Baumann P, Tinguely D, Koeb L, Schöpf J, Le P K
Int Pharmacopsychiatry. 1982;17(3):136-46. doi: 10.1159/000468569.
Conflicting results on the correlation of tricyclic levels in plasma and saliva have raised doubts about the clinical usefulness of monitoring these drugs in the latter body fluid. However, saliva drug levels may reflect the free plasma concentration, which possibly determines its level in the brain. In two groups of depressive patients, the evolution was studied of the levels of amitriptyline and nortriptyline in plasma (as free and total) and in saliva, after the administration of amitriptyline. The results show a poor correlation between total plasma and saliva concentration of amitriptyline and nortriptyline, respectively. Levels of both tricyclics in saliva exceed by far those measured in plasma dialysate. However, the relationship is such that free plasma concentrations may be predicted from those measured in saliva, if one takes into account saliva pH at the moment of collecting the sample.
血浆和唾液中三环类药物水平相关性的研究结果相互矛盾，这引发了人们对通过检测后者体液来监测这些药物临床实用性的质疑。然而，唾液中的药物水平可能反映了游离血浆浓度，而游离血浆浓度可能决定了药物在大脑中的水平。在两组抑郁症患者中，研究了服用阿米替林后血浆（游离和总浓度）及唾液中阿米替林和去甲替林水平的变化情况。结果表明，血浆中阿米替林和去甲替林的总浓度与唾液中相应药物浓度之间的相关性较差。两种三环类药物在唾液中的水平远远超过在血浆透析液中测得的水平。然而，如果在采集样本时考虑唾液的pH值，那么可以根据唾液中测得的游离血浆浓度来预测两者之间的关系。
