Abstract
Amitriptyline (AMT) and Imipramine (IMP), representative anti-depressants, were given singly or combinedly to 38 outpatients showing the depressive states. By the use of subjective test (DRS-S78) and objective test (HRS), review was made on the related changes of symptoms and concentration of the drugs. For the mesurement of serum level, reference was made for the full and exact also simple methods even in combination of many agents by the use of HPLC. In application of these methods, these cases were checked at the time initial examination, 1 st, 2 nd, 4 th week, then, the change in timecourse was pursed, therby, several conclusions obtained were as follows: AMT showed dose-dependent effect, and its clinical effect was seen after the second week of administration, and judgement was possible for the therapeutic efficacy at the 4 th week. IMP did not show any dose-dependent efficacy, but its clinical effect was observed when serum level reached 100 ng/ml, and also, it took over 2 weeks until a constant state was obtained. In combinned use of AMT with IMP, AMT was hardly affected by the effect of IMP, and similar tendency to that of single administration was observed, while IMP showed some differrences in the reactivity and single administration. Thus it is necessary to select the suitable cases. Also, in case of single administration of IMP, it is meaningless to increase the dosage recklessly, and it is necessary to establish rational plan for administration. It is very effective to evaluate the change in time course of the symptoms in order to evaluate the drug by the use of DRS-S78 and HRS. By the combined use of RS with the mesurement of serum level, earlier estimation of therapeutic effect can be obtained as compared with the conventional method. Accordingly, the mesurement of serum level of the therapeutic drug for treating the depressive state can be a powerful index for therapy.
