Kosten T R, Gawin F H, Morgan C, Nelson J C, Jatlow P
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519.
Am J Drug Alcohol Abuse. 1990;16(3-4):329-36. doi: 10.3109/00952999009001594.
Plasma concentrations of desipramine (DMI) and its 2-hydroxy metabolite (OHDMI) were compared among 72 patients being treated with desipramine for either depression (n = 39) or cocaine abuse (n = 33). Eleven cocaine abusers who were concurrently maintained on methadone had a significantly lower ratio of DMI dose to plasma concentration (0.9) than the depressives (2.2) or nonmethadone cocaine abusers (2.0). Their OHDMI/DMI ratios were significantly lower (0.19) than for either the other 22 cocaine abusers (0.39) or the depressed (0.50) patients. This difference was not due to DMI dosage. Although the underlying mechanism cannot be determined from these plasma studies, possible reduced hydroxylation of DMI in methadone patients suggests the need for DMI plasma monitoring.
对72例接受去甲丙咪嗪治疗的患者进行了比较，其中39例为抑郁症患者，33例为可卡因滥用患者，比较了他们血浆中去甲丙咪嗪（DMI）及其2-羟基代谢物（OHDMI）的浓度。11例同时服用美沙酮的可卡因滥用者，其DMI剂量与血浆浓度之比（0.9）显著低于抑郁症患者（2.2）或未服用美沙酮的可卡因滥用者（2.0）。他们的OHDMI/DMI比值（0.19）显著低于其他22例可卡因滥用者（0.39）或抑郁症患者（0.50）。这种差异并非由于DMI剂量所致。尽管从这些血浆研究中无法确定潜在机制，但美沙酮患者中DMI羟基化可能减少，这表明需要对DMI进行血浆监测。
