Antidepressant therapeutic drug monitoring by minimally-invasive techniques in eating disorders patients: preliminary results from a pilote study.

Introduction: Therapeutic Drug Monitoring (TDM) has several indications in psychiatry including patients with physical comorbidities, suspected non-compliance, severe adverse effects and tailored pharmacotherapy. Antidepressants (AD) are frequently prescribed in patients with Eating Disorders (ED) to reduce binge-eating and compensatory behaviours or to treat comorbid depression and anxiety. Objectives: TDM by means of minimally-invasive biosampling approaches may represent a useful tool in this population, considering the limited efficacy of ED's pharmacological treatment and the high rate of adverse effects. Methods: Nineteen ED outpatients on AD treatment with a Body Mass Index (BMI) <20 kg/m2 or >30 kg/m2 agreed to take part in the present study. Participants were treated with Sertraline (N=5), Fluoxetine (N=5), Vortioxetine (N=5), Citalopram (N=2), Escitalopram (N=1), Fluvoxamine (N=1). Oral fluid samples were collected from patients, together with whole blood dried microsamples, obtained by finger puncture using Volumetric Absorptive Microsampling techniques. Results: Preliminary results showed a significant correlation between plasmatic and salivary concentrations for Vortioxetine only; moreover, extreme BMI did not seem to significantly influence the AD' plasmatic concentrations, when corrected for dosage. Conclusions: Further analyses may permit to validate for the first time the use of these recent microsampling procedures for AD treatment. By increasing the population size, we aim to demonstrate that TDM may represent a valid tool to better understand the limited efficacy of AD in ED patients. Minimally-invasive biosampling approach is well tolerated in patients with belenophobia and, in our experience, is highly appreciated by all patients: it may represent in future a valid support for Precision Medicine. [ABSTRACT FROM AUTHOR]