Drugs online research references
Ciba Found Symp. 1979;(74):167-97.
The role of plasma level monitoring of tricyclic antidepressant drugs as an aid to treatment.
Braithwaite R.
Use of the tricyclic antidepressant drugs is the most common pharmacotherapeutic approach to the treatment of depression. It is a common clinical experience to find that a fair proportion of patients fail to show a satisfactory response and that others complain of side-effects. Important factors which influence this situation are the diagnostic criteria used to select patients for drug treatment, the dosage prescribed and individual compliance. Measurement of plasma drug concentrations has been proposed as a more rational way of increasing the efficacy of antidepressant medication and avoiding toxicity. A number of studies have shown a correlation between plasma concentrations of these drugs and clinical effects, but the relationship is far from simple. With amitriptyline and nortriptyline there is good evidence for a 'therapeutic window' within which maximum antidepressant action is obtained. Many patients being treated with these drugs have plasma levels outside recommended therapeutic ranges. Experience in our department has shown that there are a number of clinical situations where routine plasma level monitoring of selected antidepressants is of value: (1) inadequate clinical response; (2) side-effects/toxicity; (3) complicating medical conditions; (4) suspected poor compliance; and (5) long-term therapy. Such measurements are a relatively simple and inexpensive way of maximizing the benefits of drug therapy and a means of tailoring drug dosages to suit individual requirements.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=261683&dopt=Abstract
J Chromatogr. 1978 Nov 1;146(3):449-56.
Simplified method for monitoring tricyclic antidepressant therapy using gas--liquid chromatography with nitrogen detection.
Dawling S, Braithwaite RA.
A simplified gas chromatographic method for the rapid measurement of tricyclic antidepressant drugs in plasma using a nitrogen-sensitive detector is described. All drugs are extracted and chromatographed under identical conditions. Tertiary amines are separated from their secondary amine metabolites, which are determined simultaneously without the need for derivatisation. The lower limit of accurate determination for most drugs is 10 microgram/1. The method has been applied to the routine measurement of amitriptyline and nortriptyline in plasma from patients receiving antidepressant treatment. Large and important interindividual differences in plasma concentrations in the patients investigated have been found, and the significance of these results is discussed.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=721921&dopt=Abstract
Arch Int Pharmacodyn Ther. 1975 Jun;215(2):202-7.
Changes in rat brain monoamine metabolism following the acute administration of lithium chloride in combination with antidepressant drugs.
Leonard BE.
The acute administration of lithium chloride resulted in a decrease in the concentration of serotonin, tyrosine, dopamine and noradrenaline in the rat brain. The antidepressant drugs imipramine, amitriptyline and Org GB94 did not reverse or potentiate the effect of lithium chloride on these monoamines or tyrosine. It is concluded that the ability of lithium salts to enhance the effect of antidepressant drugs in the treatment of endogenous depression cannot readily be explained by their synergistic action on brain monoamine metabolism.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1164088&dopt=Abstract
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