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Clomipramine and Exposure for Compulsive Rituals: II. Plasma Levels, Side Effects and Outcome

Published online by Cambridge University Press:  29 January 2018

R. S. Stern ,
I. M. Marks ,
D. Mawson  and
D. K. Luscombe
R. S. Stern
Affiliation:
Institute of Psychiatry and the Maudsley Hospital, London; now Consultant Psychiatrist, St George's Hospital, London
I. M. Marks
Affiliation:
The Maudsley and Bethlem Royal Hospital, Professor of Experimental Psychopathology, Institute of Psychiatry, London
D. Mawson
Affiliation:
The Maudsley Hospital and Institute of Psychiatry, London
D. K. Luscombe
Affiliation:
Welsh School of Pharmacy, UWIST, Cathays Park, Cardiff
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Summary

Forty obsessive-compulsive ritualizers received nightly placebo or clomipramine up to 225 mgs nocte for 8 months, and received behavioural treatment (exposure in vivo) from weeks 4 to 10. Plasma concentrations of clomipramine and its primary metabolite N-desmethylclomipramine steadily increased over the first 4 weeks of treatment after which they remained relatively steady. Plasma levels correlated significantly with dose and with outcome but not with side effects. Patients with plasma clomipramine levels in the range 100–250 ng/ml and N-desmethylclomipramine levels between 230–550 ng/ml were found to improve significantly more than patients outside these ranges, thus suggesting a therapeutic window for clomipramine and its primary metabolite.

Type
Papers
Information
The British Journal of Psychiatry , Volume 136 , Issue 2 , February 1980 , pp. 161 - 166
Copyright
Copyright © Royal College of Psychiatrists, 1980 

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