title: High incidence of multisystemic reactions to zimeldine.
abstract: Forty-five patients suffering from a major depression were administered zimeldine, amitriptyline or placebo (15 patients in each group) in a double-blind controlled study. In the zimeldine group, seven of the 14 patients treated for more than one week presented a toxic syndrome consisting in a severe prostration, fever, myalgias and arthralgias. In all patients presenting this syndrome, laboratory analyses revealed an elevation of alkaline phosphatase and of aspartate and alanine aminotransferases and a decrease in white blood cell and platelet counts. Three patients presented a mild proteinuria and hematuria. Although an immunological mechanism cannot be ruled out, several characteristics of this reaction suggest the formation of a metabolite of zimeldine with direct cellular toxicity. The relatively high starting dose of 200 mg/day of zimeldine administered in the present study and the increment to 300 mg/day after only seven days might have contributed to the high incidence of toxic reactions observed.
authors.forename: R
authors.initials: R
authors.lastname: Langlois
authors.forename: G
authors.initials: G
authors.lastname: Cournoyer
authors.forename: C
authors.initials: C
authors.lastname: de Montigny
authors.forename: G
authors.initials: G
authors.lastname: Caillé
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013997:Time Factors; D015031:Zimeldine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use
chemical_list: D015031:Zimeldine; C017578:norzimelidine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase