Coppen A, Ghose K, Montgomery S, Rama Rao V A, Bailey J, Christiansen J, Mikkleson P L, van Praag H M, van de Poel F, Minsker E J, Kozulja V G, Matussek N, Kungkunz G, Jłrgensen A
Lancet. 1978 Jan 14;1(8055):63-6. doi: 10.1016/s0140-6736(78)90003-x.
54 patients in five centres participated in a study of the relationship between steady-state plasma-levels of amitriptyline (AT) and its active metabolite nortriptyline (NT) and therapeutic response. The participants were inpatients who, after a 7-12 day period of assessment, were rated greater than or equal to 16 on the Hamilton rating scale for depression. They were given 75 mg of amitriptyline for 3 days and then 150 mg daily for an active-treatment period of 6 weeks. Clinical ratings and plasma-samples were obtained at baseline then at 2, 4, and 6 weeks after starting therapy. Contrary to the findings of three previous trials, no important correlations were found between steady-state plasma-levels and therapeutic outcome or corrected side-effects. Corrected side-effects correlated negatively with therapeutic outcome. There seems little advantage in routine monitoring of AT and NT, since variations in plasma-levels do not account for the considerable variation in therapeutic outcome.
来自五个中心的54名患者参与了一项关于阿米替林（AT）及其活性代谢产物去甲替林（NT）的稳态血浆水平与治疗反应之间关系的研究。参与者为住院患者，在经过7至12天的评估期后，其在汉密尔顿抑郁评定量表上的评分大于或等于16分。他们先服用75毫克阿米替林，持续3天，然后每天服用150毫克，进行为期6周的积极治疗期。在基线时以及开始治疗后的第2、4和6周获取临床评分和血浆样本。与之前三项试验的结果相反，在稳态血浆水平与治疗结果或校正后的副作用之间未发现重要相关性。校正后的副作用与治疗结果呈负相关。常规监测AT和NT似乎没有什么优势，因为血浆水平的变化并不能解释治疗结果的显著差异。
