2-Hydroxydesipramine and desipramine plasma levels: How are they related to antidepressant response?

S. L. Stern, T. B. Cooper, L. D. Nelson, M. H. Johnson, R. F. Suckow

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Thirty-six outpatients aged 20 to 51 with RDC primary major depressive disorder (MDD) completed a 5-week trial of desipramine following a week of single-blind placebo. Five had a past history of hypomanic disorder. For all but one patient, daily dosage at bedtime was constant for the final 4 weeks, with a mean (S.D.) of 168.1 (46.5) mg. Plasma samples drawn at the three final weekly visits were assayed by high-performance liquid chromatography for 2-hydroxydesipramine (2-OH-DMI) and desipramine. Mean (S.D.) plasma levels were 59.8 (30.0) ng/ml for 2-OH-DMI and 142.9 (138.6) ng/ml for desipramine. Thirteen patients (36%) had a final 17-item Hamilton depression rating ≤6 and were classified as responders. According to receiver operating characteristics analysis, patients with plasma 2-OH-DMI levels ≤58 and <92 ng/ml had a greater likelihood of responding than those with lower or higher levels (p = 0.005, Fisher's exact test), while patients with plasma desipramine levels ≤64 ng/ml were more likely to respond than those with lower levels (p = 0.032, Fisher's exact test). Results using an alternate response criterion were similar. These findings suggest that in desipramine-treated outpatients with primary MDD the relationship between therapeutic response and plasma levels is curvilinear for 2-OH-DMI and linear for desipramine.

Original languageEnglish (US)
Pages (from-to)219-227
Number of pages9
JournalInternational clinical psychopharmacology
Volume11
Issue number4
StatePublished - Dec 1 1996

Keywords

  • 2-hydroxydesipramine
  • antidepressants
  • depression
  • desipramine
  • tricyclic plasma levels

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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    Stern, S. L., Cooper, T. B., Nelson, L. D., Johnson, M. H., & Suckow, R. F. (1996). 2-Hydroxydesipramine and desipramine plasma levels: How are they related to antidepressant response? International clinical psychopharmacology, 11(4), 219-227.