Della Corte L, Broadhurst A D, Sgaragli G P, Filippini S, Heeley A F, James H D, Faravelli C, Pazzagli A
Br J Psychiatry. 1979 Apr;134:390-400. doi: 10.1192/bjp.134.4.390.
Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly. These findings, together with the fact that significant clinical improvement was observed in only 55% of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.
在意大利和英国的两个精神科病房中，50名抑郁症住院患者接受了氯米帕明治疗，给药方式为口服，或静脉注射与口服联用。将临床反应与氯米帕明及其代谢物去甲氯米帕明的血浆水平进行比较，发现存在明显关联，尤其是去甲氯米帕明。在静脉注射治疗组中，这种关联呈线性，在口服治疗组中呈曲线。去甲氯米帕明的血浆水平与给药的氯米帕明高度相关。这些发现，再加上仅55%的患者观察到显著临床改善这一事实，表明调整给药剂量以获得更有效的代谢物血浆水平，可能会改善部分患者对该药物的临床反应。
