Pharmacopsychiatry 2004; 37(3): 123-126
DOI: 10.1055/s-2004-818990
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Paroxetine in Major Depression: Correlating Plasma Concentrations and Clinical Response

Claus Normann1 , Marion Hörn1 , Barbara Hummel2 , Heinz Grunze2 , Jörg Walden1
  • 1Dept. of Psychiatry, Albert-Ludwigs-Universität Freiburg, Germany
  • 2Ludwig-Maximilians-Universität Munich, Germany
Further Information

Publication History

Received: 19.07.2002 Revised: 9.8.2002

Accepted: 17.07.2003

Publication Date:
12 May 2004 (online)

Background: In analogy to tricyclic antidepressants, serum concentrations of selective serotonin reuptake inhibitors (SSRIs) are frequently measured in order to optimize treatment results. However, clinical evidence for this approach is sparse. Methods: Forty patients with major depression were treated with paroxetine 20 mg/day for 14 days and with 40 mg/day for further 49 days. Treatment response measured by Hamilton depression rating scales (HAMD) was correlated with paroxetine plasma concentrations. Results: There was a significant difference between paroxetine plasma levels at 20 and 40 mg/day, respectively [20 mg/d: median 24 (range 4-358); 40 mg/d: 92 (30-398)]. However, the interindividual variance was very large. 18 out of 40 patients responded to paroxetine treatment. Conclusions: Receiver operated characteristic (ROC) analysis suggested no upper or lower limit of response. Responder had significantly higher paroxetine levels at day 7 [responder: 33 (4-107); non-responder: 13 (3-77)] but not at the end of the study [responder 93 (30-361); non-responder: 94 (59-398)]. Furthermore, plasma levels were not related to adverse events, age, body weight or severity of depression. These findings do not support any need for a routine screening of paroxetine plasma concentrations in clinical practice.

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Dr. C. Normann

Department of Psychiatry and Psychotherapy

University of Freiburg

Hauptstrasse 5

79104 Freiburg

Germany

Email: claus_normann@psyallg.ukl.uni-freiburg.de