Skip to main content
SpringerLink
Log in

Pharmacokinetics and Drug Concentrations Measurement: Relevance to Treatment of Anxiety Disorders

  • Chapter
Guidelines for the Use of Psychotropic Drugs

  • 103 Accesses

Abstract

Anxiety is a mood state accompanied by psychophysiological changes (such as rapid heart rate, increased perspiration, tremor, and often by feelings of tingling of extremities, going crazy, choking or dying) associated with fear, but occurring in the absence of generally threatening stimuli. However, it is a symptom rather than a diagnostic entity. There is a group of mental disorders with anxiety as a primary symptom in the absence of major affective symptomatology and/or thought disorder. In the DSM-III, most of these have been classified under the titles of anxiety disorders, or anxiety states (Table 1). Moreover, in psychiatric outpatients anxiety commonly coexists with mild to moderate depressive symptoms in the cyclothymie and dysthymic disorders (DSM-III #300.13 and 300.40, respectively).

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Asberg, M. (1973). Plasma nortriptyline levels: Relationship to clinical effects. Clin. Pharmacol. Ther. 16: 215–229.

    Google Scholar 

  • Bianchi, G.N. and Phillips, J. (1972). A comparative trial of doxepin and diazepam in anxiety states. Psychopharmacol. 25: 86–95.

    Article  CAS  Google Scholar 

  • Bliding, A. (1974). Effects of different rates of absorption of two benzodiazepines on subjective and objective parameters. E’ur. J. Clin. Pharmacol. 7: 201–211.

    Article  PubMed  CAS  Google Scholar 

  • Bonn, J.A. and Turner, P. (1971). D-propranolol and anxiety. Lancet 1: 1355–1356.

    Article  PubMed  CAS  Google Scholar 

  • Bonn, J.A., Turner, P. and Hicks, D.C. (1972). Beta-adrenergic-receptor blockade with practolol in treatment of anxiety. Lancet 1: 814–815.

    Article  PubMed  CAS  Google Scholar 

  • Cooper, T.B. and Simpson, G.M. (1978). Kinetics of lithium and clinical response. In: M.A. Lipton, A. DiMascio and K.F. Killam, eds., Psychopharmacology: A Generation of Progress, New York, Raven Press, pp. 923–931.

    Google Scholar 

  • Dasberg, H.H., van der Kleijn, E., Guelen, P.J.R. and van Praag, H.M. (1974). Plasma concentrations of diazepam and its metabolite N-desmethyldiazepam in relation to anxiolytic effect. Clin. Pharmacol. Ther. 15: 473–483.

    PubMed  CAS  Google Scholar 

  • Davidson, J., Linnoila, M., Raft, D. and Turnbull, C.D. (1981). MAO inhibition and control of anxiety following amitryptyline therapy. Acta. Psychiatr. Scand. 63: 147–152.

    Article  PubMed  CAS  Google Scholar 

  • Ellinwood, E.H., Linnoila, M., Easier, M.E. and Molter, D.W. (1981). Onset of peak impairment after diazepam and after alcohol. Clin. Pharmacol. Ther. 30: 534–538.

    Article  PubMed  CAS  Google Scholar 

  • Glassman, A.H., Perel, J.M., Shostak, M., Kantor, S.J. and Feiss, J.L. (1977). Clinical implications of imipramine plasma levels for depressive illness. Arch. Gen. Psychiatry 34: 197–204.

    Article  PubMed  CAS  Google Scholar 

  • Gloger, G., Grunnhaus, L., Birmacher, B. and Tuondart, T. (1981). Treatment of spontaneous panic attacks with chlorimipramine. Am. J. Psychiatry 138: 1215–1271.

    PubMed  CAS  Google Scholar 

  • Gorman, J.M., Fyer, A.F., Glicklich, J., King, D. and Klein, D.F. (1981). Effect of imipramine on prolapsed mitral valves of patients with panic disorder. Am. J. Psychiatry 138: 977–978.

    PubMed  CAS  Google Scholar 

  • Granville-Grossman, K.L. and Turner, P. (1966). The Effect of Propranolol it Clinical Practice. New York, Raven Press.

    Google Scholar 

  • Hoehn-Saric, R., Merchant, A.F., Keyser, M.L. and Smith, V.K. (1981). Effects of clonidine on anxiety disorders. Arch. Gen. Psychiatry 38: 1278–1282.

