6533b85afe1ef96bd12b96e0

RESEARCH PRODUCT

Early Improvement and Serum Concentrations of Citalopram to Predict Antidepressant Drug Response of Patients with Major Depression

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description

Post hoc analyses of clinical trials have shown that early improvement around day 14 is highly predictive for later response. More- over, evidence has been given that suffi ciently high concentrations of antidepressant drugs in blood are required to attain response. In this study, we determined cut-off levels for citalo- pram serum concentrations and clinical improve- ment during the early phase of treatment to predict later response and the predictive power of these measures either alone or in combination. Methods: Inpatients with depressive disorder according to ICD-10 who received citalopram were included. Psychopathology was assessed by the 17-item Hamilton Depression (HAMD-17) rating scale, and serum concentrations of citalo- pram were measured in weekly intervals. Results: The analysis included 55 inpatients. Receiver operating characteristics analysis revealed for citalopram a serum concentration of 53 ng/ml on day 7 and a clinical improvement of 24 % on the HAMD-17 scale on day 14 as signifi - cant cut-off values to predict response after 5 weeks of treatment. Both measures taken together predicted response on week 5 with 73 % sensitivity and 85 % specifi city with an odds ratio of 14.6. Discussion: It is concluded that treatment with citalopram should be guided by symptom rating at baseline and on day 14 and serum concentra- tion determination on day 7.