Frontiers in pharmacology · 2026
Clinical utility of therapeutic drug monitoring of sertraline: a transdiagnostic systematic scoping review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Canga-Espina Covadonga, Bullard José Pablo, Tapia-Alzuguren Begoña, Gędek Adam, Aubá Enrique, Ortuño Felipe, Aldaz-Pastor Azucena, Molero Patricio
Аннотация
INTRODUCTION: Therapeutic drug monitoring (TDM) is the quantification and interpretation of drug concentrations in blood to personalize pharmacotherapy. Dose adjustment of sertraline is currently based on clinical judgment. Preliminary evidence shows relationships between sertraline blood concentration and clinical outcomes. This review aims to evaluate the clinical utility of TDM of sertraline.
METHODS: A comprehensive, systematic search of studies in several databases was conducted up to 2025/06/26 on the potential relationship between TDM of sertraline and measures of efficacy, safety and tolerability. The search identified 5 clinical trials and 5 observational studies (N = 1106).
RESULTS: The included studies are highly heterogeneous. Most of the results are observational, mainly focused on depression and obsessive-compulsive disorder, covering the whole dosage range, with populations representing the whole life-span, observational periods from 4 weeks to 1 year. Efficacy assessments utilized diverse scales and heterogeneous measures of safety/tolerability. Most of the studies do not detect concentration-effect relationships. Preliminary, non-linear concentration-effect relationships are reported for efficacy and tolerability.
CONCLUSION: There is no sufficient evidence for the clinical utility of a generalized use of TDM for sertraline. Preliminary evidence suggests associations between blood concentrations of sertraline and clinical outcomes, potentially supporting the utility of its TDM as guide for clinical judgement in the treatment of depression and obsessive-compulsive disorder, particularly in populations with specific risks. Further studies using symptom-specific clinical scales are needed to assess the potential clinical utility of sertraline TDM in personalized medicine.
SYSTEMATIC REVIEW REGISTRATION: https://osf.io/84trm/overview.
METHODS: A comprehensive, systematic search of studies in several databases was conducted up to 2025/06/26 on the potential relationship between TDM of sertraline and measures of efficacy, safety and tolerability. The search identified 5 clinical trials and 5 observational studies (N = 1106).
RESULTS: The included studies are highly heterogeneous. Most of the results are observational, mainly focused on depression and obsessive-compulsive disorder, covering the whole dosage range, with populations representing the whole life-span, observational periods from 4 weeks to 1 year. Efficacy assessments utilized diverse scales and heterogeneous measures of safety/tolerability. Most of the studies do not detect concentration-effect relationships. Preliminary, non-linear concentration-effect relationships are reported for efficacy and tolerability.
CONCLUSION: There is no sufficient evidence for the clinical utility of a generalized use of TDM for sertraline. Preliminary evidence suggests associations between blood concentrations of sertraline and clinical outcomes, potentially supporting the utility of its TDM as guide for clinical judgement in the treatment of depression and obsessive-compulsive disorder, particularly in populations with specific risks. Further studies using symptom-specific clinical scales are needed to assess the potential clinical utility of sertraline TDM in personalized medicine.
SYSTEMATIC REVIEW REGISTRATION: https://osf.io/84trm/overview.