Paroxetine Serum Concentrations in Depressed Patients and Response to Treatment

 

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Introduction: There is no established relationship between the serum concentration of selective serotonin reuptake inhibitors (SSRIs) and clinical response in depressed patients. Methods: We analyzed paroxetine concentrations in serum of 46 depressed patients during treatment with a fixed dosage of 40 mg paroxetine. Results: After 5 weeks 29 patients responded to treatment, while 17 did not. Analysis of variance with repeated measures (ANOVA-rm) revealed a significant effect of ”response” with responders having lower serum concentrations throughout the treatment period, when compared to non-responders. After 2, 3, and 4 weeks of treatment, we could define an upper threshold of paroxetine serum concentrations (week 1 : 22.7 ng/mL; week 2 : 43 ng/mL; week 3 : 53.4 ng/mL; week 4 : 39.1 ng/mL) above which response to treatment was unlikely. Conclusion: We conclude that - in contrast to other pharmacological approaches - high rather than low drug serum concentrations may be associated with non-response in paroxetine treatment of depressed patients.

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Michael Deuschle, MD

Central Institute of Mental Health

J5, 68159 Mannheim

Germany

Phone: ++49-621-1703-2321

Fax: ++49-621-1703-2325

Email: deuschle@zi-mannheim.de