Plasma 10-hydroxynortriptyline in elderly depressed patients

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Abstract
Plasma concentrations of nortriptyline (NT) and of unconjugated E-10-hydroxynortriptyline (E-10-OH-NT) were measured under steady-state conditions in elderly (.gtoreq. 60 yr) and young adult (.ltoreq. 40 yr) patients treated with NT. The 2 groups received equivalent doses of NT. Plasma NT concentrations of the 2 groups did not differ but plasma E-10-OH-NT concentrations were higher in the elderly. The plasma E-10-OH-NT/NT ratios were twice as high in the elderly group. Plasma E-10-OH-NT/NT ratios varied 2000% between individuals in the elderly group but were stable within individuals. Plasma E-10-OH-NT/NT ratios correlated positively but weakly with serum creatinine concentrations. [Age-related changes in kinetics may play a role in altering therapeutic and toxic effects of tricyclic antidepressants and related drugs in elderly patients.].

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