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We hypothesized that the frequency of routinely requested TDM is associated with hospitalization duration. In this retrospective study, patients with major depressive disorder receiving TDM of antidepressants between 2015 and 2021 (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009383) were analyzed. Inclusion criteria were a hospital stay \u22657 days and a first TDM request at admission. Regression analyses assessed associations between TDM frequency and hospitalization duration. Receiver operating characteristic analysis identified a minimum effective TDM frequency of 0.66\/week, which was associated with a mean reduction in hospitalization duration of 21 days (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20092.2*10\n                    <jats:sup>\u2212<\/jats:sup>\n                    \u00b9\u2076). The upper effective threshold was approximated at 1.3\/week. Higher TDM frequency was associated with more therapy adjustments within 7 days after TDM, including dose adaptations (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20093.07*10\n                    <jats:sup>\u2212<\/jats:sup>\n                    \u00b9\u2076) and drug initiation\/discontinuation (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20096.70*10\n                    <jats:sup>\u22126<\/jats:sup>\n                    ). Drug-specific analyses for amitriptyline, venlafaxine, and mirtazapine confirmed these associations. Cost-effectiveness analysis demonstrated a 37% cost reduction for patients with TDM frequencies \u22650.66\/week. In conclusion, frequent, clinically integrated TDM of antidepressants and timely treatment adaptations were associated with shorter hospitalization and reduced hospitalization costs. These findings suggest that at least biweekly TDM combined with subsequent treatment adaptations may represent a previously underappreciated strategy to improve clinical and economic outcomes in a tertiary referral center for severe major depression. Whether these findings are transferable to other inpatient and outpatient settings of depression care requires further studies.\n                  <\/jats:p>","DOI":"10.1038\/s41398-026-04316-8","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:46:47Z","timestamp":1785545207000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency of therapeutic drug monitoring in inpatient precision depression care and duration of hospitalization"],"prefix":"10.1038","volume":"16","author":[{"given":"Chantal","family":"Hampf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1008-4650","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Deckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4026-3561","authenticated-orcid":false,"given":"Sebastian","family":"Walther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9421-1292","authenticated-orcid":false,"given":"Heike","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Unterecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maike","family":"Scherf-Clavel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"4316_CR1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1055\/s-2004-832687","volume":"37","author":"P Baumann","year":"2004","unstructured":"Baumann P, Hiemke C, Ulrich S, Eckermann G, Gaertner I, Gerlach M, et al. 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The study was approved by the Ethics Committee of the university of Wuerzburg (reference number [20230720 03]). Due to the retrospective design of the study and the use of anonymised routine clinical data, informed consent was not required.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"J. Deckert was a co-recipient of a grant of the Bavarian Ministry of Economic Affairs, Regional Development and Energy (BayMED, MED-1604-0010) and an investigator in a European grant (Horizon 2020 SME programme of the European Union ref 696802) to P1Vital. J. Deckert and H. Weber received funding from the Deutschen Zentrum f\u00fcr Luft- und Raumfahrt (DLR) - F\u00f6rderkennzeichen 01EK2204G (P4D, Project SP1, SP5A and Coordination). M. Scherf-Clavel received honoraria from Rovi. S. Walther received honoraria from Neurolite. S. Unterecker received honoraria from Rovi and Johnson&Johnson. C. Hampf has no conflicts of interest to declare.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"387"}}