Academic Journal
View in EDS

Toward therapeutic drug monitoring of citalopram in depression? Insights from a systematic review

Bibliographic Details
Title: Toward therapeutic drug monitoring of citalopram in depression? Insights from a systematic review
Authors: Na Xu, Zaiwei Song, Dan Jiang, Rongsheng Zhao
Source: Frontiers in Psychiatry, Vol 14 (2023)
Publisher Information: Frontiers Media S.A., 2023.
Publication Year: 2023
Collection: LCC:Psychiatry
Subject Terms: citalopram, therapeutic drug monitoring, plasma concentration, depression, treatment outcome, Psychiatry, RC435-571
More Details: BackgroundWithin the framework of individualized psychopharmacotherapy, therapeutic drug monitoring (TDM) has gained increasing relevance. In the absence of high-quality evidence, the TDM of citalopram (CIT) and the recommended therapeutic ranges of the plasma concentrations have been proposed by guidelines. However, the correlation between the plasma concentration of CIT and treatment outcomes has not been well established. Therefore, the aim of this systematic review was to evaluate the relationship between plasma CIT concentration and treatment outcomes in depression.Research design and methodsPubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese databases (CNKI, Wanfang Data and Sinomed) were searched up to August 6, 2022. We included clinical studies evaluating the correlation between the plasma CIT concentration and treatment outcomes in patients with depression receiving CIT treatment. Outcomes measured included efficacy, safety, medication adherence, and cost-related outcomes. A narrative synthesis was performed to summarize findings from individual studies. This study was performed according to the Preferred Reporting Items for Systematic Reviews, Meta-Analysis (PRISMA) and the reporting guideline for Synthesis without meta-analysis (SWiM).ResultsEleven studies involving 538 patients were included in total. The reported outcomes were mainly efficacy (n = 11) and safety (n = 3); one study reported the duration of hospitalization, and no study reported medication adherence. Regarding the efficacy outcomes, three studies revealed the plasma CIT concentration-response relationship and proposed a lower limit of 50 or 53 ng/mL, whereas this was not found in the rest of the studies. Regarding adverse drug events (ADEs), one study reported more ADEs in the low-concentration group (50 ng/mL), which is not convincing from the perspective of pharmacokinetics/pharmacodynamics. Regarding the cost-related outcomes, only one study reported that the high CIT concentration group (≥50 ng/mL) contributed to shortening the hospitalization duration, but it did not provide detailed information, including direct medical expenses and multiple potential factors contributing to longer hospital stays.ConclusionsA definite correlation between plasma concentration and clinical or cost-related outcomes of CIT cannot be drawn, whereas a tendency toward improved efficacy in patients with plasma concentration above 50 or 53 ng/mL was suggestive from limited evidence.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1664-0640
Relation: https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1144573/full; https://doaj.org/toc/1664-0640
DOI: 10.3389/fpsyt.2023.1144573
Access URL: https://doaj.org/article/3402789713cd4f719428fe2c4ecec2b1
Accession Number: edsdoj.3402789713cd4f719428fe2c4ecec2b1
Database: Directory of Open Access Journals
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://resolver.ebsco.com/c/xy5jbn/result?sid=EBSCO:edsdoj&genre=article&issn=16640640&ISBN=&volume=14&issue=&date=20230401&spage=&pages=&title=Frontiers in Psychiatry&atitle=Toward%20therapeutic%20drug%20monitoring%20of%20citalopram%20in%20depression%3F%20Insights%20from%20a%20systematic%20review&aulast=Na%20Xu&id=DOI:10.3389/fpsyt.2023.1144573
    Name: Full Text Finder (for New FTF UI) (s8985755)
    Category: fullText
    Text: Find It @ SCU Libraries
    MouseOverText: Find It @ SCU Libraries
  – Url: https://doaj.org/article/3402789713cd4f719428fe2c4ecec2b1
    Name: EDS - DOAJ (s8985755)
    Category: fullText
    Text: View record from DOAJ
    MouseOverText: View record from DOAJ
Header DbId: edsdoj
DbLabel: Directory of Open Access Journals
An: edsdoj.3402789713cd4f719428fe2c4ecec2b1
RelevancyScore: 961
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 961.016296386719
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Toward therapeutic drug monitoring of citalopram in depression? Insights from a systematic review
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Na+Xu%22">Na Xu</searchLink><br /><searchLink fieldCode="AR" term="%22Zaiwei+Song%22">Zaiwei Song</searchLink><br /><searchLink fieldCode="AR" term="%22Dan+Jiang%22">Dan Jiang</searchLink><br /><searchLink fieldCode="AR" term="%22Rongsheng+Zhao%22">Rongsheng Zhao</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: Frontiers in Psychiatry, Vol 14 (2023)
– Name: Publisher
  Label: Publisher Information
  Group: PubInfo
  Data: Frontiers Media S.A., 2023.
