MedWorm: Amitriptyline

  Effect of Intravenous Lidocaine on Manifestations of Fibromyalgia

Conclusions: The addition of 240 mg intravenous lidocaine (once a week) to 25 mg amitriptyline for 4 weeks did not modify pain intensity or manifestations in patients with fibromyalgia compared with amitriptyline alone. (Source: Pain Practice)

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  AMITRIPTYLINE (Amitriptyline Hydrochloride) Tablet, Film Coated [STAT RX USA LLC]

Updated Date: Feb 24, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Contract Pharmacy Services-PA]

Updated Date: Feb 24, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Video-assisted intercostal nerve cryoablation in managing intractable chest wall pain

A 52-year-old women was referred to our unit with severe pain in the right side of the chest, having been kicked in the right flank by a horse 10 years earlier. At the time she sustained fractures to the right 10th, 11th, and 12th ribs and briefly required hospitalization. The pain was sharp and stabbing in nature. Standard oral analgesia including nonsteroidal anti-inflammatory drugs was ineffective. She obtained little relief from opiates and was reluctant to take them long term. Some transient analgesia was obtained through epidurals and intercostal nerve blocks. She had been managed with gabapentin 800 mg twice daily and amitriptyline 25 mg daily long term. (Source: The Journal of Thoracic and Cardiovascular Surgery)

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  Trigeminal trophic syndrome treated with thermoplastic occlusion

A 72-year-old man with a history of thrombotic CVA causing lateral medullary infarction presented with non-healing ulcers of the right side of the face of 5 months' duration. After extensive investigations, a diagnosis of trigeminal trophic syndrome was made. The ulcers progressed relentlessly despite amitriptyline and gabapentin, and he was treated with a combination of carbamazepine and thermoplastic mask occlusion of the right side of his face. Over the next 10 weeks the shallower facial ulcers began to diminish in depth and diameter, and the deeper ulcers stopped progressing. Although the patient showed early signs of healing, he died because of complications from the CVA. (Source: Australasian Journal of Dermatology)

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  Low-dose amitriptyline for treatment of persistent arm pain due to repetitive use

In conclusion, this study found that low-dose amitriptyline did not significantly decrease arm pain among these participants but did significantly improve arm function and well being. Future research is needed to explore the effects of higher doses and longer duration of treatment. (Source: Pain)

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  Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not ade...

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Sandoz Inc]

Updated Date: Feb 12, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Amitriptyline/antiretrovirals/disulfiram/nifedipine: Fatal lactic acidosis: case report

(Source: Reactions)

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  Validated assay for studying activity profiles of human liver UGTs after drug exposure: inhibition and induction studies.

Authors: Donato MT, Montero S, Castell JV, Gómez-Lechón MJ, Lahoz A UDP-glucuronsyltransferases (UGTs) are a family of conjugating enzymes that participate in the metabolism of many drugs. The study of potential drug-drug interactions involving UGTs has been largely hindered by the limited availability of selective functional assays for individual UGT enzymes. We propose a sensitive and reproducible procedure for the activity measurements of four major human hepatic UGT forms. The assays are based on analysis and quantification by high-performance liquid chromatography-tandem mass spectrometry of glucuronides formed from selective probe substrates, namely, beta-estradiol (UGT1A1, 3-glucuronide), 1-naphthol (UGT1A6), propofol (UGT1A9), and naloxone (UGT2B7). The analytical met...

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  An in vitro approach to estimate putative inhibition of buprenorphine and norbuprenorphine glucuronidation

Abstract  An in vitro inhibition study was performed to investigate potential drug–drug interactions on glucuronidation of buprenorphine (BUP) and norbuprenorphine (NBUP), which represents the major elimination pathway of the drug using cDNA-expressed uridine 5′-diphosphate glucuronosyltransferases (UGTs) and human liver microsomes (HLMs). Following identification of major UGT enzymes for BUP and NBUP glucuronidation, substrates were incubated with drugs (amitriptyline, nortriptyline, lamotrigine, oxazepam, and temazepam), which are extensively cleared by glucuronidation as well as are often used during maintenance treatment. To evaluate the inhibitory potential, the half maximal inhibitor concentration (IC50), the inhibition constant (K i), and the inhibitor concentrat...

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  Treatment of cyclic vomiting syndrome with co-enzyme Q10 and amitriptyline, a retrospective study

Conclusion: Our data suggest that the natural food supplement Co-Q is potentially efficacious and tolerable in the treatment of CVS, and should be considered as an option in CVS prophylaxis. Our data would likely be helpful in the design of a double-blind clinical trial. (Source: BMC Neurology)

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  Treatments for neuropathic pain differentially affect delayed matching accuracy by macaques: Effects of amitriptyline and gabapentin

Abstract: Current clinical treatments for neuropathic pain include amitriptyline, a tricyclic antidepressant with mixed pharmacology that is also clinically reported to impair cognitive performance; and gabapentin, a compound that selectively interacts with α2δ-1 calcium channel subunits. Since few assessments of cognitive performance have been made in non-human primates with these marketed treatments, the purpose of this study was to determine their relative abilities to alter working memory as measured in mature macaques in their performance of a delayed matching-to-sample task. Four delay intervals of increasing duration provided increasing impairment in task accuracies during vehicle sessions. Administration of clinically relevant doses of amitriptyline significantly decreased task a...

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  Epicrania Fugax: Ten New Cases and Therapeutic Results

Conclusions.[mdash] This description reinforces the proposal of EF as a new headache variant or a new headache syndrome. Anesthetic blockades, carbamazepine, gabapentin, and lamotrigine have been apparently effective in individual patients. Further observations and therapeutic trials are needed. (Source: Headache: The Journal of Head and Face Pain)

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  Epicrania Fugax: Ten New Cases and Therapeutic Results.

