Clinical implications of imipramine plasma levels for depressive illness.
Clinical implications of imipramine plasma levels for depressive illness.
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丙咪嗪血浆水平对抑郁症的临床意义。
DOI：
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发表时间：
1977
影响因子：
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通讯作者：
J. Fleiss
中科院分区：
文献类型：
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作者：
A. Glassman;J. Perel;M. Shostak;S. Kantor;J. Fleiss
60名抑郁症非精神分裂症患者被收进一个研究单位。在一周的无药期和一周的安慰剂期后，患者接受3.5 mg/kg盐酸丙咪嗪治疗28天。丙咪嗪及其代谢产物盐酸地昔帕明（去甲丙咪嗪）的血浆水平每周测量三次，并检查血浆稳态水平与临床结果之间的关系。稳态水平范围为50至1，050纳克/毫升。血浆水平与缓解之间存在统计学和临床显著相关性。这种关系存在于整个样本中，当双相和单极非妄想人群进行检查时，这种关系更加突出。由于观察到性别和结局之间存在很强的关系，因此单极非妄想患者按性别分层，并且仍然存在显著的关系。只有单相妄想患者未能证明血液水平和临床反应之间的关联。
Sixty depressed nonschizophrenic patients were admitted to a research unit. Following one drug-free week and one week of placebo, patients received 3.5 mg/kg of imipramine hydrochloride for 28 days. Plasma levels of imipramine and its metabolite desipramine hydrochloride (desmethylimipramine) were measured three times weekly and the relationship between plasma steady-state levels and clinical outcome was examined. Steady-state levels ranged from 50 to 1,050 ng/ml. There was a statistically and clinically significant relationship between plasma levels and response. The relationship existed across the entire sample, and was accentuated when the bipolar and unipolar nondelusional populations were examined. Because a strong relationship between sex and outcome was observed, the unipolar nondelusional patients were stratified by sex and a significant relationship still persisted. Only the unipolar delusional patients failed to demonstrate an association between blood level and clinical response.