title: Therapeutic drug monitoring of children and adolescents treated with fluoxetine.
abstract: BACKGROUND
  Information about therapeutic serum levels of fluoxetine (FLX) and its major metabolite norfluoxetine (NORFLX) in children and adolescents is scarce.
  
  
  METHODS
  Therapeutic drug monitoring (TDM) of FLX was routinely performed in 71 subjects treated for a major depressive disorder (MDD) (10-60 mg/d FLX, median: 20 mg/d). Correlations between serum concentration and dosage, age, gender, smoking habits and adverse events were analysed.
  
  
  RESULTS
  Serum concentrations of the active moiety (FLX + NORFLX) ranged from 21 to 613 ng/mL (mean concentration of 213 ± 118 ng/mL, median: 185 ng/mL). High inter-individual variability in serum concentrations of the active moiety of FLX at each dosage level was observed and no relationship between serum concentration and clinical outcome was found. Apart from smoking, none of the factors tested had a significant eff ect on the serum concentration.
  
  
  CONCLUSIONS
  It was shown that serum concentrations of the active moiety of FLX in children and adolescents seem to be similar to those in adults, with a high level of inter-individual variation. The proportion of patients who showed benefits from treatment with a dose of 20 mg/d FLX was high.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany. michael.koelch@uniklinik-ulm.de
authors.forename: M
authors.initials: M
authors.lastname: Koelch
authors.forename: A-K
authors.initials: AK
authors.lastname: Pfalzer
authors.forename: K
authors.initials: K
authors.lastname: Kliegl
authors.forename: S
authors.initials: S
authors.lastname: Rothenhöfer
authors.forename: A G
authors.initials: AG
authors.lastname: Ludolph
authors.forename: J M
authors.initials: JM
authors.lastname: Fegert
authors.forename: R
authors.initials: R
authors.lastname: Burger
authors.forename: C
authors.initials: C
authors.lastname: Mehler-Wex
authors.forename: J
authors.initials: J
authors.lastname: Stingl
authors.forename: R
authors.initials: R
authors.lastname: Taurines
authors.forename: K
authors.initials: K
authors.lastname: Egberts
authors.forename: M
authors.initials: M
authors.lastname: Gerlach
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D012727:Sex Characteristics; D012907:Smoking / Q000523:psychology; D055815:Young Adult
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; C036139:norfluoxetine