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Relationship between the plasma concentration of clomipramine and desmethylclomipramine in depressive patients and the clinical response

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Summary

Thirty one in-patients suffering from depression were treated orally with clomipramine (Cl) at various dosage, for 28 days, after a “wash-out” period of three days. In 17 patients receiving 75 mg per day of Cl, steady state plasma levels of Cl were reached at Day 14, and steady state plasma levels of its active metabolite, desmethylclomipramine (DMCl), were reached at Day 21. In contrast, in 7 other patients receiving a dosage increasing to 150 mg per day at Day 7, mean plasma levels of Cl and DMCl continued to rise during the entire treatment period. At the steady state, a correlation was found between Cl dosage expressed as mg kg body weight and the plasma concentration of Cl and DMCl. Factors such as tobacco and alcohol consumption seem to modify the Cl/DMCl ratio. A comparison of clinical response with plasma levels of Cl, DMCl and Cl + DMCl showed a significant negative linear correlation.

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Authors and Affiliations

  1. Laboratoire de Pharmacologie Clinique, Centre Hospitalier et Universitaire, Besançon, France

    B. Vandel, S. Vandel & J. M. Jounet

  2. Clinique de Neurologie et Psychiatrie, Centre Hospitalier et Universitaire, Besançon, France

    G. Allers & R. Volmat

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  1. B. Vandel
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  2. S. Vandel
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  4. G. Allers
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  5. R. Volmat
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Vandel, B., Vandel, S., Jounet, J.M. et al. Relationship between the plasma concentration of clomipramine and desmethylclomipramine in depressive patients and the clinical response. Eur J Clin Pharmacol 22, 15–20 (1982). https://doi.org/10.1007/BF00606419

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  • DOI: https://doi.org/10.1007/BF00606419

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