Conclusions.- This description reinforces the proposal of EF as a new headache variant or a new headache syndrome. Anesthetic blockades, carbamazepine, gabapentin, and lamotrigine have been apparently effective in individual patients. Further observations and therapeutic trials are needed. PMID: 20100299 [PubMed - as supplied by publisher] (Source: Headache)

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  A case of rheumatoid arthritis presenting with postherpetic neuralgia and abdominal-wall pseudohernia

We report a patient >45 years of age with a history of rheumatoid arthritis (RA) who presented with two chronic HZ complications. A 75-year-old woman was admitted with neuralgia following cutaneous herpes zoster 6 weeks before. She was on long-term glucocorticoid, antimalarial and non-steroidal anti-inflammatory treatment. Confluent ulcers began to fill with granulation tissue, crusts, scars and skin discoloration in the area of the left T12-L2 dermatomes and reducible, painless swelling of the left flank, 20 × 20 cm, without palpable defect in abdominal-wall. There were typical joint deformity and positive rheumatoid factor. On neurological examination superficial abdominal reflexes were diminished in the left side, with hypesthesia of the overlying skin...

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  Amitriptyline/bupropion/fluspirilene interaction: First report of an interaction, leading to tonic-clonic seizure in a sleep-deprived patient: case report

(Source: Reactions)

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  Sphingomyelinase dependent apoptosis of dendritic cells following treatment with amyloid peptides

In conclusion, amyloid peptides induce DC apoptosis presumably through activation of acid sphingomyelinase resulting in production of ceramide. (Source: Journal of Neuroimmunology)

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  Comparative study of clinical efficacy with amitriptyline, pregabalin, and amitriptyline plus pregabalin combination in postherpetic neuralgia

Achar Arun, Chatterjee Gobinda, Ray Tapobrata Guha, Naskar BiswanathIndian Journal of Dermatology, Venereology, and Leprology 2010 76(1):63-65 (Source: Indian Journal of Dermatology, Venereology and Leprology)

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  Placebo Comparable to Amitriptyline for Functional Abdominal Pain

(Source: AAP Grand Rounds)

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  Long-Term Results of Amitriptyline Treatment for Interstitial Cystitis.

CONCLUSIONS: Long-term administration of amitriptyline is a feasible, safe and effective treatment for IC provided that the drug is used -judiciously to minimise adverse effects. The therapeutic response to amitriptyline was uniformly observed in patients fulfilling the NIDDK criteria and in those patients with the pure clinical diagnosis of IC. PMID: 20094958 [PubMed - as supplied by publisher] (Source: Aktuelle Urologie)

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  Interaction of the human plasma membrane monoamine transporter (hPMAT) with antidepressants and antipsychotics

Abstract  Monoamine neurotransmission is efficiently terminated through synaptic reuptake of released neurotransmitters by high-affinity Na+- and Cl−-dependent neuronal monoamine transporters of the SLC6A family located in the plasma membrane of presynaptic nerve terminals. Recently, a low-affinity, high-capacity Na+- and Cl−-independent plasma membrane monoamine transporter (PMAT) belonging to the SLC29 solute carrier family has been cloned. PMAT was shown to transport monoamine neurotransmitters as well as organic cations such as 1-phenyl-4-methyl-pyridinium (MPP+). Thus, the PMAT which is highly expressed in the human brain may be involved in the modulation of central monoaminergic neurotransmission and it may be a target for drugs used to treat depression and schizoph...

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  Modulatory effects of neuropsychopharmaca on intracellular pH of hippocampal neurones in vitro

Conclusion and implications: These data substantiate the view that clinically relevant concentrations of neuroleptics and antidepressants can mediate changes in neuronal pHi, which may contribute to their pharmacological mode of action. Effects on pHi should be taken into account when therapeutic or even harmful effects of these drugs are evaluated. (Source: British Journal of Pharmacology)

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  Effects of antidepressant treatment on heart rate variability in major depression: a quantitative review

Source: DARE Area: Evidence > Medication Safety CRD Summary: This review concluded that the use of tricyclic antidepressants in patients diagnosed with major depressive disorder lead to changes in heart rate variability that were associated with an increased risk of mortality. The authors' conclusions appeared to reflect the evidence but, given the methodological limitations, these conclusions should be interpreted with caution as they may not be reliable. [Of the included studies, tricyclic antidepressants included amitriptyline, imipramine and doxepin. Selective serotonin reuptake inhibitor medications included fluvoxamine, paroxetine and fluoxetine. Other drugs included bupropion, mirtazapine, nefazodone and reboxetine. ] CRD Commentary: This review addressed a clear question in t...

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  Gabapentin versus tricyclic antidepressants for diabetic neuropathy and post-herpetic neuralgia: discrepancies between direct and indirect meta-analyses of randomized controlled trials

Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review concluded that there was no difference in pain relief between gabapentin and tricyclic antidepressants in patients with diabetic neuropathy or post-herpetic neuralgia, although direct evidence was limited. The review was well conducted and these findings are likely to be reliable. [Tricyclic antidepressants evaluated included nortriptyline, amitriptyline, desipramine, imipramine and clomipramine. ] CRD Commentary: The review addressed a focused question supported by clearly defined inclusion criteria. The literature search was limited to two electronic databases and some attempts were made to minimise publication bias; the potential for this was assessed and some evidence was found for tricyclic studie...

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Mylan Pharmaceuticals Inc.]

Updated Date: Nov 24, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Drugs and dilated cardiomyopathies: a case/noncase study in the French PharmacoVigilance Database

CONCLUSIONS The present study describes an association between some drugs and reports of dilated cardiomyopathies. This relationship involves not only some already suspected drugs (anthracyclines, antiretrovirals), but also other drugs (antipsychotics, lithium, antidepressants, retinoids) less known to induce such an ADR. Despite the mandatory limits of this kind of study (underreporting, confounding factors . . .), these data represent a pharmacovigilance signal and could contribute to establish further prospective studies in order to confirm such signals. (Source: British Journal of Clinical Pharmacology)

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  Analysis of the antinociceptive interactions in two-drug combinations of gabapentin, oxcarbazepine and amitriptyline in streptozotocin-induced diabetic mice.

