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 journalArticle

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
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Biological Psychiatry
DOIs
Publication statusE-pub ahead of print - 2019

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Psychotropic Drugs
HIV
Drug Interactions
Antidepressive Agents
Antipsychotic Agents
Outpatients
Psychiatry
Drug Therapy
Control Groups

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Evaluation of the concentrations of psychotropic drugs in HIV-infected versus HIV-negative patients : Potential implications for clinical practice. / Cattaneo, Dario; Baldelli, Sara; Resnati, Chiara; Giacomelli, Andrea; Meraviglia, Paola; Minisci, Davide; Astuti, Noemi; Ridolfo, Annalisa; De Socio, Giuseppe V; Clementi, Emilio; Galli, Massimo; Gervasoni, Cristina.

In: World Journal of Biological Psychiatry, 2019, p. 1-7.

Research output: Contribution to journalArticle

Cattaneo, D, Baldelli, S, Resnati, C, Giacomelli, A, Meraviglia, P, Minisci, D, Astuti, N, Ridolfo, A, De Socio, GV, Clementi, E, Galli, M & Gervasoni, C 2019, 'Evaluation of the concentrations of psychotropic drugs in HIV-infected versus HIV-negative patients: Potential implications for clinical practice', World Journal of Biological Psychiatry, pp. 1-7. https://doi.org/10.1080/15622975.2018.1500032
Cattaneo, Dario ; Baldelli, Sara ; Resnati, Chiara ; Giacomelli, Andrea ; Meraviglia, Paola ; Minisci, Davide ; Astuti, Noemi ; Ridolfo, Annalisa ; De Socio, Giuseppe V ; Clementi, Emilio ; Galli, Massimo ; Gervasoni, Cristina. / Evaluation of the concentrations of psychotropic drugs in HIV-infected versus HIV-negative patients : Potential implications for clinical practice. In: World Journal of Biological Psychiatry. 2019 ; pp. 1-7.
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AU - Giacomelli, Andrea

AU - Meraviglia, Paola

AU - Minisci, Davide

AU - Astuti, Noemi

AU - Ridolfo, Annalisa

AU - De Socio, Giuseppe V

AU - Clementi, Emilio

AU - Galli, Massimo

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N2 - 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.

AB - 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.

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