ABSTRACT
The ability to demethylate the classical imipraminic antidepressants is a key factor for the immediate and long-term management of long cycles primary unipolar depressions. These are preliminary observations concerning two different cases of a well-demethylating patient, and a badly-demethylating one.
Subject(s)
Depressive Disorder/drug therapy , Imipramine/pharmacokinetics , Adult , Depressive Disorder/blood , Depressive Disorder/metabolism , Female , Humans , Imipramine/administration & dosage , Imipramine/therapeutic useABSTRACT
Plasma concentrations of clomipramine (CL) and demethylclomipramine (DMCL) were determined in 24 patients with an endogenous (9) or non endogenous (15) depressive syndrome, treated in hospital for 21 days, with clomipramine; simultaneous clinical evaluations were performed with Hamilton Rating Scale. Optimal therapeutic effect was observed when the sum of CL + DMCL plasma levels was less 200 ng/ml or more 400 ng/ml. In our responders, the CL/DMCL ratio was around 0.6. The relation between demethylation and clinical outcome is considered.
Subject(s)
Clomipramine/analogs & derivatives , Clomipramine/blood , Depressive Disorder/blood , Adult , Aged , Clomipramine/therapeutic use , Depressive Disorder/drug therapy , Female , Humans , Male , Middle AgedABSTRACT
Twenty four in-patients with an endogenous or non endogenous depressive syndrome (9 and 15, respectively) were treated in hospital for 21 days with various dosages regimens of clomipramine. Plasma concentrations of clomipramine and demethylclomipramine were determined once a week in blood samples. Therapeutic effects were assessed with Hamilton Rating Scale. At day 21, optimal therapeutic effect was observed when the sum of clomipramine and demethylclomipramine plasma levels was situated between 200-400 ng/ml.
