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Serum levels of citalopram and its main metabolites in adolescent patients treated in a naturalistic clinical setting

Reis, Margareta LU ; Olsson, Gunilla; Carlsson, Björn; Lundmark, J; Dahl, ML; Walinder, J; Ahlner, J and Bengtsson, F (2002) In Journal of Clinical Psychopharmacology 22(4). p.406-413
Abstract
The prescribing of selective serotonin reuptake inhibitors for adolescents is extensive despite the fact that there are few pharmacokinetic (PK), efficacy, safety, or tolerability studies on this group. This study reports the PK findings from two trials in adolescents treated with citalopram (CIT) in naturalistic clinical settings: one retrospective and one prospective. The aim of our study was to describe serum concentrations of CIT, desmethylcitalopram (I)CIT), and didesmethylcitalopram (DDCIT) (trough values in steady state) in adolescents in relation to daily dose and clinical information obtained from therapeutic drug monitoring request forms. Altogether, 44 patients younger than 21 years were scrutinized using this combined... (More)
The prescribing of selective serotonin reuptake inhibitors for adolescents is extensive despite the fact that there are few pharmacokinetic (PK), efficacy, safety, or tolerability studies on this group. This study reports the PK findings from two trials in adolescents treated with citalopram (CIT) in naturalistic clinical settings: one retrospective and one prospective. The aim of our study was to describe serum concentrations of CIT, desmethylcitalopram (I)CIT), and didesmethylcitalopram (DDCIT) (trough values in steady state) in adolescents in relation to daily dose and clinical information obtained from therapeutic drug monitoring request forms. Altogether, 44 patients younger than 21 years were scrutinized using this combined open-label approach. The main findings were that (1) there was a pronounced interindividual variability of serum CIT, DCIT, and DDCIT concentrations in all doses prescribed, in agreement with previous studies on adults; on correcting for dose, the. coefficient of variance was about 50% for CIT, DCIT, and DDCIT; (2) the transformation of CIT to DCIT and of DCIT to DDCIT was similar within the (lose range 20 to 60 mg/day; (3) there was a difference between the sexes on comparing the dose-corrected concentrations of CIT and DCIT, with girls presenting significantly higher values than boys; and (4) there was a strong dose-serum concentration relationship in three identified subgroups of adolescents: (a) nonsmokers (CIT, r(2) = 0.71; DCIT, r(2) = 0.81), (b) girls not taking oral contraceptives (CIT, r(2) = 0.75; DCIT, r(2) = 0.71,), and (c) girls in the last 14 days of the menstrual cycle (CIT, r(2) = 0.68; DCIT, r(2) = 0.64). In summary, the present study tentatively supports influences of sex, oral contraceptives, and smoking habits on the disposition of CIT in younger patients. Hence, future studies on CIT should assess these parameters. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Psychopharmacology
volume
22
issue
4
pages
406 - 413
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:12172341
  • wos:000177104100011
  • scopus:0036327423
ISSN
0271-0749
DOI
10.1097/01.jcp.0000022674.39890.79
language
English
LU publication?
yes
id
f04b9dc3-345c-4d6b-804d-fe5d0df7644c (old id 332298)
alternative location
http://www.psychopharmacology.com/pt/re/jclnpsychopharm/abstract.00004714-200208000-00012.htm
date added to LUP
2007-11-12 10:17:00
date last changed
2017-07-30 04:35:38
@article{f04b9dc3-345c-4d6b-804d-fe5d0df7644c,
  abstract     = {The prescribing of selective serotonin reuptake inhibitors for adolescents is extensive despite the fact that there are few pharmacokinetic (PK), efficacy, safety, or tolerability studies on this group. This study reports the PK findings from two trials in adolescents treated with citalopram (CIT) in naturalistic clinical settings: one retrospective and one prospective. The aim of our study was to describe serum concentrations of CIT, desmethylcitalopram (I)CIT), and didesmethylcitalopram (DDCIT) (trough values in steady state) in adolescents in relation to daily dose and clinical information obtained from therapeutic drug monitoring request forms. Altogether, 44 patients younger than 21 years were scrutinized using this combined open-label approach. The main findings were that (1) there was a pronounced interindividual variability of serum CIT, DCIT, and DDCIT concentrations in all doses prescribed, in agreement with previous studies on adults; on correcting for dose, the. coefficient of variance was about 50% for CIT, DCIT, and DDCIT; (2) the transformation of CIT to DCIT and of DCIT to DDCIT was similar within the (lose range 20 to 60 mg/day; (3) there was a difference between the sexes on comparing the dose-corrected concentrations of CIT and DCIT, with girls presenting significantly higher values than boys; and (4) there was a strong dose-serum concentration relationship in three identified subgroups of adolescents: (a) nonsmokers (CIT, r(2) = 0.71; DCIT, r(2) = 0.81), (b) girls not taking oral contraceptives (CIT, r(2) = 0.75; DCIT, r(2) = 0.71,), and (c) girls in the last 14 days of the menstrual cycle (CIT, r(2) = 0.68; DCIT, r(2) = 0.64). In summary, the present study tentatively supports influences of sex, oral contraceptives, and smoking habits on the disposition of CIT in younger patients. Hence, future studies on CIT should assess these parameters.},
  author       = {Reis, Margareta and Olsson, Gunilla and Carlsson, Björn and Lundmark, J and Dahl, ML and Walinder, J and Ahlner, J and Bengtsson, F},
  issn         = {0271-0749},
  language     = {eng},
  number       = {4},
  pages        = {406--413},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Clinical Psychopharmacology},
  title        = {Serum levels of citalopram and its main metabolites in adolescent patients treated in a naturalistic clinical setting},
  url          = {http://dx.doi.org/10.1097/01.jcp.0000022674.39890.79},
  volume       = {22},
  year         = {2002},
}