– Name: DatePubCY
  Label: Publication Year
  Group: Date
  Data: 2023
– Name: Subset
  Label: Collection
  Group: HoldingsInfo
  Data: LCC:Psychiatry
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22citalopram%22">citalopram</searchLink><br /><searchLink fieldCode="DE" term="%22therapeutic+drug+monitoring%22">therapeutic drug monitoring</searchLink><br /><searchLink fieldCode="DE" term="%22plasma+concentration%22">plasma concentration</searchLink><br /><searchLink fieldCode="DE" term="%22depression%22">depression</searchLink><br /><searchLink fieldCode="DE" term="%22treatment+outcome%22">treatment outcome</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatry%22">Psychiatry</searchLink><br /><searchLink fieldCode="DE" term="%22RC435-571%22">RC435-571</searchLink>
– Name: Abstract
  Label: Description
  Group: Ab
  Data: BackgroundWithin the framework of individualized psychopharmacotherapy, therapeutic drug monitoring (TDM) has gained increasing relevance. In the absence of high-quality evidence, the TDM of citalopram (CIT) and the recommended therapeutic ranges of the plasma concentrations have been proposed by guidelines. However, the correlation between the plasma concentration of CIT and treatment outcomes has not been well established. Therefore, the aim of this systematic review was to evaluate the relationship between plasma CIT concentration and treatment outcomes in depression.Research design and methodsPubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese databases (CNKI, Wanfang Data and Sinomed) were searched up to August 6, 2022. We included clinical studies evaluating the correlation between the plasma CIT concentration and treatment outcomes in patients with depression receiving CIT treatment. Outcomes measured included efficacy, safety, medication adherence, and cost-related outcomes. A narrative synthesis was performed to summarize findings from individual studies. This study was performed according to the Preferred Reporting Items for Systematic Reviews, Meta-Analysis (PRISMA) and the reporting guideline for Synthesis without meta-analysis (SWiM).ResultsEleven studies involving 538 patients were included in total. The reported outcomes were mainly efficacy (n = 11) and safety (n = 3); one study reported the duration of hospitalization, and no study reported medication adherence. Regarding the efficacy outcomes, three studies revealed the plasma CIT concentration-response relationship and proposed a lower limit of 50 or 53 ng/mL, whereas this was not found in the rest of the studies. Regarding adverse drug events (ADEs), one study reported more ADEs in the low-concentration group (50 ng/mL), which is not convincing from the perspective of pharmacokinetics/pharmacodynamics. Regarding the cost-related outcomes, only one study reported that the high CIT concentration group (≥50 ng/mL) contributed to shortening the hospitalization duration, but it did not provide detailed information, including direct medical expenses and multiple potential factors contributing to longer hospital stays.ConclusionsA definite correlation between plasma concentration and clinical or cost-related outcomes of CIT cannot be drawn, whereas a tendency toward improved efficacy in patients with plasma concentration above 50 or 53 ng/mL was suggestive from limited evidence.
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: article
– Name: Format
  Label: File Description
  Group: SrcInfo
  Data: electronic resource
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1664-0640
– Name: NoteTitleSource
  Label: Relation
  Group: SrcInfo
  Data: https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1144573/full; https://doaj.org/toc/1664-0640
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.3389/fpsyt.2023.1144573
– Name: URL
  Label: Access URL
  Group: URL
  Data: <link linkTarget="URL" linkTerm="https://doaj.org/article/3402789713cd4f719428fe2c4ecec2b1" linkWindow="_blank">https://doaj.org/article/3402789713cd4f719428fe2c4ecec2b1</link>
– Name: AN
  Label: Accession Number
  Group: ID
  Data: edsdoj.3402789713cd4f719428fe2c4ecec2b1
PLink https://login.libproxy.scu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=edsdoj&AN=edsdoj.3402789713cd4f719428fe2c4ecec2b1
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.3389/fpsyt.2023.1144573
    Languages:
      – Text: English
    Subjects:
      – SubjectFull: citalopram
        Type: general
      – SubjectFull: therapeutic drug monitoring
        Type: general
      – SubjectFull: plasma concentration
        Type: general
      – SubjectFull: depression
        Type: general
      – SubjectFull: treatment outcome
        Type: general
      – SubjectFull: Psychiatry
        Type: general
      – SubjectFull: RC435-571
        Type: general
    Titles:
      – TitleFull: Toward therapeutic drug monitoring of citalopram in depression? Insights from a systematic review
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Na Xu
      – PersonEntity:
          Name:
            NameFull: Zaiwei Song
      – PersonEntity:
          Name:
            NameFull: Dan Jiang
      – PersonEntity:
          Name:
            NameFull: Rongsheng Zhao
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 04
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-print
              Value: 16640640
          Numbering:
            – Type: volume
              Value: 14
          Titles:
            – TitleFull: Frontiers in Psychiatry
              Type: main
ResultId 1