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Tricyclic Serum Levels » Elizabeth

Posted by SalArmy4me on July 20, 2001, at 1:10:56

In reply to Re: Is switching stressful for your nervous system? » SalArmy4me, posted by Elizabeth on July 20, 2001, at 0:22:21

Clinicians sure do serum levels of imipramine, desipramine, and nortriptyline--I could consider a psychiatrist inept if he didn't do them, knowing how vital serum levels are to those drugs' successes:

Clinical Psychopharmacology Seminar
http://www.vh.org/Providers/Conferences/CPS/11.html
Treatment of Refractory Depression
Original Author(s): Bruce Alexander, Pharm.D.
Latest Reviser(s): Bruce Alexander, Pharm.D.,
Creation Date: 1996
Last Revision Date: January 2000

"That serum level monitoring might lead to an improved response rate in the treatment of depression has been suggested (Perry et al 1987, Glassman et al 1977). (see table 1). The remaining TCAs and other antidepressants have inadequate data to make conclusions about therapeutic ranges. This topic is extensively reviewed in the monograph dealing with antidepressant dosing.

Glassman et al (1977) has reported that 40 to 50% of depressive patients do not achieve recommended serum levels with imipramine 200 to 225 mg/d. In this study, of the 13/16 patients that did not respond to levels < 180 ng/ml, 7 responded promptly when a level >200 ng/ml was achieved."


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