Plasma Levels of Imipramine (IMI) and Desmethylimipramine (DMI) and Clinical Response in Prepubertal Major Depressive Disorder: A Preliminary Report

A study is in progress to examine the relationship between clinical response to imipramine (IMI) of prepubertal major depressive disorder at 5 weeks and plasma levels of IMI and its metabolite desmethylimipramine (DMI). Data are presented on the first 13 children in the study. A strong correlation is emerging in nondelusional subjects between total plasma level and clinical response. A total plasma level of 146 ng/ml separates respondent from nonresponders. These data parallel those previously reported in adult major depressive disorder by several investigators.