Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (710 page)

   Multicyclic compounds that inhibit the reuptake of neurotransmitters or block their metabolism, resulting in an increase concentration of monamines in the synapse.

   Tricyclic antidepressants (TCAs): amitriptyline (Elavil), nortriptyline, doxepin, imipramine (Tofranil), desipramine, trimipramine, protriptyline, clomipramine (Anafranil)

   Selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa), paroxetine (Paxil)

   Other agents:

   Amoxapine (Moxadil), maprotiline, trazodone (Desyrel), bupropion (Wellbutrin)

   Venlafaxine (Effexor), mirtazapine (Remeron), nefazodone (Serzone), duloxetine (Cymbalta)

   
Normal range:
see Table 16.8; not established for all drugs in this class

TABLE 16–8. Normal Therapeutic Levels for Antidepressants
*

*
Not established for all drugs in this class.
† When used as an antidepressant, therapeutic range not well established when prescribed for obsessive–compulsive disorder.

   Use

   Treatment of mood disorders and depression

   Limitations

   Immunoassay screening of serum/plasma/urine for TCAs does not detect other antidepressants (e.g., SSRIs).

   Target analytes: imipramine, nortriptyline.