We examined the effects of two-drug combinations of gabapentin, oxcarbazepine, and amitriptyline on nociception in diabetic mice and aimed to determine the type of interaction between components. The nociceptive responses in normal and diabetic mice were assessed by the tail-flick test. The testing was performed before and three weeks after the diabetes induction with streptozotocin (150mg/kg; i.p.), when the antinociceptive effects of gabapentin, oxcarbazepine, amitriptyline and their two-drug combinations were examined. Gabapentin (10-40mg/kg; p.o.) and oxcarbazepine (20-80mg/kg; p.o.) produced a significant, dose-dependent antinociception in diabetic mice while amitriptyline (5-60mg/kg; p.o.) produced weak antinociceptive effect. In normal mice, neither of the drugs produced antinocicep...

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Qualitest Pharmaceuticals]

Updated Date: Nov 4, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Effect of amitriptyline vs. physiotherapy in management of fibromyalgia syndrome: What predicts a clinical benefit?

Conclusions : Therapy with amitriptyline or physiotherapy is equally effective in improving outcome in patients of fibromyalgia over a period of six months. (Source: Journal of Postgraduate Medicine)

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  Involuntary Emotional Expression Disorder

, or IEED, is a condition in which a person experiences uncontrollable episodes of emotional expression. That is, they have episodes of crying, laughter, or anger that are not in line with their present mood. The condition is also known as labile affect, pseudobulbar affect, emotional lability, and pathological laughing and crying. It can have a severe impact on the lives of both patients and caregivers, as symptoms may leave sufferers feeling guilty, awkward, embarrassed and reluctant to take part in social interaction. IEED is seen most often following brain injury or in people with dementia, motor neuron disease, and multiple sclerosis. It can appear at any stage of the associated diseases. Its prevalence was estimated in 2007 by Walter Bradley, MD, of Miami University. His team survey...

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  Spectrophotometric and chromatographic simultaneous estimation of amitriptyline hydrochloride and chlordiazepoxide in tablet dosage forms

Patel Sejal, Patel N JIndian Journal of Pharmaceutical Sciences 2009 71(4):472-476A binary mixture of amitriptyline HCl and chlordiazepoxide was determined by three different methods. The first method involved determination of amitriptyline HCl and chlordiazepoxide using the first derivative spectrophotometric technique at 219 and 230 nm over the concentration ranges of 1-20 and 2-24 μg/ml with mean accuracies 100.9±0.87 and 99.2±1.0%, respectively. The second method was reversed-phase high performance liquid chromatography using methanol: acetonitrile: 0.065 M ammonium acetate buffer (50:20:30, v/v/v), final pH adjust to 5.5 ± 0.02 with ortho phosphoric acid as the mobile phase and was pumped at a flow rate of 1.0 ml/m...

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  Delusion of Oral Parasitosis and Thalamic Pain Syndrome [CASE REPORTS]

DISCUSSION: The authors speculate that this specific type of delusion can be elicited by the disruption of the somatosensory pathway and that the subsequent cortical sensory deafferentiation and reorganization arising from this disruption may contribute to the development of delusional parasitosis. (Source: Psychosomatics)

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  Idiopathic Trigeminal Neuropathies: A Presentation of 15 Cases

Conclusion: Of the idiopathic trigeminal neuropathies, half were acute and half were chronic. Mild pain presented more frequently in the chronic patients and was relieved with amitriptyline. (Source: Journal of Oral and Maxillofacial Surgery)

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  Amphiphilic drug persuaded collapse of polyvinylpyrrolidone and poly(ethylene glycol) chains: A dynamic light scattering study.

Authors: Ali MS, Ghosh G, Kabir-Ud-Din Light scattering has proved to be useful in characterizing colloidal systems. We have studied the interaction between an amphiphilic drug, amitriptyline hydrochloride (AMT), and neutral polymers, polyvinylpyrrolidone (PVP) and poly(ethylene glycol) (PEG), using the dynamic light scattering (DLS) technique. AMT was found to interact with PVP more strongly than PEG. A large decrease of the size of aggregates upon increase of AMT concentration indicates a successive collapse of the polymer conformation. The partial negatively charged oxygen atoms, present in the amide group of PVP, were believed to be responsible for the collapse while interacting with the cationic head group of AMT. Presence of NaBr in the solution enhanced the effect markedly and ...

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  QT Alterations in Psychopharmacology: Proven Candidates and Suspects.

Authors: Alvarez PA, Pahissa J Psychotropics are among the most common causes of drug induced acquired long QT syndrome. Blockage of Human ether-a-go-go-related gene (HERG) potassium channel by psychoactive drugs appears to be related to this adverse effect. Antipsychotics such as haloperidol, thioridazine, sertindole, pimozide, risperidone, ziprasidone, quetiapine, olanzapine and antidepressants such as amitriptyline, imipramine, doxepin, trazadone, fluoxetine depress the delayed rectifier potassium current (IKr) in a dose dependent manner in experimental models. The frequency of QTc prolongation (more than 456ms) in psychiatric patients is estimated to be 8%. Age over 65 years, tricyclic antidepressants (TCA), thioridazine, droperidol, olanzapine, and higher antipsychotic doses were ...

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  In Child Pain Relief, Antidepressant And Placebo Found To Be Equally Effective

When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To view this article's video abstract, go to the AGA's YouTube Channel at http://www.youtube.com/AmerGastroAssn... (Source: Irritable-Bowel Syndrome News From Medical News Today)

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  In Child Pain Relief, Antidepressant And Placebo Found To Be Equally Effective

When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To view this article's video abstract, go to the AGA's YouTube Channel at http://www.youtube.com/AmerGastroAssn. (Source: Health News from Medical News Today)

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  Antidepressant And Placebo Are Equally Effective In Child Pain Relief

When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children. (Source: ScienceDaily Headlines)

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  Children's Belly Aches Don't Disappear With Antidepressant

Elavil worked no better than placebo in study of kids with gastrointestinal disorders (Source: Forbes.com Health News)

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  Children's Belly Aches Don't Disappear with Antidepressant

Elavil worked no better than placebo in study of kids with gastrointestinal disorders Source: HealthDay Related MedlinePlus Topics: Antidepressants, Children's Health, Digestive Diseases (Source: MedlinePlus Health News)

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  Antidepressant or placebo?

