Drug Plasma Levels and Clinical Effect [Abridged]

Abstract

substitute does not differ significantly between controls and inpatients. The sibship comparisons will be published in detail elsewhere (Birtchnell 1971). Sibship size distribution is similar in early bereaved patients and controls. There are significantly more early mother-bereaved women patients than early mother-bereaved men patients with younger siblings to be cared for, but there is no such difference among the controls. A similar state of affairs does not obtain for father-bereaved men patients. Proportionally more early bereaved patients than early bereaved controls have no older siblings, though the excess is no more marked when siblings of the same sex as the lost parent are considered. Comment Aberdeen and Dumfries are only 200 miles apart and yet show important differences both in the control populations and in the way the patients and controls differ. In both areas the mncidence of early bereavement is significantly greater in psychiatric patients and this excess is greatest for women. The Aberdeenstudy sugests that parent replacement and the composition of the sibship may modify the effects of bereavement. Acknowledgments: This study was carried out during the tenure of an MRC Clinical Research Fellowship. My thanks are due to Dr J A Baldwin

Drugs in Blood and Brain

“…They found a strong positive correlation between plasma level and effect. These results are similar to those obtained by Walther (1971) with imipramine. In both these investigations, however, the number of patients with high plasma levels is small!…”

Prediction of steady‐state imipramine and desmethylimipramine plasma concentrations from single‐dose data

“…Standard clinical practice of gradually in- creasing tricyclic antidepressant to avoid side effects would seem to mitigate against immediately placing a patient on predicted maintenance oral doses of tricyclics, yet experience has shown that high-dose tricyclic antidepressant is usually safe and well tolerated. 25 Anticholinergic side effects such as dry mouth, blurred vision, and urinary retention seem to be a function of plasma tricyclic antidepressant levels 27 or individual sensitivity to the drug. 4,19 The effects on pulse and ECG also appear to be a function of plasma levels.…”

Plasma levels and antidepressive effect of imipramine

“…Imipramine has retained a significant position in clinical use, particularly because it has less sedative effect than most of the other antidepressants. So far, only a few studies have been reported on the steady-state kinetics of imipramine during therapy, 14,16,18 and the relationship between plasma levels and therapeutic effect has not yet been established. The introduction of a new, sensitive, reproducible, and specific method for analysis of imipramine and its active metabolite desipramine in plasma 15 made such studies feasible in a larger number of patients.…”