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October 1986

Tricyclic Antidepressant Washout Effects on Cerebrospinal Fluid and Urinary Monoamine and Metabolites

Author Affiliations

Neurosciences Research Branch, National Institute of Mental Health 5600 Fishers Lane—Room 11-105 Rockville, MD 20857
Department of Psychiatry University of Texas Health Science Center/San Antonio 7703 Floyd Curl Dr San Antonio, TX 78284
Illinois State Pyschiatric Institute 1601 W Taylor St Chicago, IL 60612
Department of Psychiatry University of Pittsburgh School of Medicine 3811 O'Hara St Pittsburgh, PA 15213
Illinois State Psychiatric Institute 1601 W Taylor St Chicago, IL 60612

Arch Gen Psychiatry. 1986;43(10):1012-1013. doi:10.1001/archpsyc.1986.01800100106014

To the Editor.—  Our previous publication on cerebrospinal fluid (CSF) and urinary concentrations of biogenic amines and metabolites in depression reported higher concentrations in many of these measures relative to the concentrations measured from samples collected from age- and sexmatched normal healthy controls.1 The possibility exists that these higher concentrations in depressed subjects are due to an inadequate drug washout period before sample collection. This may be especially true in light of the publication by Charney et al2 that reported a rebound or increase in concentrations of plasma and urinary 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) following withdrawal of tricyclic antidepressants.2

Patients and Methods.—  On intake into this study, all medications were withdrawn and information regarding medication usage during the current illness was obtained from all subjects and recorded on a medication review form. Drug class (eg, antidepressant, neuroleptic, anxiolytics, sedatives), specific generic information, and time of discontinuation of medication(s)

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