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Lack of Correlation With Therapeutic Response

Jay D. Amsterdam, MD; David J. Brunswick, PhD; Larry Potter; Andrew Winokur, MD, PhD; Karl Rickels, MD

Arch Gen Psychiatry. 1985;42(4):361-364.

Abstract
• Studies of the relationship between plasma concentrations of desipramine hydrochloride and clinical response have shown contradictory results, and only one prior study examined 2-hydroxydesipramine and its relationship to treatment. We therefore performed a study in a large, carefully diagnosed group of depressed patients taking fixed maintenance doses of desipramine to elucidate a potential relationship between clinical response and plasma concentrations of desipramine and 2-hydroxydesipramine. There was no significant correlation between clinical response and steadystate plasma levels of desipramine, 2-hydroxydesipramine, or the sum of desipramine plus 2-hydroxydesipramine. Although some commercial laboratories suggest a specific therapeutic plasma level "range" for desipramine, our data provide no support for such a range, nor for the routine measurement of plasma desipramine and 2-hydroxydesipramine concentrations in depressed patients.

Author Affiliations
From the Depression Research Unit (Drs Amsterdam and Winokur and Mr Potter) and the Psychopharmacology Research Unit (Dr Rickels), Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, and the Neuropsychopharmacology Research Unit, Philadelphia Veterans Administration Medical Center (Dr Brunswick).

Footnotes
Accepted for publication July 16, 1984.

Reprint requests to Depression Research Unit, Hospital of the University of Pennsylvania, 36th and Spruce streets, Philadelphia, PA 19104 (Dr Amsterdam).

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