When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children, as per a newly released study in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute. To view this article's video abstract, go to the AGA's YouTube Channel at www.youtube.com/AmerGastroAssn........ (Source: Medicineworld.org: New Article Alert)

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  Antidepressant and placebo are equally effective in child pain relief

(American Gastroenterological Association) When used "off-label," the antidepressant amitriptyline works just as well as placebo in treating pain-predominant gastrointestinal disorders in children. (Source: EurekAlert! - Medicine and Health)

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Major Pharmaceuticals]

Updated Date: Sep 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  The synergistic interaction between morphine and maprotiline after intrathecal injection in rats.

CONCLUSIONS: Selective norepinephrine reuptake inhibitors can significantly increase the intensity and duration of morphine antinociceptive activity via both alpha(2)-adrenergic and opioid receptors. This interaction was not observed with the selective serotonin inhibitor, citalopram. PMID: 19762762 [PubMed - in process] (Source: Anesthesia and Analgesia)

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  Amitriptyline upregulates EAAT1 and EAAT2 in neuropathic pain rats.

Authors: Mao QX, Yang TD Excitatory amino acid transporters (EAATs) appear to participate in the pathogenesis of neuropathic pain. The present study was performed to evaluate the effects of the tricyclic antidepressant amitriptyline on the expressions of EAATs in neuropathic pain rats. Using spared nerve injured (SNI) male Sprague Dawley rats, we found that SNI induced an initial EAATs upregulation on postoperative day 1 within the ipsilateral spinal cord dorsal horn, followed by a downregulation on postoperative days 3 and 5. Intraperitoneal administration of amitriptyline reversed the downregulation of EAATs in SNI rats on postoperative days 3 approximately 5 and attenuated the mechanical allodynia. We further demonstrated that administration of amitriptyline alone induced an upregul...

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  Perisurgical amitriptyline produces a preventive effect on afferent hypersensitivity following spared nerve injury

This study indicates that tricyclic antidepressants given in the perioperative period may be useful in preventing nerve injury-induced sensory changes that contribute to the development of chronic post-surgical neuropathic pain. (Source: Pain)

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  Prophylactic Drugs and Cytokine and Leptin Levels in Children With Migraine

The study objective was to evaluate levels of the cytokines tumor necrosis factor α, interleukin-1β, and interleukin-6 and of leptin, and then to determine the relationship between these levels and clinical responses in children with migraine after prophylactic therapy with one of four drugs. In all, 77 children who needed prophylactic drugs were treated with cyproheptadine, amitriptyline, propranolol, or flunarizine. Serum levels of the cytokines and leptin were measured before and 4 months after the treatment. Results were compared by drug for headache frequency, severity, and duration, the PedMIDAS score, and levels of each cytokine and of leptin. Each of the four drugs not only decreased the frequency and duration but also the severity of headache, and the PedMIDAS score. None of the...

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  Acquired neuromyotonia following upper respiratory tract infection: a case report

We present a 37-year-old male subject who presented with burning sensations in his hands and feet with generalised twitching of his limbs, trunk and face. His symptoms developed 2 weeks after an upper respiratory tract infection. There was associated facial flushing and disturbed night sleep but no memory impairment or generalised sweating. Examination showed generalised myokymia and fasciculations and electromyography revealed widespread continuous semi-rhythmic doublets and triplets of low frequency with interspersed silent periods. Anti voltage gated potassium channel (VGKC) antibodies, antinuclear antibodies, anti-acetylcholine receptor antibodies and the anti-neuronal antibodies anti Hu, anti Yo and anti Ri were all negative. His symptoms improved slightly on lamotrigine and amitripty...

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  The Power of Placebo in Pediatric Functional Gastrointestinal Disease

See “Multicenter, randomized placebo-controlled trial of amitriptyline in children with functional gastrointestinal disorders,” by Saps M, Youssef N, Miranda A, et al, on page 1261. (Source: Gastroenterology)

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  The neuraxial effects of intraspinal amitriptyline at low concentrations.

CONCLUSION: The intraspinal administration of amitriptyline to dogs even in low concentrations is strongly associated with the development of intense meningeal adhesive arachnoiditis and is not safe even at low concentrations for which there was no previous evidence of toxicity. PMID: 19690274 [PubMed - in process] (Source: Anesthesia and Analgesia)

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  Low concentrations of amitriptyline inhibit nicotinic receptors in unmyelinated axons of human peripheral nerve

Conclusions and implications: These data demonstrate that low concentrations of amitriptyline suppress the response of human peripheral C-type axons to nicotine by directly inhibiting nAChRs. Blockade of tetrodotoxin-sensitive, voltage-dependent sodium channels does not contribute to this effect. An inhibitory action of amitriptyline on nAChRs in unmyelinated nociceptive axons may be an important component of amitriptyline's therapeutic effect in the treatment of neuropathic pain. (Source: British Journal of Pharmacology)

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  Effects of amitriptyline, a tricyclic antidepressant, on smooth muscle reactivity in isolated rat trachea

Conclusion  The results suggest that amitriptyline does not influence tracheal smooth muscle reactivity at clinical concentrations (<1 μM), but attenuates the reactivity at supraclinical concentrations (≥1 μM). The attenuated response to ACh brought about by amitriptyline is presumably due, at least in part, to the inhibition of phosphatidylinositol (PI) metabolism. The ability of amitriptyline to inhibit the calyculin Ainduced contraction suggests that amitriptyline also inhibits the Ca2+-calmodulin-myosin light chain pathway independently of the inhibition of PI metabolism. Finally, the difference between the IC50 values for SPC-induced contraction and those for calyculin A-induced contraction suggests that amitriptyline may also inhibit the Rho-kinase pathway. ...

