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Pharmacopsychiatry 2009; 42(5): 189-193
DOI: 10.1055/s-0029-1220890
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Duloxetine Serum Concentrations and Clinical Effects. Data from a Therapeutic Drug Monitoring (TDM) Survey

C. Waldschmitt1 , F. Vogel1 , B. Pfuhlmann2 , C. Hiemke1
  • 1Department of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany
  • 2Department of Psychiatry, Psychosomatics and Psychotherapy, University Clinic of Wuerzburg, Wuerzburg, Germany
Further Information

Publication History

received 28.10.2008 revised 07.01.2009

accepted 08.01.2009

Publication Date:
01 September 2009 (online)

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Abstract

Introduction: The aim of this study was to relate drug concentrations in serum and clinical effects in patients treated with the new antidepressant duloxetine.

Methods: Data were obtained from a newly established therapeutic drug monitoring (TDM) survey. Duloxetine was measured using HPLC with UV detection and clinical effects by the clinical global impressions (CGI) scale for improvement.

Results: The study included 103 depressed inpatients (69% female). Patients under duloxetine monotherapy who were very much improved according to CGI had significantly (p<0.05) higher serum levels than patients with moderate, minimal or lacking improvement (mean±SD and range, 93±53 ng/mL and 30–182 ng/mL and 47±39 ng/mL and 5–178 ng/mL, respectively). Daily doses were similar in the two groups (76±27 vs. 83±27 mg/d). Receiver operating characteristics (ROC) curve analysis revealed significant predictive properties of duloxetine serum levels (p=0.011) for improvement with a lower threshold concentration of duloxetine of 58 ng/mL.

Discussion: The findings indicate that therapeutic drug monitoring of duloxetine and titration to steady state serum concentrations above 58 ng/mL is useful for treatment optimization.

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Correspondence

C. HiemkePhD 

Department of Psychiatry

University of Mainz

Untere Zahlbacherstraße 8

55131 Mainz

Germany

Phone: +49/6131/177 131

Fax: +49/6131/176 789

Email: hiemke@mail.uni-mainz.de

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