Amitriptyline Nortriptyline Plasma Levels and Therapeutic Response in Depressed Women

Corona, Gian Luigi; Fenoglio, L.; Pinelli, P; Zerbi, F

doi:10.1055/s-0028-1094553

Cited by 17 publications

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“…A relationship has been reported by Braithwaite, Goulding, Theano, Bailey & Coppen (1972) Moyes (1980) and Corona, Fenoglio, Pinelli & Zerbi (1977). All of these with the exception of Kupfer et al (1977) either reported a curvilinear relationship (Montgomery & Braithwaite, 1975;Vandel et al, 1978;Montgomery etal., 1979 In the study of Liisberg et al (1978) two of the three patients with high levels were non-responders which is consistent with the curvilinear hypothesis.…”

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confidence: 69%

“…Amitriptyline the most widely used antidepressant has also been the subject of many plasma response studies. A Moyes (1980) and Corona, Fenoglio, Pinelli & Zerbi (1977). All of these with the exception of Kupfer et al (1977) either reported a curvilinear relationship (Montgomery & Braithwaite, 1975;Vandel et al, 1978;Montgomery etal., 1979 a,b;Moyes etal., 1980) or had findings which were consistent with the curvilinear hypothesis that optimum antidepressant effect is associated with intermediate plasma concentrations of amitriptyline plus its active metabolite nortriptyline of between approximately 80-200 jtg/l.…”

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confidence: 99%

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Measurement of Serum Drug Levels in the Assessment of Antidepressants

Montgomery

1981

Methods in Clinical Pharmacology—Central Nervous System

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confidence: 69%

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confidence: 99%

Measurement of Serum Drug Levels in the Assessment of Antidepressants

Montgomery

1981

Methods in Clinical Pharmacology—Central Nervous System

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“…Common factor(s) involved both in the levels attained and in the therapeutic outcome might always be responsible. For example, where all patients receive the same daily dose their plasma levels result from individual rates of drug metabolism, which are known to be determined, in part, by genetic factors (Alexanderson et al 1969(Alexanderson et al , 1973.Further doubt enters into the interpretation of studies in which AT doses were influenced by clinical criteria that might associate with outcome (Corona et al 1977(Corona et al , 1980a Offprint requests to: J.E. Burch b), or even by the progress of the patient during treatment (Click and Zisook 1982).…”

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confidence: 99%

“…Further doubt enters into the interpretation of studies in which AT doses were influenced by clinical criteria that might associate with outcome (Corona et al 1977(Corona et al , 1980a Offprint requests to: J.E. Burch b), or even by the progress of the patient during treatment (Click and Zisook 1982).…”

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Antidepressive effect of amitriptyline treatment with plasma drug levels controlled within three different ranges

et al. 1988

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Seventy-four depressed patients were treated with amitriptyline for 4-6 weeks. Their doses were individually adjusted to maintain the sum of the plasma levels of amitriptyline (AT) and nortriptyline (NT) within one of three different ranges, randomly allocated. Allowance was made for individual plasma binding of the drugs. In the 50 patients between 25 and 65 years of age, the antidepressive response at low plasma drug levels was somewhat poorer than at medium or high levels, which were equally effective. In this age group an association was found between outcome and the individual rate of AT metabolism, expressed as "reciprocal clearance" (RC), the steady-state plasma concentration of AT plus NT divided by the daily AT dose. Good antidepressive outcome was associated with high RC. The implications of these findings for patient treatment and for the interpretation of other studies are discussed. The 18 patients between 65 and 80 years of age showed no significant differences between the effectiveness of treatment at different plasma drug levels, and no significant associations between outcome and RC.

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“…In a preliminary study [16] we reported that the uri nary output of MHPG decreased in 'low' as well as in 'high' excretors, independently of AMT or NT plasma levels. In this paper we analyze the relations among drug plasma levels, urinary MHPG excretion changes, clinical outcome and side effects in depressed female inpatients treated with AMT.…”

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confidence: 99%

Amitriptyline and Nortriptyline Plasma Levels, Urinary 3-Methoxy-4-Hydroxyphenylglycol and Clinical Response in Depressed Women

et al. 1986

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Thirty-eight depressed female inpatients, treated intramuscularly with 100 mg/day amitriptyline (AMT), were monitored to investigate the relationships between plasma levels of the drug and its metabolite nortriptyline (NT), the urinary excretion of 3-methoxy-4-hydroxyphenylglycol (MHPG), side effects and clinical response. Considering the whole group, the clinical improvement was better within an intermediate range of AMT plus NT plasma concentrations (100–200 ng /ml). A more favorable outcome was also observed at NT plasma levels below 55 ng/ml. No significantly different percent clinical response among the patient clinical subgroups was observed as well as no significant correlations between MHPG decrease and drug plasma levels.

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Amitriptyline Nortriptyline Plasma Levels and Therapeutic Response in Depressed Women

Cited by 17 publications

References 0 publications

Measurement of Serum Drug Levels in the Assessment of Antidepressants

Measurement of Serum Drug Levels in the Assessment of Antidepressants

Antidepressive effect of amitriptyline treatment with plasma drug levels controlled within three different ranges

Amitriptyline and Nortriptyline Plasma Levels, Urinary 3-Methoxy-4-Hydroxyphenylglycol and Clinical Response in Depressed Women

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