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  Tricyclic Antidepressants

This article covers how tricyclic antidepressants work, allergies, pregnancy and breast-feeding, side effects common to the medication family, and interactions with drugs and alcohol. (Source: About.com Bipolar Disorder)

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  New to forum, 3rd day on suboxone...

Author: jamez70 Posted: Thu Aug 13, 2009 12:22 am Diary, I have had SEVERE SEVERE anxiety in my life. Let me try to describe it. Suddenly, out of nowhere, I have a severe panic attack without any real reason (no phobia). I try to go on.. That night, I have another one. I then become afraid to sleep in my bed, because I associate it with the panic attack. Then about 8 hours later, I have another one. Then I wonder "whats wrong with me? Do I have a tumor? Did I have a stroke?".. Then they keep coming and coming. Eventually, I enter a constant state of severe anxiety.. I sleep very little, and I stop eating. I get afraid to leave the house. Usually by that time, I seek out a psychiatrist, and I'm on the waiting list. TH...

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  Amitriptyline for pain control in scleritis may help to avoid excessive steroid use in selected cases: a case report

Conclusion: Amitriptyline may be an effective option for pain control in case with scleritis which might otherwise require unnecessarily large doses of immunosuppression. (Source: Cases Journal)

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  Digest

Antidepressant RCTs meaningful?The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial of sequenced anti-depressant therapy recruited a broad population of patients representative of outpatients with depression seeking treatment. By contrast, most randomised controlled trials (RCTs) have more restrictive eligibility criteria. STAR*D investigators have now used their data to assess the impact of this aspect of trial design (Am J Psychiatry 2009;166:599-67).They divided 2855 STAR*D participants into a group meeting standard eligibility criteria based on HAM-D score >19, lack of comorbidity and duration of current episode less than 24 months (22 per cent) and a second group who did not meet these criteria.Those meeting standard criteria were more likely to be seen in special...

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  Amitriptyline vs. pregabalin in painful diabetic neuropathy: a randomized double blind clinical trial

Conclusions As there are few differences between the two treatments in efficacy, pregabalin 150 mg twice daily might be the alternative choice as it is associated with fewer adverse effects in our population. (Source: Diabetic Medicine)

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  An Insatiable Itch

A 77-year-old Caucasian female with a history of asthma, high cholesterol, degenerative joint disease, and stroke presents for assistance in managing post-zoster scalp itch. The patient had shingles approximately 2 years before the clinic visit with lesions in the left V1 distribution. She had a 7-day course of valacyclovir and the rash resolved within 2 weeks. After the rash resolved, she had about 2 weeks of pain, followed by constant, unrelenting pruritus in the same distribution. She had no current pain, numbness, or vision problems. The pruritus is a 3/10 with occasional exacerbations to 5/10. She gets temporary relief from scratching and will scratch while sleeping. There are no other obvious aggravating or alleviating factors. She has had no significant relief with desonide 0.05% lo...

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  Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder

Conclusions: GPs in Germany often prescribe medications that have been designated as potentially inappropriate to their elderly patients with GAD--especially those with comorbid depressive disorders. Further research is needed to ascertain whether there are specific subgoups of elderly patients with GAD for whom the benefits of these medications outweigh their risks. (Source: BMC Geriatrics)

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  Acid Sphingomyelinase Inhibitors Normalize Pulmonary Ceramide and Inflammation in Cystic Fibrosis.

Conclusion: These findings employing several structurally different Asm inhibitors identify Asm as primary target in the lung to reduce ceramide concentrations. Inhaling an Asm inhibitor may be a beneficial treatment for CF, with minimal adverse systemic effects. PMID: 19635928 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory Cell and Molecular Biology)

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  [Off-label use of psychotropic medications in paediatric wards: A prospective study.]

CONCLUSION: The high rates of off-label prescription documented here and elsewhere highlight the need for further controlled clinical trials to evaluate the risks and benefits of psychotropic medication in children and adolescents. PMID: 19640689 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)

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  Amitriptyline/citalopram overdose: Cardiogenic shock in an elderly patient treated with insulin: case report

(Source: Reactions)

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  AMITRIPTYLINE HYDROCHLORIDEtablet, Film Coated [Qualitest Pharmaceuticals]

Updated Date: Jul 24, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Antidepressant Directly Stimulates Brain Growth Factor Receptors

The tricyclic antidepressant amitriptyline can directly bind and stimulate the growth factor receptors TrkA and TrkB in the brain. Other antidepressants do not have the same properties. The finding suggests a distinct mechanism by which some antidepressant and pain relief compounds may function. (Source: ScienceDaily Headlines)

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  HPLC of basic drugs using non-aqueous ionic eluents: evaluation of a 3 mum strong cation-exchange material.

Authors: Morgan PE, Manwaring V, Flanagan RJ HPLC columns packed with 3 mum particle size HPLC Technology Techsphere SCX (propylsulfonic acid-modified) silica offer considerable advantages over 5 mum SCX packings in the analysis of basic drugs using 100% methanol eluents containing an ionic modifier such as ammonium perchlorate. The basic drugs studied included clozapine and norclozapine, olanzapine, quinine and quinidine, and amitriptyline, nortriptyline, imipramine and desipramine. The 3 mum column was not only more efficient for a given column length compared with 5 mum materials, but also elution times were less, a phenomenon observed in reversed-phase systems. The high efficiencies and excellent peak shapes obtained with the 3 mum SCX-modified packing together with the relatively ...

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  Headache (chronic tension-type)

New option(s) added for: Anticonvulsant drugs New option added, for which we found no systematic review or RCTs. Categorised as Unknown effectiveness. Spinal manipulation (chiropractic and osteopathic treatment) Two systematic reviews and one further RCT added to benefits and harms. One RCT identified by one review found greater reduction in headache severity after treatment with palpatory examination plus osteopathic manipulation versus palpatory examination alone or versus instruction to rest in people with muscle tension-type headache. One RCT identified by both reviews found a reduction in headache intensity with amitriptyline versus spinal manipulation after 6 weeks’ treatment, but no significant reduction in headache f...

