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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">psychiatry</journal-id><journal-title-group><journal-title xml:lang="ru">ПСИХИАТРИЯ</journal-title><trans-title-group xml:lang="en"><trans-title>Psychiatry (Moscow) (Psikhiatriya)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1683-8319</issn><issn pub-type="epub">2618-6667</issn><publisher><publisher-name>FSBSI “The Mental Health Research Centre”;   LLC «Publisher «MIA»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/2618-6667-2025-23-4-48-57</article-id><article-id custom-type="elpub" pub-id-type="custom">psychiatry-1420</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПСИХОПАТОЛОГИЯ, КЛИНИЧЕСКАЯ И БИОЛОГИЧЕСКАЯ ПСИХИАТРИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PSYCHOPATHOLOGY, CLINICAL AND BIOLOGICAL PSYCHIATRY</subject></subj-group></article-categories><title-group><article-title>Проведение терапевтического лекарственного мониторинга венлафаксина в рамках индивидуализации фармакотерапии депрессии</article-title><trans-title-group xml:lang="en"><trans-title>Conducting Therapeutic Drug Monitoring of Venlafaxine in the Context of Individualization of Pharmacotherapy for Depression</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4950-5336</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мирошниченко</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Miroshnichenko</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Игорь Иванович Мирошниченко, доктор медицинских наук, заведующий лабораторией, лаборатория фармакокинетики</p><p>Москва</p></bio><bio xml:lang="en"><p>Igor I. Miroshnichenko, Dr. Sci. (Med.), Head of laboratory, Laboratory of pharmacokinetics</p><p>Moscow</p></bio><email xlink:type="simple">igormir@psychiatry.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9326-4683</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьмин</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzmin</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иван Игоревич Кузьмин, научный сотрудник, лаборатория фармакокинетики</p><p>Москва</p></bio><bio xml:lang="en"><p>Ivan I. Kuzmin, Researcher, Laboratory of pharmacokinetics</p><p>Moscow</p></bio><email xlink:type="simple">4204@1090393.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0607-4812</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Застрожин</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zastrozhin</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михаил Сергеевич Застрожин, доктор медицинских наук, доцент, кафедра наркологии, постдок</p><p>Сан-Франциско</p></bio><bio xml:lang="en"><p>Mihail S. Zastrozhin, Dr. Sci. (Med.), Docent, Department of narcology, postdoc</p><p>San Francisco</p><p> </p></bio><email xlink:type="simple">mszastrozhin@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4639-1276</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цветаева</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsvetaeva</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дарья Андреевна Цветаева, младший научный сотрудник, отдел гериатрической психиатрии</p><p>Москва</p></bio><bio xml:lang="en"><p>Darya A. Cvetaeva, Psychiatrist, Junior Researcher, Department of Geriatric Psychiatry</p><p>Moscow</p></bio><email xlink:type="simple">5608@1090393.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9154-4104</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шишковская</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Shishkovskaya</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татьяна Игоревна Шишковская, кандидат медицинских наук, младший научный сотрудник, отдел по изучению эндогенных психических расстройств и аффективных состояний</p><p>Москва</p></bio><bio xml:lang="en"><p>Tatyana I. Shishkovskaya, Cand. Sci. (Med.), Junior Researcher, Department of Endogenous Mental Disorders and Affective States</p><p>Moscow</p></bio><email xlink:type="simple">ttnszy@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5198-6637</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поздняков</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pozdnyakov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сергей Александрович Поздняков, младший научный сотрудник, лаборатория генетики и фундаментальных исследований</p><p>Москва</p></bio><bio xml:lang="en"><p>Sergey A. Pozdnyakov, Junior Researcher, Laboratory of Genetics and Basic Research</p><p>Moscow</p></bio><email xlink:type="simple">S.Pozdniakov.mnpcn@rambler.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3509-1622</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафарова</surname><given-names>Т. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Safarova</surname><given-names>T. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>атьяна Петровна Сафарова, доктор медицинских наук, ведущий научный сотрудник, отдел гериатрической психиатрии</p><p>Москва</p></bio><bio xml:lang="en"><p>Tatyana P. Safarova, Dr. Sci. (Med.), Leading Researcher, Department of Geriatric Psychiatry</p><p>Moscow</p></bio><email xlink:type="simple">2513@1090393.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8344-0620</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Олейчик</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Oleychik</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Игорь Валентинович Олейчик, доктор медицинских наук, руководитель отдела, отдел по изучению эндогенных психических расстройств и аффективных состояний</p><p>Москва</p></bio><bio xml:lang="en"><p>Igor V. Olejchik, Dr. Sci. (Med.), Head of Department, Department, of Endogenous Mental Disorders and Affective States</p><p>Moscow</p></bio><email xlink:type="simple">2302@1090393.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2653-0427</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковлева</surname><given-names>О. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakovleva</surname><given-names>O. