Antidepressant Drugs (Cyclic): Amitriptyline, Nortriptyline, Protriptyline, Doxepin, Imipramine

Antidepressant Drugs (Cyclic): Amitriptyline, Nortriptyline, Protriptyline, Doxepin, Imipramine is a topic covered in the Davis's Lab & Diagnostic Tests.

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General

Synonym/Acronym:
Cyclic antidepressants: amitriptyline (Elavil, Endep, Etrafon, Limbitrol, Triavil); nortriptyline (Allegron, Aventyl HCL, Nortrilen, Norval, Pamelor); protriptyline (Vivactil); doxepin (Adapin, Co-Dax, Novoxapin, Sinequan, Triadapin); imipramine (Berkomine, Dimipressin, Janimine, Pertofrane, Presamine, SK-Pramine, Tofranil PM).

Common Use:
To monitor subtherapeutic, therapeutic, or toxic drug levels in evaluation of effective treatment modalities.

Specimen:
Serum collected in a red-top tube.

DrugRoute of AdministrationRecommended Collection Time
AmitriptylineOralTrough: immediately before next dose (at steady state)
NortriptylineOralTrough: immediately before next dose (at steady state)
ProtriptylineOralTrough: immediately before next dose (at steady state)
DoxepinOralTrough: immediately before next dose (at steady state)
ImipramineOralTrough: immediately before next dose (at steady state)

Normal Findings:
(Method: Chromatography for amitriptyline, nortriptyline, protriptyline, and doxepin; immunoassay for imipramine)

DrugTherapeutic Range Conventional UnitsConversion to SI UnitsTherapeutic Range SI UnitsHalf-Life (h)Volume of Distribution (L/kg)Protein Binding (%)Excretion
Amitriptyline125–250 ng/mLSI units = Conventional units × 3.6450–900 nmol/L20–4010–3685–95Hepatic
Nortriptyline50–150 ng/mLSI units = Conventional units × 3.8190–570 nmol/L20–6015–2390–95Hepatic
Protriptyline70–250 ng/mLSI units = Conventional units × 3.8266–950 nmol/L60–9015–3191–93Hepatic
Doxepin110–250 ng/mLSI units = Conventional units × 3.58394–895 nmol/L10–2510–3075–85Hepatic
Imipramine180–240 ng/mLSI units = Conventional units × 3.57643–857 nmol/L6–189–2360–95Hepatic

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Citation

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TY - ELEC T1 - Antidepressant Drugs (Cyclic): Amitriptyline, Nortriptyline, Protriptyline, Doxepin, Imipramine ID - 425348 Y1 - 2017 PB - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425348/all/Antidepressant_Drugs__Cyclic_:_Amitriptyline__Nortriptyline__Protriptyline__Doxepin__Imipramine ER -