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  Efficacy of venlafaxine compared with tricyclic antidepressants in depressive disorder: a meta-analysis

AbstractWith respect to the pharmacological characteristic, venlafaxine is comparable with tricyclic antidepressants (TCAs), and venlafaxine might be comparable in efficacy. We performed a systematic review investigating the relative efficacy and tolerability of venlafaxine compared with TCAs (imipramine, clomipramine, amitriptyline, nortriptyline and desipramine). Relevant double-blind randomised trials were identified from systematic searches of electronic databases. An exact analysis of the estimated odds ratios of response of the TCA relative to venlafaxine showed no overall significance of treatment effect (P = 0.38). The odds ratios were not homogenous across studies (P = 0.0213). The average dose of venlafaxine was 103.5 mg/day and for the TCA 106.1 mg/day. An exact analysis of the ...

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  Effects of oxotremorine and physostigmine on the inhibitory avoidance impairment produced by amitriptyline in male and female mice.

Authors: Monleón S, Urquiza A, Vinader-Caerols C, Parra A We have previously observed that amitriptyline and other antidepressants produce impairing effects on inhibitory avoidance (also called passive avoidance) in mice of both sexes. In the present study we investigated the involvement of the cholinergic system in the inhibitory avoidance impairment produced by acute amitriptyline in male and female CD1 mice. For this purpose, the effects on said task of acute i.p. administration of several doses of amitriptyline, either alone or in combination with the cholinergic agonists oxotremorine and physostigmine, were evaluated. Pre-training administration of 5, 7.5, 10 or 15mg/kg of amitriptyline produced a significant impairment of inhibitory avoidance in both males and females. When ...

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  Amitriptyline: Sedation, dry mouth and constipation in pregnancy: case report

(Source: Reactions)

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  Multicenter, Randomized, Placebo-Controlled Trial of Amitriptyline in Children With Functional Gastrointestinal Disorders

Conclusions: Both amitriptyline and placebo were associated with excellent therapeutic response. There was no significant difference between amitriptyline and placebo after 4 weeks of treatment. Patients with mild to moderate intensity of pain responded better to treatment. (Source: Gastroenterology)

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  Amitriptyline: Sedation, dry mouth and constipation in pregnancy: case report.

Page: 7 (Source: Reactions Weekly)

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  Amitriptyline overdose: Acute intoxication leading to fatal asphyxia?: case report.

Page: 6 (Source: Reactions Weekly)

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  Pharmacological characterization of standard analgesics on mechanical allodynia in streptozotocin-induced diabetic rats.

Authors: Yamamoto H, Shimoshige Y, Yamaji T, Murai N, Aoki T, Matsuoka N The present study was designed to investigate the anti-allodynic effects of current analgesic agents, such as pregabalin, amitriptyline, mexiletine, morphine, and diclofenac, in a rat model of streptozotocin (STZ)-induced diabetic neuropathy. Diabetic rats developed a sustained decrease in withdrawal threshold response to the von Frey test within 8 weeks after a single injection of STZ (45 mg/kg, i.v.). The anti-allodynic effects of analgesic agents were examined after a single oral or subcutaneous administration at 3 and 7 weeks after beginning of STZ treatment. Pregabalin (3-30 mg/kg, p.o.), an antiepileptic agent, dose-dependently blocked the mechanical allodynia in rats treated both at 3 and 7 weeks. Mexiletin...

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  Amitriptyline overdose: Acute intoxication leading to fatal asphyxia?: case report

(Source: Reactions)

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  Therapeutic Efficacy and Safety of Amitriptyline in Patients with Cystic Fibrosis

Cell Physiol Biochem 2009;24:65-72 (DOI:10.1159/000227814) (Source: Cellular Physiology and Biochemistry)

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  Amitriptyline: Myoclonus: case report

(Source: Reactions)

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  Antidepressant Directly Stimulates Brain Growth Factor Receptors

The widely used antidepressant and pain medication amitriptyline--but not other closely related drugs -- can impersonate the brain's own growth factors, researchers at Emory University School of Medicine have shown. The results are published online and will appear in the June 26 issue of the journal Chemistry & Biology. (Source: Health News from Medical News Today)

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  [The role of the neuromodulators in the preventive treatment of migraine.]

CONCLUSIONS. Topiramate and valproic acid have demonstrated efficacy in migraine prevention. Lamotrigine is efficacious for the treatment of migraine aura. Even though new studies are necessary, zonisamide could be a good option for the preventive treatment of migraine. PMID: 19557697 [PubMed - in process] (Source: Revista de Neurologia)

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  Amitriptyline: Myoclonus: case report.

Page: 4 (Source: Reactions Weekly)

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  Amitriptyline withdrawal: Mania: case report.

Page: 7 (Source: Reactions Weekly)

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  Amitriptyline is a TrkA and TrkB receptor agonist that promotes TrkA/TrkB heterodimerization and has potent neurotrophic activity.

We report here that amitriptyline, an antidepressant drug, directly binds TrkA and TrkB and triggers their dimerization and activation. Amitriptyline, but not any other tricyclic or selective serotonin reuptake inhibitor antidepressants, promotes TrkA autophosphorylation in primary neurons and induces neurite outgrowth in PC12 cells. Amitriptyline binds the extracellular domain of both TrkA and TrkB and promotes TrkA-TrkB receptor heterodimerization. Truncation of amitriptyline binding motif on TrkA abrogates the receptor dimerization by amitriptyline. Administration of amitriptyline to mice activates both receptors and significantly reduces kainic acid-triggered neuronal cell death. Inhibition of TrkA, but not TrkB, abolishes amitriptyline's neuroprotective effect without impairing its an...

