclic antidepressants. METHODS: In this study, 120 patients with major depressive disorders were treated with 10-40 mg/day of paroxetine for 6 weeks, and a total of 89 patients completed the protocol. A clinical evaluation using the Montgomery-Asberg Depression Rating Scale (MADRS) was performed at 0, 1, 2, 4 and 6 weeks. RESULTS: Significant correlations were found between the plasma concentrations of paroxetine and the percentage improvement in the total MADRS scores (r = -0.282, p < 0.01) and the final MADRS scores at 6 weeks (r = 0.268, p < 0.05). The conventional receiver-operating-characteristic curve showed the fraction of true positive results and false negative results for various cut-off levels of paroxetine concentration for response and remission. The thresholds for both response and remission that gave the maximal sensitivity and specificity for paroxetine concentrations were 64.2 ng/ml. CONCLUSIONS: These results suggest that plasma paroxetine concentrations are negatively associated with improvement and that response occurs at the upper threshold of 64.2 ng/ml of paroxetine. These findings should be replicated with a larger patient sample.[1]

References

Inverse correlation between clinical response to paroxetine and plasma drug concentration in patients with major depressive disorders. Yasui-Furukori, N., Nakagami, T., Kaneda, A., Inoue, Y., Suzuki, A., Otani, K., Kaneko, S. Hum. Psychopharmacol (2011) [Pubmed]

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