    Article  PubMed  CAS  Google Scholar 

  • Jobson, K., Linnoila, M., Gillam, J. and Sullivan, J.L. (1978). Successful treatment of severe anxiety attacks with tricyclic antidepressants: a potential mechanism of action. Am. J. Psychiatry 135: 863–864.

    PubMed  CAS  Google Scholar 

  • Johnstone, E.C., Owens, D.G.C., Frith, C.D., McPherson, K., Dowie, C., Riley, G. and Gold, A. (1980). Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychol. Med. 10: 321–328.

    Article  PubMed  CAS  Google Scholar 

  • Johnstone, E.C., Bourne, R.C., Crow, T.J., Frith, C.D., Gamble, S., Lofthouse, R., Owen, F., Owens, D.G.C., Robinson, J. and Stevens, M. (1981). The relationships between clinical response, psychophysiological variables and plasma levels of amitriptyline and diazepam in neurotic outpatients. Psychopharmacol. 72: 233–240.

    Article  CAS  Google Scholar 

  • Kanto, J., Iisalo, E., Lehtinen, V., Salminen, J. (1974). The concentrations of diazepam and its metabolites in the plasma after an acute and chronic administration. Psychopharmacologia 36: 123–131.

    Article  PubMed  CAS  Google Scholar 

  • Kathol, R.G., Noyes, R., Slymen, D.J., Crowe, R.R., Clancy, J. and Kerber, R.E. (1980). Propranolol in chronic anxiety disorders. Arch. Gen. Psychiatry 37: 1361–1365.

    Article  PubMed  CAS  Google Scholar 

  • Kahn, R.J., McNair, D.M., Covi, L., Downing, R.W., Fisher, S., Lipman, R.S., Rickels, K. and Smith, V.K. (1981). Effects of psychotropic agents in high anxiety subjects. Psychopharmacol. Bull. 17 (3): 97–100.

    Google Scholar 

  • Kelly, D., Guirguis, W., Frommer, E., Mitchell-Heggs, N. and Sargant, W. (1970). Treatment of phobic states with antidepressants. Br. J. Psychiatry 116: 387–398.

    Article  PubMed  CAS  Google Scholar 

  • Klein, D.F. (1967). Importance of psychiatric diagnosis in prediction of clinical drug effects. Arch. Gen. Psychiatry 16: 118–126.

    Article  PubMed  CAS  Google Scholar 

  • Kline, N.S. (1967). Drug treatment of phobic disorders. Am. J. Psychiatry 123: 1447–1450.

    PubMed  CAS  Google Scholar 

  • Kragh-Sorensen, P., Eggert-Hansen, C., Baastrup, C. and Hvidberg, E.F. (1976). Self-inhibiting action of nortriptyline’s antidepressive effect at high plasma levels. Psychopharmacology 45: 305–312.

    Article  CAS  Google Scholar 

  • Lin, K.-M. and Friedel, R.O. (1979). Relationship of plasma levels of chlordiazepoxide and metabolites to clinical response. Am. J. Psychiatry 136: 18–23.

    PubMed  CAS  Google Scholar 

  • Linnoila, M. (1981). Relationship between plasma levels of antidepressants and therapeutic response. In T.A. Ban, R. Gonzales, A.S. Jablensky, N.A. Sartorius and F. E. Vartanian, eds., Prevention and Treatment of Depression, Baltimore, University Park Press, pp. 219–232.

    Google Scholar 

  • Norman, T.R., Burrows, G.D., Bianchi, G.N., Maguire, K.P. and Wurm, J.M.E. (1980). Doxepin plasma levels and anxiolytic response. Int. Pharmacopsy chist. 15: 247–252.

    CAS  Google Scholar 

  • Perel, J.M., Stiller, R.L. and Glassman, A.H. (1978). Studies on plasma level/ effect relationships in imipramine therapy. Comm. Psychopharmacol. 2: 429–439.

    CAS  Google Scholar 

  • Ravaris, C.L., Robinson, D.S., Ives, J.O., Nies, A. and Bartlett, D. (1980). Phenelzinc and amitriptyline in the treatment of depression. Arch. Gen. Psychiatry 37: 1075–1080.

    Article  PubMed  CAS  Google Scholar 

  • Rifkin, A., Klein, D.F., Dillon, D. and Levitt, M. (1981). Blockade by imipramine or desipramine of panic induced by sodium lactate. Am. J. Psychiatry 138: 676–677.

