Effects of Amitriptyline and Imipramine on Amine Metabolites in the Cerebrospinal Fluid of Depressed Patients

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Abstract
The effect of tricyclic antidepressant treatment on the metabolism of brain serotonin and dopamine was evaluated in depressed patients by studying levels of the respective metabolites (5-hydroxyindoleacetic acid [5HIAA] and homovanillic acid [HVA]) in the cerebrospinal fluid (CSF) after the administration of probenecid. probenecid causes rapid accumulation of 5HIAA and HVA by inhibiting transport out of the CSF, thus providing a measure of amine turnover. Treatment with amitriptyline hydrochloride and imipramine hydrochloride was associated with a reduced accumulation of 5HIAA, whereas, HVA accumulation was not affected. These findings suggest that, in depressed patients, central nervous system serotonin turnover is decreased during treatment with amitriptyline and imipramine.