Long-term efficacy and therapeutic drug monitoring of sertraline in major depression

Abstract

Maintenance treatment for depression should be considered as a chronic disease management programme. Several studies have reported that sertraline (SRT) can be useful in preventing relapses and recurrent episodes of major depression.Twenty-three outpatients, 14 males and 9 females, affected by major depressive disorder, recurrent (DSM-IV criteria) were included. The patients were prescribed 25-150 mg of SRT for 12 months and were evaluated at baseline (T(0)), after 15 days (T(0.5)), 30 days (T(1)), 6 months (T(6)) and 12 months (T(12)) by using the brief psychiatric rating scale (BPRS), Hamilton rating scale for anxiety (HRS-A) and Hamilton rating scale for depression (HRS-D). Plasma samples for SRT level determination were collected at T(0.5), T(1), T(6) and T(12). There was a positive relationship between SRT oral dose and drug plasma levels. Lower plasma levels, 25-50 ng/ml, were adequate for clinical maintenance treatment. Our data suggest that SRT seems to be effective and well tolerated at low dosages both in the acute and maintenance treatment of recurrent depression. Monitoring the SRT plasma level, even though not strictly necessary from a clinical point of view, can be useful in optimizing treatment.