Bertschy G, Vandel S, Jounet J M, Allers G
Clinique de Neurologie et de Psychiatrie, C.H.U. Saint-Jacques, Besançon.
Encephale. 1990 Jan-Feb;16(1):43-5.
Valpromide is largely used in the therapy of affective disorders for its presumed thymoregulating activity. So, it is often associated with tricyclic antidepressant treatment. Previous clinical studies lead us to consider the possibility of an interaction between valpromide and tricyclic antidepressants, interaction which could result in an increase of antidepressant plasma concentrations. But no pharmacokinetic study has been realized up to now in order to clearly demonstrate such a phenomenon. The authors studied amitriptyline and nortriptyline plasma levels in two groups of ten patients receiving 125 mg amitriptyline, once a day, during 20 days. In the second group, patients also received 600 mg valpromide daily after ten days on amitriptyline. In the first group amitriptyline and nortriptyline plasma concentrations remained stable between the tenth and the twentieth day. In the second group, addition of valpromide resulted in a significant increase of antidepressant plasma levels: from 70.5 +/- 35 to 105.5 +/- 49 ng/ml (p less than 0.0003) for amitriptyline, and from 61.0 +/- 34 to 100.5 +/- 65 ng/ml (p less than 0.01) for nortriptyline.
丙戊酰胺因其假定的胸腺调节活性而广泛用于情感障碍的治疗。因此，它常与三环类抗抑郁药联合使用。先前的临床研究使我们考虑丙戊酰胺与三环类抗抑郁药之间相互作用的可能性，这种相互作用可能导致抗抑郁药血浆浓度升高。但迄今为止，尚未进行药代动力学研究以明确证明这种现象。作者研究了两组各10名患者的阿米替林和去甲替林血浆水平，这些患者每天服用125毫克阿米替林，持续20天。在第二组中，患者在服用阿米替林10天后，每天还服用600毫克丙戊酰胺。在第一组中，阿米替林和去甲替林的血浆浓度在第10天至第20天之间保持稳定。在第二组中，添加丙戊酰胺导致抗抑郁药血浆水平显著升高：阿米替林从70.5±35纳克/毫升升至105.5±49纳克/毫升（p＜0.0003），去甲替林从61.0±34纳克/毫升升至100.5±65纳克/毫升（p＜0.01）。
