[Insufficient effect of nortriptyline in a rapid metabolizer of sparteine].
A 61-year old woman suffering from depression was treated with 150 mg nortriptyline daily for eight weeks by her general practitioner. In spite of this dose, her S-nortriptyline was only 100 nmol/1 (recommended range: 225-600 nmol/1), and she remained depressed and was admitted to hospital. A sparteine test gave a metabolic ratio of 0.06, hence the patient was classified as a very rapid extensive metabolizer. Her nortriptyline dose was increased to 250 mg/day and the S-nortriptyline rose to 528 nmol/l. After eight weeks of sufficient nortriptyline treatment, the patient was still depressed. The patient recovered completely after a series of five electroconvulsive treatments.
Stage
K B
KB
Odense Sygehus, psykiatrisk afdeling P.
Brøsen
K
K
D005260:Female; D006801:Humans; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009661:Nortriptyline / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D013034:Sparteine / Q000378:metabolism*
D013034:Sparteine; D009661:Nortriptyline
Manglende effekt af nortriptylin hos en hurtig omdanner af spartein.