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Monitoring of tricyclic antidepressant plasma levels and clinical response: a review of the literature. Part II

Published online by Cambridge University Press:  28 April 2020

I.R. De Oliveira
Affiliation:
Clinique des Maladies Mentales et de l'Encéphale, 100, rue de la Santé, 75014Paris, France Departamento de Farmacologia e Fisiologia, ICS, Universidade Federal da Bahia, Vale do Canela, 40.140, Salvador, Brazil
P.A.S. Do Prado-Lima
Affiliation:
Clinique des Maladies Mentales et de l'Encéphale, 100, rue de la Santé, 75014Paris, France
B. Samuel-Lajeunesse
Affiliation:
Clinique des Maladies Mentales et de l'Encéphale, 100, rue de la Santé, 75014Paris, France
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Summary

Part II of this paper contains some general considerations on tricyclic antidepressant (TCA) monitoring. Long-term assessment of TCA plasma levels is advised by the few existent studies, although each of these focusses on different aspects. Cardiovascular and central nervous system toxicity is reviewed as well as pharmacokinetics and the importance of protein binding. Some consideration is also given to their use in elderly patients. The authors conclude that although available data support its usefulness in many situations, routine measurement of TCA levels is not warranted.

Résumé

Résumé

La deuxième partie de cet article porte quelques considérations générales concernant le monitorage des antidépresseurs tricycliques (ADT). Les dosages des taux plasmatiques à long-terme sont conseillés par les rares études disponibles, bien que chaque étude porte sur des aspects différents du sujet. Nous présentons une revue concernant la toxicité cardiovasculaire et du système nerveux central. La pharmacocinétique et l'importance de la liaison aux protéines plasmatiques sont aussi discutées. Nous discutons l'usage des ADT chez les patients déprimés âgés. Les auteurs de cet article concluent que le monitorage de routine des ADT n ‘est pas indispensable, bien que les données disponibles soutiennent leur indication dans certaines situations.

Type
Original article
Copyright
Copyright © European Psychiatric Association 1989

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