title: Assessing a therapeutic exchange protocol for second-generation antidepressants: clinical results.
abstract: OBJECTIVE
  To design a therapeutic exchange protocol for antidepressants and clinically assess variables, such as: compliance level, frequency of cases with clinically significant increase on the Udvalg-für-Kliniske-Undersogelser (UKU) psychopharmacological scale, adverse effects analysis, overall analysis of UKU rating development and patients' level of acceptance. Secondary objectives were to correlate psychopharmacological treatment aspects with the pharmacological morbidity level, and evaluate the clinical impact of pharmacotherapeutic optimisation measures.
  
  
  METHODS
  The protocol is designed in accordance with a bibliographical review, which was approved by the Pharmacy and Therapeutics Commission. Sequential study was carried out with a sample of 30 patients. Three measurements were taken (base line, at 48-72 hours and at 1-3 weeks) to calculate the pharmacotherapeutic morbidity with the UKU rating scale and the Global Clinical Impression. Pharmacotherapeutic optimisation measures were used for those patients with high pharmacotherapeutic morbidity levels.
  
  
  RESULTS
  The compliance level was 73.3%. One patient experienced ≥25% increase on the UKU rating scale and another patient suffered from an adverse effect. The final UKU rating reached statistical significance compared with the measurements taken at 48-72 hours (P=.032) and with the base line measurement (P=.007). Patient acceptance was 90%. The impact of optimisation measurements on the pharmacotherapeutic morbidity level was clinically and statistically significant (P<.001).
  
  
  CONCLUSIONS
  The proposed protocol has been widely accepted and it is quite certain that it is to be introduced in at a general hospital level.
authors.affiliation: Servicio de Farmacia, Hospital General Universitario de Alicante, Alicante, Spain. pacomartinezgranados@gmail.com
authors.forename: F
authors.initials: F
authors.lastname: Martínez-Granados
authors.forename: E
authors.initials: E
authors.lastname: Climent-Grana
authors.forename: E
authors.initials: E
authors.lastname: Pérez-Martínez
authors.forename: J P
authors.initials: JP
authors.lastname: Ordovás-Baines
authors.forename: J
authors.initials: J
authors.lastname: Selva Otaolaurruchi
authors.forename: M A
authors.initials: MA
authors.lastname: Bernabéu Martínez
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002985:Clinical Protocols; D003863:Depression / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013810:Therapeutic Equivalency
chemical_list: D018687:Antidepressive Agents, Second-Generation