Skip to main content
Log in

Binding of amitriptyline and nortriptyline in plasma determined from their equilibrium distributions between red cells and plasma, and between red cells and buffer solution

  • Original Investigations
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

In a new method for the measurement of plasma binding, amitriptyline (AT) and nortriptyline (NT) were allowed to reach equilibrium distribution between the cells and plasma of whole blood. A separate sample of the cells was equilibrated with a buffer solution containing the drugs. From the two distribution ratios for each drug, the fraction free in the plasma was calculated. Equilibria were achieved rapidly, avoiding denaturation of binding proteins. The pH was adequately controlled and the composition of the plasma was not altered by the experimental procedures. Large volumes of buffer solution gave amounts of free drug readily measurable by gas chromatography. Duplicate determinations showed coefficients of variation of 6% and 4.8% respectively for the free fractions of AT and NT in a given plasma sample. In 51 subjects the mean percentage of AT free in plasma was 4.31±0.59 SD and, of NT, 8.59±0.86. Binding was independent of drug concentration in the therapeutic range and did not differ between males and females nor between patients and normal subjects. It increased slightly with age. It was not affected by chylomicrons in the blood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Alexanderson B, Borgå O, Alvan G (1973) The availability of orally administered nortriptyline. Eur J Clin Pharmacol 5:181–185

    Google Scholar 

  • Annan W, Isherwood DM (1969) An automated method for the direct determination of total serum cholesterol. J Med Lab Technol 26:202–211

    Google Scholar 

  • Åsberg M, Cronholm B, Sjöqvist F, Tuck D (1971) Relationship between plasma level and therapeutic effect of nortriptyline. Br Med J 3:331–334

    Google Scholar 

  • Baumann P, Koeb L, de Nayer A, Perey M, Rivier L, Tinguely D (1980) Methodological problems concerning the determination of free amitriptyline and nortriptyline in plasma. Arzneim Forsch 30:1199

    Google Scholar 

  • Bertilsson L, Braithwaite R, Tybring G, Garle M, Borgå O (1979a) Techniques for plasma protein binding of demethylchlorimipramine. Clin Pharmacol Ther 26:265–271

    Google Scholar 

  • Bertilsson L, Mellström B, Sjöqvist F (1979b) Pronounced inhibition of noradrenaline uptake by 10-hydroxy metabolites of nortriptyline. Life Sci 25:1285–1292

    Google Scholar 

  • Bickel MH (1975) Binding of chlorpromazine and imipramine to red cells, albumin, lipoproteins and other blood components. J Pharm Pharmacol 27:733–738

    Google Scholar 

  • Borgå O, Azarnoff DL, Forshell GP, Sjöqvist F (1969) Plasma protein binding of tricyclic antidepressants in man. Biochem Pharmacol 18:2135–2143

    Google Scholar 

  • Borgå O, Piafsky KM, Nilsen OG (1977) Plasma protein binding of basic drugs. I. Selective displacement from α1-acid glycoprotein by tris-(2-butoxyethyl)-phosphate. Clin Pharmacol Ther 22:539–544

    Google Scholar 

  • Brinkschulte M, Breyer-Pfaff U (1979) Binding of tricyclic antidepressants and perazine to human plasma. Naunyn Schmiedebergs Arch Pharmacol 308:1–7

    Google Scholar 

  • Brinkschulte M, Breyer-Pfaff U (1980) The contribution of α1-acid glycoprotein, lipoproteins and albumin to the plasma binding of perazine, amitriptyline and nortriptyline in healthy man. Naunyn Schmiedebergs Arch Pharmacol 314:61–66

    Google Scholar 

  • Bucolo G, David H (1973) Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 19:476–482

    Google Scholar 

  • Burch JE, Raddats MA, Thompson SG (1979) A reliable routine method for determination of plasma amitriptyline and nortriptyline by gas chromatography. J Chromatogr 162:351–366

    Google Scholar 

  • Burrows G, Scoggins BA, Turecek LR, Davis B (1974) Plasma nortriptyline and clinical response. Clin Pharmacol Ther 16:639–644

    Google Scholar 

  • Coppen A, Montgomery S, Ghose K, Rama Rao VA, Bailey J, Christiansen J, Mikkleson PL, van Praag HM, van de Poel F, Minsker EJ, Kozulja VG, Matussek N, Kungkunz G, Jørgensen A (1978) Amitriptyline plasma concentration and clinical effect. Lancet I:63–66

