Abstract
Eighteen subjects with “endogenous” depression-11 women and 7 men were include in the study. They met DSM-III-R criteria for major depression. In the course of the treatment with tricyclic antidepressants (TCA) 3 patients (17%) become manic, 1 patient (5%) was not in compliance with the drug chosen. The remaining patients – 8 women (57%) and 6 men (43%) were with mean age 51 (SD = 17.38) and 36.2 (SD = 15.27) years respectively. After one week placebo period the patients randomly assigned to 2.5 mg/kg body weight Amitriptylin-AMI or Imipramine-IMI with mean daily doses 175 mg (SD = 53.03) for AMI and 204, 2 mg (SD = 66.8) for IMI. Mean plasma study states levels were 223.27 ng/ml (SD = 128.6) for AMI and 253.21 ng/ml (SD = 148.31) for IMI. Seven of 10 responders-R (71%) had therapeutic plasma levels-pharmacokinetic R. Three of them had plasma levels outside the established therapeutic range. Three of the 4 nonresponders-NR had plasma levels outside the therapeutic range, but one was within it-pharmacodynamic NR. Comparing the R and NR group within and without the therapeutic range we found X2 = 9.3 and p < 0.001. In conclusion the clinical response of the patients with “endogenous” depression depends strongly upon the plasma study states level.
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Stoynova, V., Mikova, O. & Svinaroff, D. Plasma Levels of Tricyclic Antidepressants and Clinical Response. Neuropsychopharmacol 11, 286 (1994). https://doi.org/10.1038/sj.npp.1380217
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DOI: https://doi.org/10.1038/sj.npp.1380217