[Prescription of psychopharmaceuticals. A survey of drug treatment at 10 psychiatric hospitals]. / Forskrivning av psykofarmaka. En oversikt over medikamentell behandling i ti psykiatriske sykehus.

This study describes a survey of the drugs prescribed to long-term psychiatric patients and psychogeriatric patients in ten Norwegian psychiatric hospitals. Of 1,124 patients, 12% received no psychotropic drugs and 14% were given a combination of more than three psychotropic drugs. Of 872 patients given neuroleptics, 81% received antipsychotic medication with low-dose neuroleptics and 27% received depot-neuroleptics. Hypnotics and minor tranquillizers were commonly prescribed together with neuroleptics and antidepressants. Anti-parkinsonian drugs were prescribed for 37% of those receiving neuroleptics. Neuroleptics, minor tranquillizers and anti-parkinsonian drugs were commonly given three times a day. The prescription pattern differed between the hospitals. Guidelines are suggested for more rational use of psychotropic drugs.

High-performance liquid chromatographic determination of citalopram and four of its metabolites in plasma and urine samples from psychiatric patients.

A high-performance liquid chromatographic method is used for the determination of citalopram [1-(3-dimethylaminopropyl)-1-(4-fluorophenyl)-5-phthalancarbonitrile+ ++] and four of its metabolites (the methylamino, amino, propionic acid and N-oxide derivatives) in plasma and urine. The plasma samples were extracted with diethyl ether at pH 10 and pH 4. Filtered urine samples could be injected directly on to the column. Steady-state drug and metabolite levels were investigated in fifteen psychiatric patients. In urine, 12 +/- 5% (mean +/- S.D.) of a given dose of citalopram was excreted in unchanged form. The propionic acid derivative was further conjugated, possibly to glucuronic acid. Mean steady-state plasma levels and metabolites in 24-h urine are given as percentages of the dose.

Determination of the antidepressant agent citalopram and metabolites in plasma by liquid chromatography with fluorescence detection.

A high-performance liquid chromatographic method is described for the determination of citalopram [1-(3-(dimethylaminopropyl)-1-(4-fluorophenyl)-5-phthalancarbonitrile] and its two main metabolites (the methylamino and amino derivatives). The compounds were extracted from alkaline plasma with diethyl ether. The combined ether layers were evaporated after addition of 50 microliter of 0.1 N HCl. The residual extracts were purified with diethyl ether and 20 microliter were injected into a Spherisorb ODS 5-micrometer column with acetonitrile--0.6% phosphate buffer pH 3 (55:45, v/v) as the mobile phase. Using a fluorescence detector the detection limits are 1 ng/ml of plasma for citalopram and the methylamino metabolite and 0.5 ng/ml for the amino metabolite.