Challenges in therapeutic drug monitoring of classical tricyclic and newer antidepressants: analytical and pharmacogenetics considerations

Document Type

Book Chapter

Publication Date

2024

Identifier

DOI: 10.1016/B978-0-443-18649-3.00002-1

Abstract

Depression is a common health issue. Antidepressants are one of the most frequently prescribed drugs. Due to their narrow therapeutic window, noncompliance issues, and genetic variability, antidepressants are frequently monitored. Immunoassays and chromatographic methods are commonly used for the measurement of antidepressants. Immunoassays are easy to perform and provide rapid turn-around time. However, immunoassays lack specificity and are not available for most antidepressants. Chromatographic methods such as gas or liquid chromatography linked to mass spectrometry are versatile and specific than immunoassays. However, chromatographic methods are analytically challenging and not available on routine basis. For optimal use of therapeutic drug monitoring, knowledge of many other factors such as age, co-morbidities, co-administration of other drugs, and pharmacogenetics is essential, particularly in patients who do not respond optimally to the drug therapy.

Journal Title

Therapeutic Drug Monitoring (Second Edition)

First Page

217

Last Page

240

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