ABSTRACT
This chapter reviews some basic clinical understanding of depression and updates the monitoring of antidepressants. It provides a brief historical account of depressive illness, and updates the various hypotheses and types of depression. The chapter reviews clinical pharmacology and pharmacokinetics of the first-generation antidepressants: imipramine, desipramine, amitriptyline, nortriptyline, and doxepin. It describes a detailed treatment for new antidepressants: amoxapine, aprotiline, trimipramine, and trazodone. The chapter delineates the rationale for monitoring, and the role of the laboratory. It recommends briefly about sampling protocol and reviews reversed-phase high-performance liquid chromatography (HPLC) assays of antidepressants from the viewpoints of sample preparation and LC analysis. Monitoring of selected antidepressants may be readily achieved by reversed-phase liquid chromatographic analyses to answer questions related to therapeutic response, side effects, toxicity, pharmacokinetic parameters, and noncompliance. LC offers efficient and accurate determination, easily performed by the lab technologist.
