监测阿米替林及其羟基化和去甲基化代谢产物的血浆水平在预测抑郁状态临床结局中的意义。

Significance of monitoring plasma levels of amitriptyline, and its hydroxylated and desmethylated metabolites in prediction of the clinical outcome of depressive state.

作者信息

Shimoda K, Yasuda S, Morita S, Shibasaki M, Someya T, Bertilsson L, Takahashi S

机构信息

Department of Psychiatry, Shiga University of Medical Science, Japan.

出版信息

Psychiatry Clin Neurosci. 1997 Feb;51(1):35-41. doi: 10.1111/j.1440-1819.1997.tb02364.x.

DOI:10.1111/j.1440-1819.1997.tb02364.x

PMID:9076859

Abstract

The clinical significance of monitoring the plasma levels of amitriptyline and its metabolites in prediction of the clinical outcome of depressive episode was investigated in 49 inpatients. Discriminant analysis of drug concentrations (at two weeks after initiation of drug treatment) and clinical outcome revealed that increasing the plasma levels of amitriptyline, cis-isomers of hydroxylated metabolites (Z-10-hydroxyamitriptyline and Z-10-hydroxynortriptyline) predicted a better clinical outcome, while increasing of plasma levels of nortriptyline and trans-isomers of hydroxylated metabolites (E-10-hydroxyamitriptyline and E-10-hydroxynortriptyline) were shown to predict a poor clinical outcome in the depressive episode of the subjects, and that clinical outcome of approximately 73% of the subjects could be correctly predicted.

摘要

对49名住院患者进行了研究，以探讨监测阿米替林及其代谢物血浆水平在预测抑郁发作临床结局中的临床意义。对药物浓度（药物治疗开始两周后）和临床结局进行判别分析发现，阿米替林、羟基化代谢物的顺式异构体（Z-10-羟基阿米替林和Z-10-羟基去甲替林）血浆水平升高预示着更好的临床结局，而去甲替林和羟基化代谢物的反式异构体（E-10-羟基阿米替林和E-10-羟基去甲替林）血浆水平升高则预示着受试者抑郁发作的临床结局较差，且约73%受试者的临床结局能够被正确预测。