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 language | English (US) |
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Pages (from-to) | 219-227 |
Number of pages | 9 |
Journal | International clinical psychopharmacology |
Volume | 11 |
Issue number | 4 |
State | Published - Dec 1 1996 |
Keywords
- 2-hydroxydesipramine
- antidepressants
- depression
- desipramine
- tricyclic plasma levels
ASJC Scopus subject areas
- Psychiatry and Mental health
- Pharmacology (medical)