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In the submitted case-history the authors publish the case of successful treatment of a 9-year-old girl whose life was at risk after intoxication with a large dose of amitriptyline. Concurrently they deal with the social background of emotional disorders and some peculiar features in this girl with suicidal behaviour; attention is also drawn to specific features of the psychopathological picture of psychiatric child morbidity.

In a 21-day investigation in 15 patients with depression the authors investigated the incidence of undesirable side-effects in relation to plasma amitriptyline levels. The authors found the upper range of plasma concentrations when the patient's risk is minimal as regards serious undesirable complications. This upper limit is 350 micrograms/l; as compared with previous work, they consider amitriptyline levels from 150 to 350 350 micrograms/l safe and therapeutically effective. The authors consider investigation of plasma levels indicated in risk patients and in patients with an inadequate response to treatment.

The authors assessed in a 21-day investigation the levels of amitriptyline and its metabolites in plasma and saliva, using the RIA method, in an attempt to reveal the relationship between the therapeutic effect and the assessed concentrations. They did not find a clear relationship between the therapeutic effect and plasma levels; when eliminating extreme maximal and minimal values, we may speak of concentrations where clinical improvement is recorded: from 150 to 450 micrograms/l. The concentration in saliva correlated at higher levels with the plasma concentration; this gives a theoretical chance of screening by this method. From the clinical aspect it is essential to express an opinion on the development of side-effects in relation to plasma levels. This problem will be discussed in a subsequent paper.