三环类抗抑郁药的治疗药物监测

THERAPEUTIC DRUG MONITORING OF TRICYCLIC ANTIDEPRESSANTS

三环类抗抑郁药的治疗药物监测是近三十年来研究比较活跃的一个领域，通过测定血浆／血清中的药物浓度指导临床用药，可大大减少给药的盲目性，有利于实现个体化治疗，提高疗效，减少药物不良反应，并可检查病人用药的顺应性，而且可为三环类抗抑郁药过量中毒的诊断和治疗提供重要的客观依据。本文就三环类抗抑郁药血药浓度与疗效的关系，血药浓度与药物不良反应的关系，影响血药浓度的因素，测定方法。

Therapeutic drug monitoring(TDM) of tricyclic antidepressants(TCAs) is an active field of research in the past three decades. By detecting TCAs in the plasma /serum of patients, TDM is useful to do dosage adjustment and individualization, to enhance therapeutic efficacy, to avoid toxicity, to check compliance, and to provide dependable evidence for the diagnosis and treatment of overdosage. This article has reviewed published papers in the aspects of the relationship between TCAs plasma/ serum levels and clinical response, including toxicity, factors influencing TCAs levels, methods of detecting TCAs levels in serum/plasma, and how TDM of TCAs be done clinically.