Altered Amitriptyline Kinetics in a Depressed Patient with Porto-Caval Anastomosis

Author:

Hrdina P.D.1,Lapierre Y.D.2,Koranyi E.K.3

Affiliation:

1. Department of Pharmacology, University of Ottawa, Ottawa, Ontario.

2. Psychiatry and Pharmacology, University of Ottawa, Ottawa, Ontario; Director of Research, Royal Ottawa Hospital, Ottawa, Ontario.

3. University of Ottawa; Director Education, Royal Ottawa Hospital, Ottawa, Ontario.

Abstract

A case of altered kinetics of amitriptyline in a patient with porto-caval anastomosis and liver cirrhosis who showed an unusually strong sedative response to the drug, is presented. Therapy with tricyclic antidepressants should be initiated with lower doses and adjusted by plasma level monitoring inpatients with liver by-pass.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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