A comparison of maprotiline and its desmethylated metabolite serum concentrations in outpatients and inpatients.
An investigation was conducted on drug defaulting in 26 depressed patients (11 outpatients and 15 inpatients) treated with maprotiline (MPT), using the interrogation methods and measurements of drug serum levels. All the outpatients visited the clinic regularly and complied with taking the prescripted drugs as directed. The results were as follows: (1) The relationships between the MPT and desmethylmaprotiline (DMPT) serum levels and the daily MPT doses showed highly linear regressions in all the patients, and in the inpatients and outpatients separately. There were significant differences between the regression coefficients obtained in the outpatients and inpatients with respect to MPT (P less than 0.01) and DMPT (P less than 0.001). There was a discrepancy between the results from the patients' reports and measurements of the drug serum levels. This finding indicated noncompliance by the outpatients. (2) Comparing various factors of the outpatients to those of the inpatients, the DMPT/MPT ratio of the former was higher than that of the latter (P less than 0.05). This was also due to the patients' noncompliance, and this ratio, therefore, was considered to be a sensitive marker for checking the compliance of the patients treated with MPT.
Department of Neuropsychiatry, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
K
K
Kurata
H
H
Kido
M
M
Hasegawa
M
M
Inoue
N
N
Yamaguchi
D000328:Adult; D000553:Ambulatory Care; D000873:Anthracenes / Q000097:blood*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008376:Maprotiline / Q000031:analogs & derivatives / Q000097:blood* / Q000627:therapeutic use; D008875:Middle Aged; D010349:Patient Compliance
D000873:Anthracenes; D008376:Maprotiline; C027056:desmethylmaprotiline