Pharmacopsychiatry 2005; 38(3): 118-121
DOI: 10.1055/s-2005-864121
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Paroxetine Serum Concentrations in Depressed Patients and Response to Treatment

M. Gilles1 , M. Deuschle1 , S. Kellner1 , M. Shams2 , 4 , B. Krumm1 , S. Härtter5 , I. Heuser1 , 3 , C. Hiemke2
  • 1Central Institute of Mental Health, Mannheim, Germany
  • 2University of Mainz, Dept. of Psychiatry, Mainz, Germany
  • 3Charité University Hospital, Berlin, Germany
  • 4MS is a graduate student of the Mansoura University of Egypt
  • 5Boehringer Ingelheim Pharma GmbH, Biberach, Germany
Further Information

Publication History

Received: 16.7.2003 Revised: 24.10.2003

Accepted: 4.10.2004

Publication Date:
18 May 2005 (online)

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