Evaluation of the concentrations of psychotropic drugs in HIV-infected versus HIV-negative patients: Potential implications for clinical practice

Dario Cattaneo, Sara Baldelli, Chiara Resnati, Andrea Giacomelli, Paola Meraviglia, Davide Minisci, Noemi Astuti, Annalisa Ridolfo, Giuseppe V. De Socio, Emilio Clementi, Massimo Galli, Cristina Gervasoni

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The management of psychiatric illness in HIV-infected patients is clinically challenging because of the risk of potential drug–drug interactions. Here, we aimed to measure the antidepressant and/or antipsychotic drug concentrations in HIV-infected patients during routine outpatient visits. Methods: Six hundred HIV-infected patients were screened during the first 15 months after the introduction of our outpatient polytherapy management service in a search for subjects treated with psychotropic drugs for at least 3 months. The distribution of psychotropic drug concentrations in HIV-infected patients was compared with that observed in a control group of HIV-negative patients monitored over the same period. Results: The search identified 82 HIV-infected patients concomitantly receiving antiretroviral and psychotropic drug treatment, 55% of whom had plasma psychotropic drug concentrations that were below minimum effective levels. The same result was found in only 26% of the samples taken from HIV-negative patients. These results were not affected by patients’ gender, age, adherence to therapies or drug–drug interactions. Conclusions: A higher rate of sub-therapeutic antidepressant and/or antipsychotic drugs concentrations were found in HIV-infected patients. The creation of multidiscliplinary specialist teams may contribute to improving the management of such complex patients.

Original languageEnglish
JournalWorld Journal of Biological Psychiatry
DOIs
Publication statusE-pub ahead of print - Jan 1 2018

Keywords

  • antidepressants
  • antipsychotics
  • Drug interactions
  • pharmacotherapy
  • psychopharmacology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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