Am J Psychiatry 1986; 143:1283-1286
Copyright © 1986 by American Psychiatric Association
Preliminary data on the relationship between nortriptyline plasma level and response in depressed children
B Geller, TB Cooper, EC Chestnut, JA Anker and MD Schluchter
Twenty-two subjects 6-12 years old who met Research Diagnostic Criteria and
DSM-III criteria for major depressive disorder received a fixed daily dose
of nortriptyline during an 8-week protocol. Weekly plasma levels were
measured; the raters performing behavioral assessments were blind to these
levels. There was a highly significant difference between the mean
steady-state plasma levels and the milligram-per- kilogram doses of the
responders and nonresponders. The data suggest that the lower limit of the
therapeutic range of nortriptyline in children (over 60 ng/ml) is similar
to that reported for adults. The disadvantages of the use of a
milligram-per-kilogram dose rather than a pharmacokinetic approach are
discussed.
