{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:41:41Z","timestamp":1792086101795,"version":"4.4.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacopsychiatry"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction Cross sectional therapeutic drug monitoring (TDM) data mining\n                    introduces new opportunities for the investigation of medication treatment\n                    effects to find optimal therapeutic windows. Medication discontinuation has been\n                    proven useful as an objective surrogate marker to assess treatment failure. This\n                    study aimed to investigate the treatment effects of escitalopram and\n                    pharmacokinetic influences on blood levels using retrospectively assessed data\n                    from a TDM database.<\/jats:p><jats:p>\n          Methods Data was collected from 134 patients longitudinally treated with\n                    escitalopram for whom TDM was requested to guide drug therapy. Escitalopram\n                    metabolism was estimated by the log-transformed dose-corrected concentrations\n                    and compared within subpopulations differing in age, gender, renal function,\n                    smoking status, body mass index, and comedication.<\/jats:p><jats:p>\n          Results Patients with a depressive episode who were treated with\n                    escitalopram and discontinued the treatment within the hospital stay showed\n                    lower serum concentrations compared to patients who continued escitalopram\n                    treatment with a concentration of 15\u2009ng\/mL separating both\n                    groups. Variability was high between individuals and factors influencing blood\n                    levels, including dose, sex, and age. Comedication that inhibits cytochrome P450\n                    (CYP) 2C19 isoenzymes were further found to influence escitalopram\n                    pharmacokinetics independent of dose, age or sex.<\/jats:p><jats:p>\n          Discussion Medication switch is a valuable objective surrogate marker to\n                    assess treatment effects under real-world conditions. Of note, treatment\n                    discontinuation is not always a cause of insufficient response but may also be\n                    related to other factors such as medication side effects. TDM might not only be\n                    useful in addressing these issues but titrating drug concentrations into the\n                    currently recommended reference range for escitalopram will also increase\n                    response in non-responders and avoid treatment failure in underdosed\n                    patients.<\/jats:p>","DOI":"10.1055\/a-2039-2829","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T23:30:21Z","timestamp":1679441421000},"page":"73-80","source":"Crossref","is-referenced-by-count":12,"title":["Low Escitalopram Concentrations in Patients with Depression predict\n                    Treatment Failure: A Naturalistic Retrospective Study"],"prefix":"10.1055","volume":"56","author":[{"given":"Xenia M.","family":"Hart","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health, Department of Molecular\n                    Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Amann","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health, Department of Molecular\n                    Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Brand","sequence":"additional","affiliation":[{"name":"Laboratory Limbach Analytics GmbH, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzie","family":"Eichentopf","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health, Department of Molecular\n                    Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Gr\u00fcnder","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health, Department of Molecular\n                    Neuroimaging, Medical Faculty Mannheim, University of Heidelberg, Mannheim,\n                    Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1097\/FTD.0b013e31815b3f62","article-title":"Therapeutic drug monitoring of escitalopram in an outpatient setting","volume":"29","author":"M Reis","year":"2007","journal-title":"Ther Drug Monit"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1007\/s00228-014-1696-8","article-title":"Impact of age on serum concentrations of venlafaxine and escitalopram in\n                    different CYP2D6 and CYP2C19 genotype subgroups","volume":"70","author":"R B Waade","year":"2014","journal-title":"Eur J Clin Pharmacol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/FTD.0b013e31819114ea","article-title":"Serum concentrations of antidepressant drugs in a naturalistic setting:\n                    Compilation based on a large therapeutic drug monitoring database","volume":"31","author":"M Reis","year":"2009","journal-title":"Ther Drug Monit"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/FTD.0000000000000506","article-title":"Effects of cytochrome P450 (CYP) 2C19 genotypes on steady-state plasma\n                    concentrations of escitalopram and its desmethyl metabolite in Japanese patients\n                    with depression","volume":"40","author":"S Tsuchimine","year":"2018","journal-title":"Ther Drug Monit"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1176\/appi.ajp.2017.17050550","article-title":"Impact