[Plasma level monitoring of psychotropic drugs in children. II -- Antidepressants (author's transl)].

Children and young adolescents with either depressive syndromes or enuresis were treated with clomipramine for periods of 1 to 9 months. Plasma concentrations of the drug and of its demethylated metabolite were monitored and compared with clinical effects. In children, clomipramine proved rapidly absorbed by the oral route, and its rate of distribution seemed to be related to age since the dose-concentration ratio was lower in the youngest subjects. There was a clear correlation between side-effects and clomipramine levels but not demethyl-chlorimipramine levels. In enuresis, a therapeutic effect was obtained with clomipramine levels of 20 to 60 ng/ml; lower levels were associated with ineffectiveness and higher levels with side-effects. The relationship between daily doses and plasma concentrations varied considerably from one patient to another but was almost constant in the same individual. The results obtained underline the usefulness of routinely monitoring antidepressant plasma levels in children.