Evidence for altered desipramine disposition in methadone-maintained patients treated for cocaine abuse.

Abstract

Plasma concentrations of desipramine (DMI) and its 2-hydroxy metabolite (OHDMI) were compared among 72 patients being treated with desipramine for either depression (n = 39) or cocaine abuse (n = 33). Eleven cocaine abusers who were concurrently maintained on methadone had a significantly lower ratio of DMI dose to plasma concentration (0.9) than the depressives (2.2) or nonmethadone cocaine abusers (2.0). Their OHDMI/DMI ratios were significantly lower (0.19) than for either the other 22 cocaine abusers (0.39) or the depressed (0.50) patients. This difference was not due to DMI dosage. Although the underlying mechanism cannot be determined from these plasma studies, possible reduced hydroxylation of DMI in methadone patients suggests the need for DMI plasma monitoring.

• Authors: T R Kosten, F H Gawin, C Morgan, J C Nelson, P Jatlow
• Journal: The American journal of drug and alcohol abuse (Am J Drug Alcohol Abuse) Vol. 16 Issue 3-4 Pg. 329-36 ( 1990) ISSN: 0095-2990 [Print] England
• PMID: 2288330 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Cocaine
• Desipramine
• Methadone

Topics

• Adult
• Cocaine (adverse effects, pharmacokinetics)
• Depressive Disorder (blood, drug therapy)
• Desipramine (administration & dosage, pharmacokinetics)
• Dose-Response Relationship, Drug
• Female
• Humans
• Male
• Methadone (administration & dosage, adverse effects)
• Middle Aged
• Substance-Related Disorders (blood, rehabilitation)