    Google Scholar 

  • Danon A, Chen Z (1979) Binding of imipramine to plasma proteins: effect of hyperlipoproteinaemia. Clin Pharmacol Ther 25:316–321

    Google Scholar 

  • Ehrnebo M, Agurell S, Jalling B, Boreus LO (1971) Age differences in drug binding by plasma proteins: studies on human foetuses, neonates and adults. Eur J Clin Pharmacol 3:189–193

    Google Scholar 

  • Glassman AH, Hurwic MJ, Perel JM (1973) Plasma binding of imipramine and clinical outcome. Am J Psychiatry 130:1367–1369

    Google Scholar 

  • Kragh-Sørensen P, Hansen CE, Åsberg M (1973) Plasma nortriptyline levels in endogenous depression. Lancet I:113–115

    Google Scholar 

  • Kragh-Sørensen P, Hansen CE, Baastrup PC, Hvidberg EF (1976) Selfinhibiting action of nortriptyline's antidepressive effect at high plasma levels. Psychopharmacologia 45:305–312

    Google Scholar 

  • Linnoila M, Dorrity F, Jobson KJ (1978) Plasma and erythrocyte levels of tricyclic antidepressants in depressed patients. Am J Psychiatry 135:557–560

    Google Scholar 

  • Lunde PKM, Rane A, Yaffe SJ, Lund L, Sjökvist F (1970) Plasma protein binding of diphenyl hydantion in man. Clin Pharmacol Ther 11:846–855

    Google Scholar 

  • Maguire KP, Burrows GD, Norman TR, Scoggins BA (1980) Blood/plasma distribution ratios of psychotropic drugs. Clin Chem 26:1624–1625

    Google Scholar 

  • Montgomery SA, McCauley R, Rani SJ, Montgomery DB, Braithwaite R, Dawling S (1979) Amitriptyline plasma concentration and clinical response. Br Med J 1:230–231

    Google Scholar 

  • Nilsen OG (1976) The binding of quinidine to protein fractions of normal human serum. Biochem Pharmacol 25:1007–1012

    Google Scholar 

  • Piafsky KM, Borgå O (1977) Plasma protein binding of basic drugs. II. Importance of α1-acid glycoprotein for interindividual variation. Clin Pharmacol Ther 22:545–549

    Google Scholar 

  • Potter WZ, Muscettola G, Goodwin FK (1979) Binding of imipramine to plasma protein and to brain tissue: relationship to CSF tricyclic levles in man. Psychopharmacology 63:187–192

    Google Scholar 

  • Robinson DS, Cooper TB, Ravaris CL, Ives JO, Nies A, Bartlett D, Lamborn KR (1979) Plasma tricyclic drug levels in amitriptylinetreated depressed patients. Psychopharmacology 63:223–231

    Google Scholar 

  • Rollins DE, Alván G, Bertilsson L, Gillette JR, Mellström B, Sjoqvist F, Traskman L (1980) Interindividual differences in amitriptyline demethylation. Clin Pharmacol Ther 28:121–129

    Google Scholar 

  • Snedecor GW (1952) Query 92. biometrics 8:85–86

    Google Scholar 

  • Stern I, Shapiro B (1953) A rapid and simple method for the determination of esterified fatty acids and for total fatty acids in blood. J Clin Pathol 6:158–160

    Google Scholar 

  • Stevenson IH, Wilson NM (1978) Implications of dose regimen and protein binding for plasma nortriptyline estimations. Neuropharmacology 17:423–426

    Google Scholar 

  • Van Slyke DD, Phillips RA, Dole VP, Hamilton PB, Archibald RM, Plazin J (1950) Calculation of haemoglobin from blood specific gravities. J Biol Chem 183:349–360

    Google Scholar 

  • Veith RC, Raisys VA, Perera C (1978) The clinical impact of blood collection methods on tricyclic antidepressants as measured by GC/MS-SIM. Commun Psychopharmacol 2:491–494

    Google Scholar 

  • Weder HJ, Bickel MH (1970) Interactions of drugs with proteins. I. Binding of tricyclic thymoleptics to human and bovine plasma proteins. J Pharm Sci 59:1505–1507

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burch, J.E., Roberts, S.G. & Raddats, M.A. Binding of amitriptyline and nortriptyline in plasma determined from their equilibrium distributions between red cells and plasma, and between red cells and buffer solution. Psychopharmacology 75, 262–272 (1981). https://doi.org/10.1007/BF00432436

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00432436

Key words

Navigation