Abstract
Six healthy volunteers were given single doses of amitriptyline (AT) and of nortriptyline (NT) separated by at least 10 days. Plasma concentrations of both compounds were measured at intervals for 48 or 72 h. the total areas under the concentration-time curves for the ingested drug were greater for NT, but AT concentrations showed much higher peak values and took more than 12 h to reach the terminal β phase of elimination. Doses of 50 mg AT produced areas averaging slightly less than half those for 100 mg AT in the same subject, suggesting some saturation of the elimination process. The consumption of a large, fatty meal just before taking the AT tablets had little effect on the plasma drug concentration curves. NT half-lives, measured after ingestion of NT tablets, were used in analysing the production of NT from doses of AT in the same subject. There was a rapid early production, amounting to 30–67% of the total and presumably resulting from the first pass of AT through the liver. NT was then formed continuously at a rate always, proportional to the simultaneous rate of AT elimination. The total amount of NT entering the systemic circulation was about one-quarter of the AT dose.
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References
Alexanderson B (1972a) Pharmacokinetics of nortriptyline in man after single and multiple oral doses: The predictability of steady-state plasma concentrations from single-dose plasma-level data. Eur J Clin Pharmacol 4:82–91
Alexanderson B (1972b) Pharmacokinetics of desmethylimipramine and nortriptyline in man after single and multiple oral doses: A crossover study. Eur J Clin Pharmacol 5:1–10
Alexanderson B, Borgå O, Alván G (1973) The availability of orally administered nortriptyline. Eur J Clin Pharmacol 5:181–185
Alván G, Borgå O, Lind M, Palmér L, Siwers B (1977) First-pass hydroxylation of nortriptyline: Concentrations of parent drug and major metabolites in plasma. Eur J Clin Pharmacol 11:219–224
Bridges JW, Sent JG, Johnson P (1976) The effects of some pharmacologically active amines on the rate of gastric emptying in rats. Life Sci 18:97–108
Brunswick DJ, Amsterdam JD, Mendels J, Stern SL (1979) Prediction of steady-state imipramine and desmethylimipramine plasma concentrations from single-dose data. Clin Pharmacol Ther 25:605–610
Burch J, Hullin RP (1978) The absorption rate and bioavailability of amitriptyline in the form of Lentizol. Neuropharmacology 17:1069–1071
Burch JE, Hullin RP (1981) Amitriptyline pharmacokinetics. Single doses of Lentizol compared with ordinary amitriptyline tablets. Psychopharmacology 74:43–50
Burch JE, Raddats MA, Thompson SG (1979) A reliable routine method for the determination of plasma amitriptyline and nortriptyline by gas chromatography. J Chromatogr 162:351–366
Dawling S, Braithwaite RA (1978) Simplified method for monitoring tricyclic antidepressant therapy using gas-liquid chromatography with nitrogen detection. J Chromatogr 148:449–456
Dencker H, Dencker SJ, Green A, Nagy A (1976) Intestinal absorption, demethylation, and enterohepatic circulation of imipramine. Clin Pharmacol Ther 19:584–586
Eschenhof E, Rieder J (1969) Untersuchungen über das Schicksal des Antidepressivums Amitriptylin im Organismus der Ratte und des Menschen. Arzneim Forsch 19:957–966
Fredricson Overø K, Gram LF, Hansen V (1975) Kinetics of nortriptyline in man according to a two compartment model. Eur J Clin Pharmacol 8:343–347
Garland WA, Min BH, Birkett DJ (1978) The kinetics of amitriptyline following single oral dose administration, to man. Res Commun Chem Pathol Pharmacol 22:475–484
Gibaldi M, Boyes RN, Feldman S (1971) Influence of first-pass effect on availability of drugs on oral administration. J Pharm Sci 60:1338–1340
Gram LF, Andreasen PB, Fredricson Overø K, Christansen J (1976) Comparison of single-dose kinetics of imipramine, nortriptyline and antipyrine in man. Psychopharmacology 50:21–27
Gram LF, Fredricson Overø K (1975) First-pass metabolism of nortriptyline in man. Clin Pharmacol Ther 18:305–314
Jørgensen A (1977) Comparative bioavailability studies with a sustainedrelease preparation of amitriptyline and ordinary tablets given to human volunteers. Eur J Clin Pharmacol 12:187–190
Jørgensen A, Hansen V (1976) Pharmacokinetics of amitriptyline infused intravenously in man. Eur J Clin Pharmacol 10:337–341
Liisberg P, Mose H, Amdisen A, Jørgensen A, Høpfner-Petersen HE (1978) A clinical trial comparing sustained-release amitriptyline (Saroten Retard) and conventional amitriptyline tablets (Saroten) in endogeneously depressed patients with simultaneous determination of serum levels of amitriptyline and nortriptyline. Acta Psychiatr Scand 57:426–435
Minder R, Schnetzer F, Bickel MH (1971) Hepatic and extrahepatic metabolism of the psychotropic drugs chlorpromazine, imipramine and imipramine-N-oxide. Naunyn Schmiedeberg's Arch Pharmacol 268:334–337
Montgomery S, Braithwaite R, Dawling S (1978) High plasma nortriptyline levels in the treatment of depression-I. Clin Pharmacol Ther 23:309–314
Nagy A, Johansson R (1975) Plasma levels of imipramine and desipramine in man after different routes of administration Naunyn Schmiedeberg's Arch Pharmacol 290:145–160
Nagy A, Johansson R (1977) The demethylation of imipramine and clomipramine as apparent from their plasma kinetics. Psychopharmacology 54:125–131
Potter WZ, Zavadil AP, Goodwin FK (1978) Prediction of steady-state plasma concentration of imipramine. Psychopharmacol Bull 14:29–33
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
Rowland M (1972) Influence of route of administration on drug availability. J Pharm Sci 61:70–74
Santagostino G, Facino RM, Pirillo D (1974) Urinary excretion of amitriptyline N-oxide in humans. J Pharm Sci 63:1690–1692
Wagner JG, Northam JI, Alway CD, Carpenter OS (1965) Blood levels of drug at equilibrium state after multiple dosing. Nature 207:1301–1302
Ziegler VE, Clayton PJ, Biggs JT (1977) A comparison study of amitriptyline and nortriptyline with plasma levels. Arch Gen Psychiatry 34:607–612
Ziegler VE, Biggs JT, Ardekani AB, Rosen SH (1978a) Contribution to the pharmacokinetics of amitriptyline. J Clin Pharmacol 18:462–467
Ziegler VE, Biggs JT, Wylie LT, Coryell WH, Hanifl KM, Hawf DJ, Rosen SH (1978b) Protriptyline kinetics. Clin Pharmacol Ther 23:580–584
Ziegler VE, Biggs JT, Wylie LT, Rosen SH, Hawf DJ, Coryell WH (1978c) Doxepin kinetics. Clin Pharmacol Ther 23:573–579
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Burch, J.E., Hullin, R.P. Amitriptyline pharmacokinetics a crossover study with single doses of amitriptyline and nortriptyline. Psychopharmacology 74, 35–42 (1981). https://doi.org/10.1007/BF00431754
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DOI: https://doi.org/10.1007/BF00431754