Nine (15%) of 59 patients treated with imipramine at doses of 150 to 300
mg/day had steady-state plasma levels greater than 500 ng/ml. Low capacity
for hydroxylation was found in all six patients for whom hydroxy
metabolites were measured. Maximum tricyclic levels in the nine study
patients were comparable to levels found in tricyclic antidepressant
overdoses (651-2439 ng/ml). No study patient experienced any adverse
effects: QRS durations were all less than 100 msec, and a mildly dry mouth
was the most commonly reported side effect (five of nine patients).
Depressive symptoms recurred in three patients when their imipramine dose
was decreased.
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