title: Adequate treatment with imipramine in continuation treatment.
abstract: Maintenance treatment studies done with tricyclic antidepressants have used the equivalent of 150 mg or less of imipramine in prophylactic clinical trials. In an ongoing 3-year maintenance trial, the authors are using imipramine in dosages greater than 150 mg/day for both acute and continuation treatment (4 to 6 months) of recurrent depression in order to test the efficacy of this dosage level. Fifty-seven depressed patients who received tricyclic drug treatment and interpersonal psychotherapy during the acute and continuation phases of the study tolerated this dosage level well (mean dose, 217 mg/day of imipramine), reported few adverse effects on a somatic symptom checklist, and demonstrated a high level of compliance as shown by plasma concentration/dosage (L/D) ratios. The authors found that the time course of the L/D ratio is associated with higher steady-state plasma concentrations than those observed with similar dosages in shorter-term tricyclic antidepressant treatment.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213.
authors.forename: D J
authors.initials: DJ
authors.lastname: Kupfer
authors.forename: J M
authors.initials: JM
authors.lastname: Perel
authors.forename: E
authors.initials: E
authors.lastname: Frank
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy
chemical_list: D007099:Imipramine