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Relationship between Plasma Level and Therapeutic Effect of Nortriptyline
- Publication Year :
- 1971
-
Abstract
- The relationship between plasma concentration of nortriptyline and therapeutic effect after two weeks' treatment with the drug was investigated in 29 psychiatric inpatients. Endogenous depression was diagnosed in all patients. Amelioration of depressive symptoms was estimated as reduction in score on a rating scale, based on a psychiatric interview. Amelioration was not correlated to the patient's sex or age. There was a curved relationship between plasma level of nortriptyline and therapeutic effect. Amelioration was most pronounced in the intermediate plasma level range (50-139 ng nortriptyline/ml plasma) and was slight both at lower and at higher plasma levels. This type of relationship may be due to the dual action of tricyclic antidepressants which has been found in animal experiments. On larger dosages a phenothiazine-like blockade of the monoaminergic receptor is added to the blockade of monoamine reuptake thought to be related to the antidepressant action of the drugs.THIS STUDY THUS SUGGESTS TWO POSSIBLE REASONS FOR A THERAPEUTIC FAILURE WITH NORTRIPTYLINE: a too low or a too high plasma level. The large individual variation in the pharmacokinetics of the tricyclic antidepressants makes prediction of plasma level from dosage in a given individual virtually impossible without knowledge of rate of elimination and apparent volume of distribution. Hence monitoring plasma levels may be a way to increase the efficacy of treatment with these drugs.
- Subjects :
- Adult
Male
Dose
Receptors, Drug
Nortriptyline
Pharmacology
Sex Factors
Pharmacokinetics
Phenothiazines
medicine
Humans
Amines
General Environmental Science
Aged
Volume of distribution
chemistry.chemical_classification
Psychiatric Status Rating Scales
business.industry
Depression
Therapeutic effect
General Engineering
Age Factors
General Medicine
Papers and Originals
Middle Aged
chemistry
Depression, Chemical
Endogenous depression
General Earth and Planetary Sciences
Antidepressant
Female
business
Tricyclic
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....42334492a2dca90ae88e750aaf34756e