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ольга Борисовна Яковлева, кандидат медицинских наук, ведущий научный сотрудник, отдел гериатрической психиатрии</p><p>Москва</p></bio><bio xml:lang="en"><p>Olga B. Yakovleva, Cand. Sci. (Med.), Leading Researcher, Department of Geriatric Psychiatry</p><p>Moscow</p></bio><email xlink:type="simple">yakob2003@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научный центр психического здоровья»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budget Scientific Institution Mental Health Research Centre Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Калифорнийский университет в Сан-Франциско</institution><country>Россия</country></aff><aff xml:lang="en"><institution>University of California San Francisco</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ «Московский научно-практический центр наркологии Департамента здравоохранения Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Scientific and Practical Center of Narcology of the Department of Health of Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>25</day><month>11</month><year>2025</year></pub-date><volume>23</volume><issue>4</issue><fpage>48</fpage><lpage>57</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мирошниченко И.И., Кузьмин И.И., Застрожин М.С., Цветаева Д.А., Шишковская Т.И., Поздняков С.А., Сафарова Т.П., Олейчик И.В., Яковлева О.Б., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Мирошниченко И.И., Кузьмин И.И., Застрожин М.С., Цветаева Д.А., Шишковская Т.И., Поздняков С.А., Сафарова Т.П., Олейчик И.В., Яковлева О.Б.</copyright-holder><copyright-holder xml:lang="en">Miroshnichenko I.I., Kuzmin I.I., Zastrozhin M.S., Tsvetaeva D.A., Shishkovskaya T.I., Pozdnyakov S.A., Safarova T.P., Oleychik I.V., Yakovleva O.B.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.journalpsychiatry.com/jour/article/view/1420">https://www.journalpsychiatry.com/jour/article/view/1420</self-uri><abstract><p>Обоснование: терапевтический лекарственный мониторинг представляет собой одно из наиболее перспективных направлений в клинической практике для оптимизации лечения антидепрессантами. Тем не менее до сих пор мало известно о взаимосвязи между клинической эффективностью и концентрацией венлафаксина в сыворотке/плазме крови. Цель исследования: разработать персонифицированные подходы к назначению венлафаксина при депрессии с использованием терапевтического лекарственного мониторинга минимальных и максимальных уровней препарата. Пациенты, материалы исследования и методы: отобраны 52 пациента, находящиеся в стационаре с диагнозом депрессии (F32 и F33 по МКБ-10) и получавшие венлафаксин. Концентрации препарата и его активного метаболита О-десметилвенлафаксина в плазме крови определяли валидированным методом высокоэффективной жидкостной хроматографии с масс-спектрометрическим детектированием (ВЭЖХ-МС). Воздействие потенциально влияющих факторов оценивали с помощью многомерной линейной регрессионной модели. Результаты: у 73% и 67% пациентов концентрация активного компонента венлафаксина была в пределах рекомендованного терапевтического диапазона (прежний и пересмотренный терапевтические диапазоны соответственно). Концентрация венлафаксина в плазме крови зависела от возраста, массы тела и активности CYP2D6. На метаболизм венлафаксина, выраженный в виде соотношения концентраций метаболита и исходного вещества, влияли возраст, уровень CYP2D6 и индекс массы тела (ИМТ). Не обнаружено значимых различий в концентрации венлафаксина в плазме крови между пациентами, принимавшими препарат однократно и дважды в день. Сочетание нескольких переменных факторов оказывало дополнительное влияние на концентрацию в плазме крови. Концентрация активного компонента в плазме крови была выше у пожилых женщин. Выводы: данное исследование убедительно свидетельствует о том, что мониторинг — более подходящее средство для оптимизации лечения, чем титрование пероральной дозы. В частности, наибольшая эффективность может быть достигнута у пациентов с уровнем активного компонента около 400 нг/мл. Терапевтический лекарственный мониторинг венлафаксина рекомендуется для применения в клинической практике, особенно в начале фармакотерапии пожилых людей.</p></abstract><trans-abstract xml:lang="en"><p>Background: therapeutic drug monitoring represents one of the most promising tools in clinical practice to optimise antidepressant treatment. Nevertheless, little is still known regarding the relationship between clinical efficacy and serum/ plasma concentration of venlafaxine. The aim of study was to develop personalized approaches to prescribing venlafaxine for depression through therapeutic drug monitoring of minimum and maximum levels of the drug. Patients, Materials and Methods: 52 hospitalized patients with depression (F32 and F33 according to ICD-10) receiving venlafaxine were selected. Plasma concentrations of the drug and its active metabolite O-desmethylvenlafaxine were determined using a validated HPLC-MS method. The effects of potentially infiuencing factors was assessed using a multivariate linear regression model. Results: 73% and 67% of patients reached the venlafaxine active moiety concentrations within the recommended therapeutic range (previous and revised therapeutic ranges respectively). Plasma concentrations were dependent on age, weight, and CYP2D6 activity. Venlafaxine metabolism expressed as a metabolite-to-parent concentrations ratio was infiuenced by a combination of age, CYP2D6, and body mass index (BMI). We did not observe any significant difference in plasma concentrations between the patients with a single and two per day administration. Combining variables made an additive effect on plasma concentrations. Active moiety plasma concentrations were higher in older women. Conclusion: this study strongly suggests that monitoring could represent a more appropriate tool than the oral dosage to optimise the treatment with venlafaxine. Specifically, highest efficacy might be achieved in patients at active moiety levels around 400 ng/mL. Therapeutic drug monitoring of venlafaxine is recommended in clinical practice, especially in the elderly when beginning the pharmacotherapy.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>венлафаксин</kwd><kwd>О-десметилвенлафаксин</kwd><kwd>терапевтический лекарственный мониторинг</kwd><kwd>высокоэффективная жидкостная хроматография с масс-спектрометрией</kwd></kwd-group><kwd-group xml:lang="en"><kwd>venlafaxine</kwd><kwd>O-desmethylvenlafaxine</kwd><kwd>therapeutic drug monitoring</kwd><kwd>high-performance liquid chromatography with mass spectrometry</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ates HC, Roberts JA, Lipman J, Cass AEG, Urban GA, Dincer C. On-Site therapeutic drug monitoring. 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