of CYP2C19 genotype on escitalopram exposure and therapeutic failure: A\n                    retrospective study based on 2,087 patients","volume":"175","author":"M M Juki\u0107","year":"2018","journal-title":"Am J Psychiatry"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/JCP.0000000000001080","article-title":"Smoking is associated with lower dose-corrected serum concentrations of\n                    escitalopram","volume":"39","author":"M Scherf-Clavel","year":"2019","journal-title":"J Clin Psychopharmacol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1007\/s00702-012-0952-2","article-title":"Effects of gender and age on serum concentrations of antidepressants under\n                    naturalistic conditions","volume":"120","author":"S Unterecker","year":"2013","journal-title":"J Neural Transm (Vienna)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1055\/s-0043-116492","article-title":"Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology:\n                    Update 2017","volume":"51","author":"C Hiemke","year":"2018","journal-title":"Pharmacopsychiatry"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S2215-0366(19)30217-2","article-title":"Optimal dose of selective serotonin reuptake inhibitors, venlafaxine, and\n                    mirtazapine in major depression: A systematic review and dose-response\n                    meta-analysis","volume":"6","author":"T A Furukawa","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/acps.13235","article-title":"In search of a dose-response relationship in SSRIs-a systematic review,\n                    meta-analysis, and network meta-analysis","volume":"142","author":"C Braun","year":"2020","journal-title":"Acta Psychiatr Scand"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"826138","DOI":"10.3389\/fpsyt.2022.826138","article-title":"Is therapeutic drug monitoring relevant for antidepressant drug therapy?\n                    Implications from a systematic review and meta-analysis with focus on moderating\n                    factors","volume":"13","author":"CS M Funk","year":"2022","journal-title":"Front Psychiatry"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.euroneuro.2017.06.009","article-title":"Escitalopram plasma levels and antidepressant response","volume":"27","author":"V Florio","year":"2017","journal-title":"Eur Neuropsychopharmacol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"A S Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1080\/15622975.2018.1557346","article-title":"WFSBP guidelines on how to grade treatment evidence for clinical guideline\n                    development","volume":"20","author":"A Hasan","year":"2019","journal-title":"World J Biol Psychiatry"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"787043","DOI":"10.3389\/fpsyt.2021.787043","article-title":"Therapeutic reference ranges for psychotropic drugs: A protocol for systematic\n                    reviews","volume":"12","author":"X M Hart","year":"2021","journal-title":"Front Psychiatry"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"972141","DOI":"10.3389\/fpsyt.2022.972141","article-title":"Systematic review on the therapeutic reference range for escitalopram: Blood\n                    concentrations, effects and SERT occupancy","volume":"13","author":"L Eichentopf","year":"2022","journal-title":"Front Psychiatry"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.psychres.2009.06.004","article-title":"Comparative effectiveness of biomarkers and clinical indicators for predicting\n                    outcomes of SSRI treatment in Major Depressive Disorder: Results of the BRITE-MD\n                    study","volume":"169","author":"A F Leuchter","year":"2009","journal-title":"Psychiatry Res"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/JCP.0000000000001312","article-title":"Tolerability of high-dose venlafaxine after switch from escitalopram in\n                    nonresponding patients with major depressive disorder","volume":"41","author":"J Engelmann","year":"2021","journal-title":"J Clin Psychopharmacol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2165\/11204340-000000000-00000","article-title":"Escitalopram: In the treatment of major depressive disorder in adolescent\n                    patients","volume":"12","author":"L P Yang","year":"2010","journal-title":"Paediatr Drugs"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"e00190","DOI":"10.1002\/prp2.190","article-title":"Chronic P-glycoprotein inhibition increases the brain concentration of\n                    escitalopram: Potential implications for treating depression","volume":"3","author":"F E O'brien","year":"2015","journal-title":"Pharmacol Res Perspect"}],"container-title":["Pharmacopsychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2039-2829.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T23:32:40Z","timestamp":1679441560000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2039-2829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":20,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,3,21]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2039-2829","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0176-3679","1439-0795"],"issn-type":[{"value":"0176-3679","type":"print"},{"value":"1439-0795","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}