Should plasma level monitoring of tricyclic antidepressants be introduced in clinical practice?

Abstract

A review of studies relating plasma concentrations of antidepressant drugs to clinical response is presented. Of the 39 studies reviewed about half favor various relationships in the eight drugs studied. Possible reasons for the discrepancies are discussed and suggestions for future studies outlined. Some results of the effects of long term lithium administration are presented. They show that the tricyclics will play an important role in maintenance therapy for recurring affective disorders. Routine monitoring of plasma levels of tricyclic antidepressants is not warranted.