Medical and economic benefits of routinely requested therapeutic drug monitoring of antidepressants

In psychiatry, therapeutic drug monitoring (TDM) is highly-recommended for a group of psychotropic drugs. Information about the cost-effectiveness of TDM is mainly lacking. We aimed to investigate if routinely requested TDM at admission to hospital offers an advantage with regard to the duration of hospitalization compared to patients where TDM was requested during their stay in hospital.

Patients with TDM for antidepressant drugs during the years 2015-2021 were assessed for analyses, retrospectively. The first TDM request of patients with depressive symptoms (F32/F33), and a duration of hospitalization of at least 7 days were included. Mann-Whitney-U test was used to test for differences between the duration of hospitalization attributed to the time of TDM.

When TDM was requested at admission, patients (N=417) had a significantly shorter stay in hospital compared to patients for whom TDM was requested during their hospitalization (N=673; p=5.04*10^-4).

Due shorter hospitalization duration by in average 5 days, requesting TDM for antidepressants routinely at admission has not only medical, but also economic benefits. In conclusion, in patients with depressive symptoms treated with antidepressants, we suggest routine TDM at admission to individualize antidepressant therapy.

Publication History

Article published online:
12 March 2024