Hostname: page-component-5447f9dfdb-t9wd7 Total loading time: 0 Render date: 2025-07-30T14:32:19.591Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term treatment of endogenous depression with nortriptyline with control of plasma levels1

Published online by Cambridge University Press:  09 July 2009

Per Kragh-Sørensen ,
Christian Eggert Hansen ,
Niels-Erik Larsen ,
Jørgen Næstoft  and
Eigill F. Hvidberg
Per Kragh-Sørensen*
Affiliation:
From Department O, The State Mental Hospital, Glostrup The Department of Clinical Chemistry, The Copenhagen County Hospital, Glostrup Clinical Pharmacology Research Unit, Danish State Medical Research Council, Copenhagen, Denmark
Christian Eggert Hansen
Affiliation:
From Department O, The State Mental Hospital, Glostrup The Department of Clinical Chemistry, The Copenhagen County Hospital, Glostrup Clinical Pharmacology Research Unit, Danish State Medical Research Council, Copenhagen, Denmark
Niels-Erik Larsen
Affiliation:
From Department O, The State Mental Hospital, Glostrup The Department of Clinical Chemistry, The Copenhagen County Hospital, Glostrup Clinical Pharmacology Research Unit, Danish State Medical Research Council, Copenhagen, Denmark
Jørgen Næstoft
Affiliation:
From Department O, The State Mental Hospital, Glostrup The Department of Clinical Chemistry, The Copenhagen County Hospital, Glostrup Clinical Pharmacology Research Unit, Danish State Medical Research Council, Copenhagen, Denmark
Eigill F. Hvidberg
Affiliation:
From Department O, The State Mental Hospital, Glostrup The Department of Clinical Chemistry, The Copenhagen County Hospital, Glostrup Clinical Pharmacology Research Unit, Danish State Medical Research Council, Copenhagen, Denmark
*
2Address for correspondence: Dr. Per Kragh-Sørensen, Department O, The State Mental Hospital, Glostrup, DK-2600 Glostrup, Denmark.
Get access Rights & Permissions [Opens in a new window]

Sysnopsis

The study was undertaken in order to clarify the clinical pharmacological basis for a correct design of controlled trials of the prophylactic effect of tricyclic antidepressants. Twenty-two patients, successfully treated with nortriptyline (NT) in hospital for endogenous depression, continued the treatment for up to five months in the outpatient clinic. Plasma levels of NT were checked, and ratings were performed regularly. Depressive relapses, all related to low plasma levels of NT, were seen in three patients. The gas Chromatographic method, described in detail, has proved suitable for clinical routine and the results demonstrate the value of monitoring plasma levels in achieving therapeutic control.

Information

Type
Research Article
Information
Psychological Medicine , Volume 4 , Issue 2 , May 1974 , pp. 174 - 180
Copyright
Copyright © Cambridge University Press 1974

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

1

This study was supported by The Danish Medical Research Council (512–1646).

References

REFERENCES

Alexanderson, B., Evans, D. A. P., and Sjöqvist, F. (1969). Steady-state plasma levels of nortriptyline in twins: influence of genetic factors and drug therapy. British Medical Journal, 4, 764–768.CrossRefGoogle ScholarPubMed
Angst, J., Dittrich, A., and Grof, P. (1969a). Course of endogenous affective psychoses and its modification by prophylactic administration of imipramine and lithium. International Pharmacopsychiatry, 2, 1–11.CrossRefGoogle Scholar
Angst, J., Grof, P., Hippius, H., Pöldinger, W., Varga, E., Weis, P., and Wyss, F. (1969b). Verlaufsgesetzlichkeiten depressiver Syndrome, in Das depressive Syndrom, pp. 93–100. Edited by Hippius, H. and Selbach, H.. Urban und Schwarzenberg: München.Google Scholar
Angst, J., Weis, P., Grof, P., Baastrup, P. C., and Schou, M. (1970). Lithium prophylaxis in recurrent affective disorders. British Journal of Psychiatry, 116, 604–614.CrossRefGoogle ScholarPubMed
Åsberg, M., Crönholm, B., Sjöqvist, F., and Tuck, D. (1970). Correlation of subjective side effects with plasma concentrations of nortriptyline. British Medical Journal, 4, 18–21.CrossRefGoogle ScholarPubMed
Åsberg, M., Crönholm, B., Sjöqvist, F., and Tuck, D. (1971a). Relationship between plasma level and therapeutic effect of nortriptyline. British Medical Journal, 3, 331–334.CrossRefGoogle ScholarPubMed
Åsberg, M., Evans, D. A. P., and Sjöqvist, F. (1971b). Genetic control of nortriptyline kinetics in man. A study of relatives of propositi with high plasma concentrations. Journal of Medical Genetics, 8, 129–135.CrossRefGoogle Scholar
Åsberg, M., Kragh-Sørensen, P., Mindham, R. H. S., and Tuck, J. R. (1973). International reliability and communicability of a rating scale for depression. Psychological Medicine, 3, 458–465.CrossRefGoogle ScholarPubMed
Bennett, I. F. (1967). Is there a superior antidepressant? In Antidepressant Drugs, pp. 375–393. Edited by Garattini, S. and Dukes, M. N. G.. International Congress Series No. 122. Excerpta Medica: Amsterdam.Google Scholar
Borgå, O., and Garle, M. (1972). A gas Chromatographic method for the quantitative determination of nortriptyline and some of its metabolites in human plasma and urine. Journal of Chromatography, 68, 77–88.CrossRefGoogle ScholarPubMed
Braithwaite, R. A., and Widdop, B. (1971). Specific gas-chromatographic method for the measurement of ‘steady-state’ plasma levels of amitriptyline and nortriptyline in patients. Clinica Chimica Acta, 35, 461–472.CrossRefGoogle ScholarPubMed
Braithwaite, R. A., Goulding, R., Theano, G., Bailey, J., and Coppen, A. (1972). Plasma concentration of amitriptyline and clinical response. Lancet, 1, 1297–1300.CrossRefGoogle ScholarPubMed
Cronholm, B., Schalling, D., and Åsberg, M. Development of a rating scale for depression, in Psychological Measurement: Modern Problems in Pharmacopsychiatry. Edited by Pichot-Karger, P., Basel. (In press).Google Scholar
Gram, L. F., and Overø, K. F. (1972). Drug interaction: inhibitory effects of neuroleptics on metabolism of tricyclic antidepressants in man. British Medical Journal, 1, 463–465.CrossRefGoogle ScholarPubMed
Grof, P., and Vinař, O. (1966). Maintenance and prophylactic imipramine doses in recurrent depressions. Activitas Nervosa Superior (Praha), 8, 383–385.Google Scholar
Grof, P., Schou, M., Angst, J., Baastrup, P. C., and Weis, P. (1970). Methodological problems of prophylactic trials in recurrent affective disorders. British Journal of Psychiatry, 116, 599–603.CrossRefGoogle ScholarPubMed
Gutiérrez Agramonte, E. (1962). El tratamiento preventivo de las depresiones con el Tofranil. Revista Cubana de Medicina 1, No. 2, 110–112.Google Scholar
Hordern, A., Burt, C. G., Gordon, W. F., and Holt, N. F. (1964). Amitriptyline in depressive states: six-months treatment results. British Journal of Psychiatry, 110, 641–647.CrossRefGoogle Scholar
Isaaksson, A., Ottosson, J.-O., and Perris, C. (1969). Methodologische Aspekte der Forschung über prophylaktische Behandlung bei affektiven Psychosen, in Das depressive Syndrom, pp. 561–574. Edited by Hippius, H. and Seibach, H.. Urban und Schwarzenberg: München.Google Scholar
Kay, D. W. K., Fahy, T., and Garside, R. F. (1970). A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients. British Journal of Psychiatry, 117, 667–671.CrossRefGoogle ScholarPubMed
Kragh-Sørensen, P., Åsberg, M., and Eggert Hansen, C. (1973). Plasma-nortriptyline levels in endogenous depression. Lancet, 1, 113–115.CrossRefGoogle ScholarPubMed
Medical Research Council (1965). Clinical trial of the treatment of depressive illness. Report by its Clinical Psychiatry Committee. British Medical Journal, 1, 881–886.CrossRefGoogle Scholar
Mindham, R. H. S., Howland, C., and Shepherd, M. (1973). An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine, 3, 5–17.CrossRefGoogle ScholarPubMed
Porter, A. M. W. (1969). Drug defaulting in a general practice. British Medical Journal, 1, 218–222.CrossRefGoogle ScholarPubMed
Schou, M., Thomsen, K., and Baastrup, P. C. (1970). Studies on the course of recurrent endogenous affective disorders. International Pharmacopsychiatry, 5, 100–106.CrossRefGoogle Scholar
Seager, C. P., and Bird, R. L. (1962). Imipramine with electrical treatment in depression—a controlled trial. Journal of Mental Science, 108, 704–707.CrossRefGoogle ScholarPubMed
Wechsler, H., Grosser, G. H., and Greenblatt, M. (1965). Research evaluating antidepressant medications on hospitalized mental patients: a survey of published reports during a five-year period. Journal of Nervous and Mental Disease, 141, 231–239.CrossRefGoogle ScholarPubMed
Willcox, D. R. C., Gillan, R., and Hare, E. H. (1965). Do psychiatric out-patients take their drugs? British Medical Journal, 2, 790–792.CrossRefGoogle Scholar
Wilson, J. D., and Enoch, M. D. (1967). Estimation of drug rejection by schizophrenic in-patients, with analysis of clinical factors. British Journal of Psychiatry, 113 209–211.CrossRefGoogle ScholarPubMed