    PubMed  CAS  Google Scholar 

  • Rickels, K., Perloff, M., Stepansky, W., Dion, H.S., Case, W.G. and Sapra, R.K. (1969). Doxepin and diazepam in general practice and hospital clinic neurotic patients: a collaborative controlled study. Psychopharmacologia 15: 265–279.

    Article  PubMed  CAS  Google Scholar 

  • Robinson, D.S., Nies, A., Ravaris, C.L. and Lamborn, K.R. (1973). The monoamine inhibitor, phenelzine, in the treatment of depressive-anxiety states. Arch. Gen. Psychiatry 29: 407–413.

    Article  PubMed  CAS  Google Scholar 

  • Robinson, D.S., Nies, A., Ravaris, L., Ives, J.O. and Bartlett, K. (1978). Clinical pharmacology of phenelzine. Arch. Gen. Psychiatry 35: 629–635.

    Article  PubMed  CAS  Google Scholar 

  • Sheehan, D.V., Ballenger, J. and Jacobsen, G. (1980). Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms. Arch. Gen. Psychiatry 37:51–59.

    Article  PubMed  CAS  Google Scholar 

  • Stern, R.S., Marks, I.M., Mawson, D. and Luscombe, D.K. (1980). Clomipramine and exposure for compulsive rituals: II: Plasma levels, side effects and outcome. Br. J. Psychiatry 136: 161–166.

    Article  PubMed  CAS  Google Scholar 

  • Tansella, M., Sicilliani, O., Burti, L., Schiavon, M., Zimmerman-Tansella Ch., Genna, M., Tognoni, G. and Morselli, P.L. (1974). N-desmethyl-diazepam and amylobarbitone sodium as hypnotics in anxious patients. Plasma levels, clinical efficacy and residual effects. Psychopharmacologia 41: 81–85.

    Article  Google Scholar 

  • Thoren, P., Asberg, M., Bertilsson, L., Mellstrom, B., Sjogvist, F., and Traskman, L. (1979). Clomipramine treatment of obsessive compulsive disorder. II. Arch. Gen. Psychiatry 37: 1289–1294.

    Article  Google Scholar 

  • Tyrer, P.J. and Lader, M. (1973). Effects of beta adrenergic blockade with sotalol in chronic anxiety. Clin. Pharmacol. Ther. 14: 418–425.

    PubMed  CAS  Google Scholar 

  • Tyrer, P. (1976). Towards rational therapy with monoamine oxidase inhibitors. Br. J. Psychiatry 128: 354–360.

    Article  PubMed  CAS  Google Scholar 

  • Venkatesh, A., Pauls, D.L., Crowe, R., Noyes, R., van Valkenburg, C., Martins, J.B. and Kerber, R.E. (1980). Mitral valve prolapse in anxiety neurosis (panic disorder). Am. Heart J. 100: 302–305.

    Article  PubMed  CAS  Google Scholar 

  • Wilkinson, G.R. and Shand, D.G. (1975). A physiological approach to hepatic drug clearance. Clin. Pharmacol. Ther. 18: 377–390.

    PubMed  CAS  Google Scholar 

  • Ziegler, V.E., Clayton, P.J., Taylor, J.R., Co, B.T. and Biggs, J.T. (1976). Nortriptyline plasma levels and therapeutic response. Clin. Pharmacol. Ther. 20: 458–463.

    PubMed  CAS  Google Scholar 

  • Zitrin, C.M., Klein, D.F. and Woerner, M.G. (1980). Treatment of agoraphobia with group exposure in vivo and imipramine. Arch. Gen. Psychiatry 37: 63–72.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Markku Linnoila
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Clarke Institute of Psychiatry, University of Toronto, Canada

    Harvey C. Stancer Ph.D., M.D., F.R.C.P.(C)  & Vivian M. Rakoff M.A., M.B., F.R.C.P.(C)  & 

  2. Toronto General Hospital, University of Toronto, Canada

    Paul E. Garfinkel M.S., M.D., F.R.C.P.(C)

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Spectrum Publications, Inc.

About this chapter

Cite this chapter

Linnoila, M. (1984). Pharmacokinetics and Drug Concentrations Measurement: Relevance to Treatment of Anxiety Disorders. In: Stancer, H.C., Garfinkel, P.E., Rakoff, V.M. (eds) Guidelines for the Use of Psychotropic Drugs. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-7618-7_22

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-7618-7_22

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-7620-0

  • Online ISBN: 978-94-011-7618-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation