Interpretatie: | Toxische concentratie mirtazapine is onbekend.
Desmethylmirtazapine draagt nauwelijks bij aan de farmacologische werking (max 5-10% van de activiteit van mirtazapine zelf) maar wordt wel bepaald omdat de ratio meer informatie kan geven over het juiste afname moment, therapietrouw, normaal metabolisme en interacties.
Normale ratio desmethylmirtazapine - mirtazapine: 0.2 - 1.2
Normale som spiegel mirtazapine - desmethylmirtazapine 50-300 ug/L.
Bij de interpretatie van de resultaten dient rekening gehouden te worden met de meetonzekerheid van de analysemethode. Voor meer informatie kunt u terecht bij de laboratoriumapotheker. |
Bronvermelding: | -Hiemke et al. AGNP consensus guidelines for therapeutic drug monitoring in psychiatry: update 2011. pharmacospychiatry 44:195-235
-Grasmäder K , Verwohlt P L , Kühn K U et al. Relationship between mirtazapinedose, plasma concentration, response, and side effects in clinical practice . Pharmacopsychiatry 2005 ; 38 : 113 – 117
-Kirkton C , McIntyre I M . Therapeutic and toxic concentrations of mirtazapine . J Anal Toxicol 2006 ; 30 : 687 – 691
-Lind A B , Reis M , Bengtsson F et al. Steady-state concentrations of mirtazapine, N-desmethylmirtazapine, 8-hydroxymirtazapine and their enantiomers in relation to cytochrome P450 2D6 genotype, age and smoking behaviour . Clin Pharmacokinet 2009 ; 48 : 63 – 70
-Meineke I , Kress I , Poser W et al. Therapeutic drug monitoring and its metabolite desmethylmirtazapine by HPLC with fl uorescence detection . Ther Drug Monit 2004 ; 26 : 277 – 283
-Reis M , Prochazka J , Sitsen A et al. Inter- and intraindividual pharmacokinetic variations of mirtazapine and its N-demethyl metabolite in patients treated for major depressive disorder: a 6-month therapeutic drug monitoring study . Ther Drug Monit 2005 ; 27 : 469 – 477
-Shams M , Hiemke C , Härtter S . Therapeutic drug monitoring of antidepressant mirtazapine and its N-demethylated metabolite in human serum . Ther Drug Monit 2004 ; 26 : 78 – 84
- TDM monografie NVZA mirtazapine (www.tdm-monografie.org)
|