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  Amitriptyline withdrawal: Mania: case report

(Source: Reactions)

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  Antidepressant directly stimulates brain growth factor receptors

(Emory University) The tricyclic antidepressant amitriptyline can directly bind and stimulate the growth factor receptors TrkA and TrkB in the brain. Other antidepressants do not have the same properties. The finding suggests a distinct mechanism by which some antidepressant and pain relief compounds may function. (Source: EurekAlert! - Social and Behavioral Science)

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  Plasma amitriptyline level after acute administration, and driving performance in healthy volunteers. - Iwamoto K, Kawamura Y, Takahashi M, Uchiyama Y, Ebe K, Yoshida K, Iidaka T, Noda Y, Ozaki N.

AIMS: Amitriptyline triggers the impairment of cognitive and motor functions and has been confirmed to have harmful effects on driving performance. Although interindividual differences in plasma concentration may cause variations in driving performance, th... (Source: SafetyLit: All (Unduplicated))

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  A Randomized, Placebo-Controlled Clinical Trial of Chiropractic and Medical Prophylactic Treatment of Adults With Tension-Type Headache: Results From a Stopped Trial

Conclusion: Although the sample size was smaller than initially required, a statistically significant and clinically important effect was obtained for the combined treatment group. There are considerable difficulties with recruitment of subjects in such a trial. This trial should be replicated with a larger sample. (Source: Journal of Manipulative and Physiological Therapeutics)

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  Disputed case of homicide by smothering due to severe amitriptyline intoxication of the victim

We report a fatal case of a female for whom the forensic autopsy revealed injuries to the external respiratory orifices indicating smothering. Subsequent postmortem toxicological analysis confirmed heavy amitriptyline acute intoxication. The victim had serious psychological problems, was under long-term treatment with antidepressants and was a systematic alcohol abuser. Forensic autopsy determined damage to the external airways, along with multiple formal petechial hemorrhages (Tardieu) in various parts of the body. The presence of amitriptyline, nortriptyline and 10-hydroxynortriptyline was confirmed by GC–MS and quantified by HPLC in blood (7.0μg/ml amitriptyline and 7.4μg/ml nortriptyline). The cause of death was disputed between severe intoxication (poisoning or suicide attempt) an...

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  Amitriptyline overdose: Various toxicities: case report

(Source: Reactions)

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  Amitriptyline/aripiprazole overdose: Sedation, dizziness and unstable gait: case report

(Source: Reactions)

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  Amitriptyline/remifentanil interaction: Refractory hypotension in an elderly patient: case report

(Source: Reactions)

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  Amitriptyline overdose: Various toxicities: case report.

Page: 6 (Source: Reactions Weekly)

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  Amitriptyline/aripiprazole overdose: Sedation, dizziness and unstable gait: case report.

Page: 6 (Source: Reactions Weekly)

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  Amitriptyline/remifentanil interaction: Refractory hypotension in an elderly patient: case report.

Page: 7 (Source: Reactions Weekly)

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  Amitriptyline overdose: Coma, tonic-clonic seizures and ventricular tachycardia in a child: case report

(Source: Reactions)

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  Amitriptyline overdose: Coma, tonic-clonic seizures and ventricular tachycardia in a child: case report.

Page: 8 (Source: Reactions Weekly)

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  Antidepressants: Brand Name or Generic?

For many antidepressants, the issue of brand-name versus generic has no practical significance. Elavil was first marketed almost a half century ago, and its patent has long expired. It lives on, however, but as generic amitriptyline. Today, only a few antidepressants are still fully protected by patents, namely, Cymbalta (2010), Lexapro (2012), and Pristiq (2022) for major depressive disorder (MDD); and Seroquel (2011) and Symbyax (2017) for bipolar depression. (Source: Psychiatric Times)

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  Limbitrol (Chlordiazepoxide Amitriptyline DS Tablets) - new on RxList

Limbitrol (Chlordiazepoxide Amitriptyline DS Tablets) drug description - FDA approved labeling for prescription drugs and medications at RxList (Source: RxList - New and Updated Drug Monographs)

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  Effective prophylactic therapy for cyclic vomiting syndrome in children using valproate

Abstract: This trial sought to evaluate our experience using the antimigraine prophylactic drug, use of valproate for the prophylactic management of cyclic vomiting syndrome (CVS) in children. Thirteen children diagnosed with severe CVS were enrolled. Prophylactic therapy consisted of valproate administered at a dose of 10–40mg/kg/day. Upon enrollment in the study, all patients underwent diagnostic tests to rule out organic causes of their symptoms. Vomiting was severe enough in all patients to cause dehydration requiring hospitalization for intravenous rehydration. Nine of 13 patients did not respond to numerous previous medical therapies like propranolol, amitriptyline, cyproheptadine, phenobarbital, phenytoin, and carbamazepine. Three of 13 patients required combination therapy with v...

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  Tricyclic Antidepressants

Information on the tricyclic antidepressants, including Adapin (doxepin), Anafranil (clomipramine), Elavil (amitriptyline), Endep (amitriptyline), Ludiomil (maprotiline), Norpramin (desipramine), Pamelor (nortryptyline), Pertofrane (desipramine), Sinequan (doxepin), Surmontil (trimipramine), Tofranil (imipramine), and Vivactil (protriptyline) (Source: About.com Mental Health)

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  Migraine as a Cause of Persistent Nausea or Vomiting in Palliative Care: A Case Series

We present three patients with troublesome nausea uncontrolled by conventional antiemetic therapy. On questioning, all three had other symptoms suggestive of migraine, and two had a family history. Their symptoms settled with the use of various antimigraine therapies. Amitriptyline appears to be particularly useful. A therapeutic trial of prophylaxis may be indicated for patients whose nausea and vomiting may be attributed to migraine. (Source: Journal of Pain and Symptom Management)

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  Switching from pathogenetic treatment with α-lipoic acid to gabapentin and other analgesics in painful diabetic neuropathy: a real-world study in outpatients

