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Related Experiment Videos

Plasma 10-hydroxynortriptyline in elderly depressed patients.

R C Young, G S Alexopoulos, C A Shamoian

    Clinical Pharmacology and Therapeutics
    |April 1, 1984
    PubMed
    Summary

    Elderly patients show higher plasma concentrations of E-10-hydroxynortriptyline (E-10-OH-NT) compared to young adults, despite equivalent nortriptyline (NT) doses. This suggests age-related differences in nortriptyline metabolism and E-10-OH-NT/NT ratios.

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    THORACIC NEUROBLASTOMA WITH SPONTANEOUS REMISSION.

    Medical journal, Armed Forces India·2016

    Area of Science:

    • Pharmacology
    • Geriatric Medicine
    • Clinical Pharmacy

    Background:

    • Nortriptyline (NT) is a widely prescribed tricyclic antidepressant.
    • Metabolism and clearance of drugs can change with age, impacting efficacy and safety.
    • Understanding age-related pharmacokinetic differences is crucial for optimizing drug therapy in the elderly.

    Purpose of the Study:

    • To compare plasma concentrations of nortriptyline (NT) and its active metabolite, unconjugated E-10-hydroxynortriptyline (E-10-OH-NT), in elderly and young adult patients.
    • To investigate the impact of age on the E-10-OH-NT/NT ratio under steady-state conditions.
    • To explore potential correlations between E-10-OH-NT/NT ratios and clinical parameters like serum creatinine.

    Main Methods:

    • Steady-state plasma concentrations of NT and E-10-OH-NT were measured in two groups: elderly (≥60 years) and young adults (≤40 years).

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  • Both groups received equivalent daily doses of nortriptyline.
  • Statistical analysis was performed to compare concentrations and ratios between groups and to assess correlations.

    • Main Results:

    • Plasma NT concentrations did not significantly differ between elderly and young adult groups.
    • Plasma E-10-OH-NT concentrations were significantly higher in the elderly group.
    • The plasma E-10-OH-NT/NT ratio was approximately double in the elderly compared to the young adults, with substantial inter-individual variability in the elderly group.
    • A weak positive correlation was observed between E-10-OH-NT/NT ratios and serum creatinine concentrations.

    Conclusions:

    • Elderly patients exhibit altered nortriptyline metabolism, leading to higher plasma levels of the E-10-OH-NT metabolite.
    • The increased E-10-OH-NT/NT ratio in the elderly suggests reduced clearance or altered formation of this metabolite with aging.
    • Age-related changes in drug metabolism necessitate careful monitoring of nortriptyline therapy in older adults.