Multicyclic antidepressant serum drug assays: a utilization review.

Multicyclic antidepressant (MCA) kinetics are complex and influenced by many factors, making clinical interpretation of serum concentration data difficult. To assess the effectiveness of MCA serum assay utilization in a private, university-affiliated psychiatric hospital, actual use over a 1-year period was reviewed retrospectively against criteria derived from the contemporary literature. Overall, compliance with the criteria was poor.

Idiosyncratic pharmacokinetics complicating treatment of major depression in an elderly woman.

A 64-year-old woman with major depression developed toxic symptoms while on a regimen of 150 to 200 mg/day of desipramine. Her elimination half-life for desipramine was found to be greatly prolonged, at approximately 150 hours. Her ability to metabolize diphenhydramine and lorazepam was found to be impaired as well.

Nonlinear desipramine pharmacokinetics: a case study.

A case of nonlinear desipramine pharmacokinetics is described. During routine clinical monitoring serum desipramine concentrations appeared to change disproportionately with dose. Following a series of controlled dosage decreases, from 400 to 50 mg/day, the patient's steady state serum concentrations fit a nonlinear pharmacokinetic model.

Evaluation of a new lithium dosage-prediction technique.

The accuracy of a lithium dosage prediction technique was studied retrospectively. The dosage-prediction technique evaluated is based on lithium body clearance. The medical records of 71 psychiatric patients (30 men, 41 women) were reviewed.

Amoxapine (Asendin, Lederle Laboratories).

Amoxapine is a tricyclic antidepressant agent, which is chemically related to the antipsychotic agent loxapine, but which appears to block selectively the neuronal reuptake of norepinephrine; it is qualitatively similar to desipramine. In studies of patients with mixed depressive illnesses, amoxapine is at least as effective as amitriptyline and imipramine and probably more effective than placebo in ameliorating depressive symptoms. Claims of more rapid onset of therapeutic effects are based on group mean data obtained from small samples of depressed patients with heterogeneous and imprecisely defined diagnostic types.

Screening and selecting candidates for a hospital pharmacy residency program.

An applicant screening and selection procedure for a hospital pharmacy residency program which (1) efficiently processes a large number of applicants while minimizing the subjective nature of the review process and (2) ranks candidates for submission to the ASHP Residency Matching Program is described. A screening and selection committee consisting of five staff members of the hospital pharmacy department was created. Goals of the residency program and qualities of the optimal resident were defined prior to development of the screening and selection program.

Effects of stimulus familiarity on the rehearsal strategies transfer mechanism in retarded and nonretarded individuals.

The possibility that the familiarity value of stimuli might be a component of the rehearsal strategies mechanism in Ellis' (1970) multiprocess theory of short-term memory was investigated. Retarded and nonretarded subjects of equal CA were given either PA pretraining of nonsense pictures with colors or were presented with nonsense pictures alone. They were then compared in their performance on either an experimenter- or subject-paced serial memory task in which the nonsense pictures were employed as stimuli.