Pharmacopsychiatry 2011; 21 - A3
DOI: 10.1055/s-0031-1292290

Therapeutic drug monitoring (TDM) in children and adolescents during sertraline therapy

K Klampfl 1, Y Fleischmann 1, Ch Wewetzer 2, B Pfuhlmann 3, C Mehler-Wex 4, M Gerlach 1
  • 1Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Germany
  • 2Clinics of the City Cologne GmbH, Child and Adolescent Psychiatry and Psychotherapy, Cologne, Germany
  • 3Laboratory for Therapeutic Drug Monitoring, Clinics for Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Germany
  • 4Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Germany

Introduction: The aim of this prospective naturalistic study was to examine the relationship between dosage, serum concentration and clinical outcome in children and adolescents using sertraline for depressive, obsessive-compulsive or anxiety symptoms with the overarching goal to obtain an age-specific therapeutic serum concentration range for sertraline. Methods: Steady state trough serum concentrations of sertraline were measured in 66 patients aged 10 to 18 (mean 15.1) years. The therapeutic effect was assessed by the clinical global impression improvement subscale and side effects by the Udvalg for Kliniske Undersogelser-Side Effect Rating Scale. Results: A linear relationship between the dose and the serum concentration of sertraline (Pearson r = 0.68) was found. Mean serum concentrations were not significantly influenced by age, gender and comedication. 73% of the measured drug levels in children and adolescents were assessed within the therapeutic window (10–50 microg/l) suggested for adults. No reationship between the serum concentration of sertraline and the therapeutic effect could be found. Patients with documented side effects had higher mean serum levels of sertraline (p = 0.08). Discussion: Further studies with greater sample sizes and diagnose-specific as well as age-specific psychometric instruments are needed to validate our results.