Why the study?
Does monitoring of tricyclic antidepressant plasma levels improve clinical response and prevent toxicity in patients taking tricyclic antidepressants?
Does monitoring of tricyclic antidepressant plasma levels improve clinical response and prevent toxicity in patients taking tricyclic antidepressants?
Routine measurement of tricyclic antidepressant plasma levels is not warranted, despite its potential usefulness in specific clinical situations.
Supports selective over routine TCA monitoring in practice; leaves open optimal thresholds for targeted high-risk subgroups.
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.
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Oliveira et al. (1989) studied this question.
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