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Clinical Response and Tricyclic Plasma Levels During Treatment with Clomipramine

Published online by Cambridge University Press:  29 January 2018

L. Della Corte
Affiliation:
Istituto Interfacolta di Farmacologia e Tossicologia, University of Florence, Italy
A. D. Broadhurst
Affiliation:
The West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk
G. P. Sgaragli
Affiliation:
Istituto Interfacolta di Farmacologia e Tossicologia, University of Florence, Italy
S. Filippini
Affiliation:
Clinica Psichiatrica, University of Florence, Italy
A. F. Heeley
Affiliation:
Peterborough District Hospital, Thorpe Road, Peterborough, Cambs
H. D. James
Affiliation:
Moorhaven Hospital, Bittaford, Ivybridge, S. Devon
C. Faravelli
Affiliation:
Medico interno
A. Pazzagli
Affiliation:
Clinica Psichiatrica, University of Florence, Italy

Summary

Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly.

These findings, together with the fact that significant clinical improvement was observed in only 55 per cent of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1979 

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