[The usefulness of therapeutic drug monitoring during treatment with second-generation antidepressants].

Abstract

Background: Although there is clear evidence that therapeutic drug monitoring (TDM) has beneficial effects for patients treated with tricyclic antidepressants, it is generally not recommended for second-generation antidepressants (SGA). However, it has been suggested that methodological shortcomings might influence the results in TDM studies with SGA.

Aim: A qualitative assessment of randomized controlled trials (RCTs) that specifically investigated drug concentration-effect relationships of SGA in patients with major depressive disorder (MDD) to analyze the potential benefit of TDM during treatment with these agents.

Method: A literature search, using the PubMed, Embase, and Cochrane CENTRAL databases, was conducted for RCTs. A research protocol was used to make a quality assessment.

Results: A total of 15 studies were included. Evidence for the existence of a drug concentration-effect relationship during the administration of SGA in adult patients with MDD is virtually non-existent. The argument that methodological shortcomings might influence the results in TDM studies with SGA is weak.

Conclusion: There is little evidence that methodological shortcomings of studies would influence the results in TDM studies with SGA. This does not mean that TDM during treatment with SGA cannot be useful in specific situations.