In this study we tried to elucidate the relationship between steady-state serum levels of amitriptyline along with its active metabolite nortriptyline , therapeutic responses and side effects. Twenty inpatients , who were, at different times, ad mitted to the Department of Neuropsyc hiatry , Chung - Ang University Hospital sometime between 1990.1.1 and 1991.6.30 and who met the DSM - III - R criteria for major depression and treated with amitriptyline for at least 4 weeks, were selected. Serum levels of tricyclic antidepressant, depression score and side effect score were measure d at the time of admission , first, second , thirdand fourth week of treatment respectively . The results of the study were as follows 1) Baseline and next 4weekly Hamilton rating scores for depression were 32.65士 5.82， 24.10± 7.13，19.15士 5.88，14.65士 5.30 and 11.05士 5.03 respectively . These results show signific ant difference according to the therapeutic period . 2) Weekly side effect scores were 13.35士 5.19，10.05士 4.39，7.60± 2.99 and 5.50士 2.60. There is significant difference in side effect scores according to the therapeutic period . 3) The combined mean serum levels of amitriptyline and nortripty line of 17 responders was 187.86± 72 .69 ng /ml，and that of 3 nonresponders was 221.74± 56.56. These results show no significant difference . 4) There are no correlations between TCA serum levels and clinical responses or side effects except at third week.
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