title: Correlation between steady-state plasma concentrations of mianserin and trazodone in depressed patients.
abstract: OBJECTIVE
  The correlations between steady-state plasma concentrations of mianserin and its active metabolite desmethylmianserin and those of trazodone and its active metabolite m-chlorophenylpiperazine (m-CPP) were examined in 19 depressed patients.
  
  
  METHODS
  Ten patients received first mianserin (30 mg per day) and second trazodone (150 mg per day), while 9 patients received these treatments in the opposite sequence, with at least 2-week intervals between the two phases. Blood was sampled at steady state, 1-3 weeks after initiation of each treatment. Plasma concentrations of mianserin, the separate enantiomers S(+)- and R(-)-mianserin, desmethylmianserin, trazodone and m-CPP were measured by means of high-performance liquid chromatography.
  
  
  RESULTS
  There was a significant correlation between steady-state plasma concentrations of trazodone and total mianserin (r = 0.59) or S(+)-mianserin (r = 0.57), but not R(-)-mianserin (r = 0.33).
  
  
  CONCLUSIONS
  The present study thus suggests that the metabolic capacity of mianserin, especially the more active S(+)-enantiomer, and that of trazodone correlate to each other. This finding supports the previous suggestions that cytochrome P4502D6 is involved in the metabolism of mianserin and trazodone.
authors.affiliation: Department of Neuropsychiatry, Hirosaki University Hospital, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Otani
authors.forename: G
authors.initials: G
authors.lastname: Tybring
authors.forename: K
authors.initials: K
authors.lastname: Mihara
authors.forename: N
authors.initials: N
authors.lastname: Yasui
authors.forename: S
authors.initials: S
authors.lastname: Kaneko
authors.forename: T
authors.initials: T
authors.lastname: Ohkubo
authors.forename: T
authors.initials: T
authors.lastname: Nagasaki
authors.forename: K
authors.initials: K
authors.lastname: Sugawara
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000097:blood / Q000493:pharmacokinetics*; D019389:Cytochrome P-450 CYP2D6 / Q000378:metabolism*; D003863:Depression / Q000188:drug therapy / Q000201:enzymology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000097:blood / Q000493:pharmacokinetics*; D008875:Middle Aged; D014196:Trazodone / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D008803:Mianserin; D019389:Cytochrome P-450 CYP2D6; D014196:Trazodone