Nortriptyline (Allegron, Aventyl) is the demethylated metabolite of amitriptyline. Preliminary trials by Bennett (1962), Oltman et al. (1963) and Leahy et al. (1964) indicated that it might be an effective anti-depressant. Forrest et al. (1964) found that it compared favourably with amitriptyline, a widely used anti-depressant of established efficacy. This investigation also compares nortriptyline with amitriptyline.

No abstract

Desipramine (Pertofran) is the monomethyl analogue of imipramine (Tofranil) and is marketed as a potent anti-depressant agent. The literature on this drug has already been adequately reviewed by Rose et al. (1964) and Waldron et al. (1965). It is therefore sufficient to note that earlier reports claiming a more rapid action than imipramine have not been supported by more recent investigations. This paper reports a double-blind controlled comparison of imipramine and desipramine, designed to investigate the relative effectiveness, speed of action and side-effects of these two drugs.

This study was conducted to examine the interpatient variability in steady-state plasma concentrations of fluphenazine by repeat depot intramuscular administration, and to determine the relationship between these concentrations and clinical state. Steady-state pre-dose concentrations of fluphenazine in plasma were measured using a sensitive and specific gas chromatography/mass spectrometry (GC/MS) assay in 24 patients with schizophrenia who were receiving continuous treatment with depot intramuscular fluphenazine decanoate. Clinical response was measured using the Andreasen Scale for positive and negative symptoms. Steady-state plasma concentrations of fluphenazine ranged from undetectable (< 0.1 ng/ml) to 27.9 ng/ml, with a median of 0.5 ng/ml. No significant associations were found between plasma concentration and dosage, or age and sex of the patient. Steady-state plasma concentrations in patients taking anticholinergic agents were significantly higher than in patients not receiving such drugs (P < 0.05 by Mann-Whitney U-test). Poorer control, expressed as the sum of the negative symptom scores or the sum of the positive and negative symptom scores, was related to higher log transformed plasma concentration of fluphenazine and higher fluphenazine decanoate dosage. The log transformed plasma concentrations of fluphenazine and the fluphenazine decanoate dosages were weakly related. Patients receiving another antipsychotic drug in addition to fluphenazine decanoate tended to have poorer clinical control and higher dosages of fluphenazine decanoate. These results indicate the useful role that plasma level monitoring can fulfil in identifying patients who are therapy-resistant despite high plasma levels.