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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 14 (1978), S. 185-190 
    ISSN: 1432-1041
    Schlagwort(e): amitriptyline ; nortriptyline ; depression ; therapeutic plasma level ; Hamilton rating scale
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Summary Plasma levels of amitriptyline and nortriptyline were measured twice weekly in 62 patients treated for three weeks with i.m. amitriptyline 120 mg/day. In half the patients the ratio of amitriptyline to nortriptyline was under 1 and in the other half it was greater than 1. 30 of these 62 patients were clinically monitored with the Hamilton Rating Scale and the side effects of the drug were recorded. There was no correlation between plasma level of the drug and its side effects, but there was a statistically significant curvilinear correlation between the plasma levels of amitriptyline plus nortriptyline and nortriptyline alone, and the clinical effect. The practical value of this type of investigation was demonstrated by showing that patients whose drug plasma level was not in the therapeutic range, were clinically improved after adjustment of the dose. The plasma level of amitriptyline plus nortriptyline must lie between 60 to 220 ng/ml, and that of nortriptyline between 60 to 140 ng/ml, to obtain the best clinical effect. Associated treatments, age, weight and sex of patients, and the type of depression did not appear significantly to affect the plasma level of the drug.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 37 (1989), S. 595-598 
    ISSN: 1432-1041
    Schlagwort(e): amitriptyline ; nortriptyline ; pharmacokinetics ; linear kinetics ; depressed patients ; toxicity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Summary The linearity of the (AMT) kinetics of amitriptyline has been tested in 135 depressed dosed twice daily by measuring plasma. Their (AMT) and nortriptyline (NT) levels under steady-state conditions. The AMT concentration/dose ratios at low and high dosages were not significantly different and there was a linear relationship between the dose ratios and the concentration ratios. No change in the metabolic ratio (AMT/NT) was observed between the two dosages. Although the results are consistent with linear AMT kinetics, there may have been nonlinear kinetics in some patients as the ratio between the concentration/dose ratios in them at low and high dosages was greater than one. Those patients were characterized by a low concentration/dose ratio at low dosage. No clinical adverse effect appeared in the study.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1432-2072
    Schlagwort(e): Amitriptyline ; Nortriptyline ; Drug interaction ; Therapeutic plasma concentration
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Amitriptyline (AT) and nortriptyline (NT) plasma levels were checked in 86 patients treated with AT by oral or IM administration. Fifty-six patients were also treated with a phenothiazine. In 20 of these patients receiving AT IM with a phenothiazine, the plasma levels of NT (and the variability of these levels between patients) were higher than in nine patients receiving the antidepressant drug alone at the same dosage and by the same route. In eleven patients receiving AT orally with a phenothiazine the plasma levels of NT (and the variability of these levels between patients) were higher, and the ratio of plasma levels of AT and NT were lower than in eight patients receiving the antidepressant drug alone at the same dosage and by the same route. These results suggest an increase of the demethylation of AT and/or a decrease of the hydroxylation of NT and/or a decrease of its elimination. The differences in the variability of the plasma levels of AT and NT could be due to a saturation of the enzymatic system of biotransformation of the antidepressant drug by phenothiazine and to a first-pass effect when the drug is given orally. The correlation between the plasma levels of AT and NT and the clinical effect has been studied in the 86 patients. The correlation between the NT plasma level and the clinical response seems to be more curvilinear when AT is associated with a phenothiazine. This suggests a potentialization of the post-synaptic alpha-receptor blocking effect of NT by the neuroleptic drug.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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