Abstract
Opinions on the value of measuring tricyclic plasma levels vary substantially. In the United States, plasma levels of several tricyclics are frequently used to ‘optimise’ therapy. In the UK, plasma level monitoring is less often undertaken and measured levels are more usually used simply to assure compliance rather than as a guide to dose adjustment.
Highlights
The value of antidepressant serum levels was reviewed by a 1985 American Psychiatric Association Task Force (Glassman et al, 1985)
Several criteria must be met for plasma level monitoring of any drug to be worthwhile
There should be a wide variation in individual drug handling, clinical response must be difficult to establish in individual patients and plasma levels must relate directly to clinical and adverse effects
Summary
The value of antidepressant serum levels was reviewed by a 1985 American Psychiatric Association Task Force (Glassman et al, 1985). Several criteria must be met for plasma level monitoring of any drug to be worthwhile. There should be a wide variation in individual drug handling, clinical response must be difficult to establish in individual patients and plasma levels must relate directly to clinical and adverse effects. It is well known that plasma tricyclic levels vary considerably in individuals given the same dose, so the first of these criteria is met.
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