Validation of a therapeutic plasma level range in amitriptyline treatment of depression.
In the course of a double-blind study, 29 depressed patients received amitriptyline 150 mg/day for 4 weeks. Scores on the Hamilton Depression Rating Scale were assessed before treatment and after 2 and 4 weeks, and plasma levels of amitriptyline, nortriptyline, and (E)-10-hydroxynortriptyline were monitored weekly. Response reflected by percent reduction of Hamilton Depression Rating Scale score and by final score was better at steady-state amitriptyline + nortriptyline concentrations of 125-210 ng/ml than at lower and higher plasma levels. This applied to the total group and to the subgroup of 22 female patients. The data confirm the results of a previous study performed in the same hospital. An influence of the (E)-10-hydroxynortriptyline concentration in plasma on therapeutic outcome was not discernible. The results suggest that plasma level monitoring may be helpful when patients do not respond to conventional amitriptyline doses.
Breyer-Pfaff
U
U
Department of Toxicology, University of Tübingen, Federal Republic of Germany.
Giedke
H
H
Gaertner
H J
HJ
Nill
K
K
D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000008:administration & dosage / Q000097:blood* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000031:analogs & derivatives / Q000097:blood; D011569:Psychiatric Status Rating Scales
C013567:10-hydroxynortriptyline; D000639:Amitriptyline; D009661:Nortriptyline