In conclusion, switching from long-term treatment with α-lipoic acid to central analgesic drugs such as gabapentin in painful diabetic neuropathy was associated with considerably higher rates of side effects, frequencies of outpatient visits, and daily costs of treatment. The pathogenic treatment option represents for the practicing diabetologist an effective, safe, and cost-effective treatment option for the majority of patients with diabetic polyneuropathy. (Source: Journal of Diabetes and Its Complications)

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  Amitriptyline in IC: Primary endpoint not met, but data offer hope

The largest trial to examine the efficacy, safety, and tolerability of amitriptyline as a treatment for interstitial cystitis failed to show a benefit of the drug versus placebo in an intent-to-treat analysis, but a secondary analysis examining study participants who tolerated high-dose therapy gave researchers a reason to call the study findings positive. (Source: Modern Medicine)

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  Preventive Migraine Treatment

The pharmacologic treatment of migraine may be acute (abortive) or preventive (prophylactic), and patients with frequent severe headaches often require both approaches. Preventive therapy is used to try to reduce the frequency, duration, or severity of attacks. The preventive medications with the best-documented efficacy are amitriptyline, divalproex, topiramate, and the beta-blockers. Choice is made based on a drug's proven efficacy, the physician's informed belief about medications not yet evaluated in controlled trials, the drug's adverse events, the patient's preferences and headache profile, and the presence or absence of coexisting disorders. Because comorbid medical and psychologic illnesses are prevalent in patients who have migraine, one must consider comorbidity when choosing pre...

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  A case report of acute mania secondary to pedicled latissimus dorsi breast reconstruction and amitriptyline withdrawal

A 51-year-old female patient was referred to the plastic surgery service for left pedicled latissimus dorsi breast reconstruction. She had had several operative procedures over the last 20 years, including a hysterectomy and a mastectomy, with no adverse postoperative complications. The patient had been receiving a 50mg daily dose of amitriptyline prescribed by her general practitioner for insomnia and anxiety approximately 3 years prior to the breast reconstruction. She did not undergo any surgical procedures during this period. The patient had accidentally missed taking her amitriptyline on a few occasions in the past with no adverse withdrawal events. She had no previous history of mania or major psychiatric illness. Unfortunately, the patient missed taking her amitriptyline the night b...

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  CHLORDIAZEPOXIDE AND AMITRIPTYLINE HCL (Chlordiazepoxide And Amitriptyline Hydrochloride) Tablet [Par Pharmaceutical Inc]

Updated Date: Apr 24, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Two different doses of Amitriptyline ER in the prophylaxis of migraine: long-term results and predictive factors

Conclusions: The prophylactic effect of amitriptyline seen in our study was rather weak and did not differ between the two treatment groups. The results of this 6-month, prospective, open-label clinical observation are therefore not encouraging. (Source: European Journal of Neurology)

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  Weight change and clinical markers of cardiovascular disease risk during preventive treatment of migraine

Bigal ME, Lipton RB, Biondi DM, Xiang J & Hulihan J. Weight change and clinical markers of cardiovascular disease risk during preventive treatment of migraine. Cephalalgia 2009. London. ISSN 0333-1024 Migraine, particularly migraine with aura, and increased body weight are independent risk factors for cardiovascular disease (CVD). The association of weight change and clinical markers of CVD risk was evaluated in subjects participating in a randomized double-blind, parallel-group study of migraine-preventive treatment comparing 100 mg/day of topiramate and amitriptyline. Individuals from both treatment groups were pooled and stratified into three groups. The 'major weight gain' group gained [ge] 5% of their baseline body weight at the conclusion of the study; the 'major weight loss' group l...

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  Benign clinical picture after ingestion of 780 milligrams of aripiprazole and 1050 milligrams of amitriptyline

Prakash Ravi, Munda Sanjay, Pattojoshi Amrit, Choudhary Pranav PrakashIndian Journal of Medical Sciences 2009 63(2):77-80 (Source: Indian Journal of Medical Sciences)

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  Amitriptyline pharmacokinetics in experimental spinal cord injury in the rabbit

Reihanikermani H, Ansari M, Soltani A, Meymandi M SIndian Journal of Pharmaceutical Sciences 2008 70(6):782-785Previous studies have demonstrated that pharmacokinetic behavior of several drugs such as paracetamol, theophylline, and aminoglycosides are significantly altered in spinal cord injured patients. No pharmacokinetic study of amitriptyline has been performed in patients and experimental models of spinal cord injury. Pharmacokinetic parameters of amitriptyline in orally treated rabbits subjected to laminectomy and spinal cord injury compared with those underwent laminectomy alone. Among twenty four male rabbits were included in this study, nine of them subjected to spinal cord injury at the 8&lt;sup&gt; th&lt;/sup&gt; thoracic level by knife severance meth...

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  Morphine/amitriptyline/ranitidine interaction: Overdose of morphine resulting in unconsciousness in an elderly patient, reversed with naloxone: case report

(Source: Reactions)

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  Morphine/amitriptyline/ranitidine interaction: Overdose of morphine resulting in unconsciousness in an elderly patient, reversed with naloxone: case report.

Page: 26 (Source: Reactions Weekly)

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  Evaluation of the effect of locally administered amitriptyline gel as adjunct to local anesthetics in irreversible pulpitis pain

Conclusion: &lt;/b&gt; Inter-pulp space administration of amitriptyline 2% gel for completing analgesia in irreversible pulpitis pain could be effective and useful as a conjunctive therapy to injections of local anesthetics. (Source: Table of Contents : Indian Journal of Dental Research : 2006 - 17(3))

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  Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis.

Authors: Rahimi R, Nikfar S, Rezaie A, Abdollahi M We aimed to evaluate the efficacy of tricyclic antidepressants (TCAs) as a therapeutic option for irritable bowel syndrome (IBS) through meta-analysis of randomized controlled trials. For the years 1966 until September 2008, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of TCAs in the management of IBS. Seven randomized, placebo-controlled clinical trials met our criteria and were included in the meta-analysis. TCAs used in the treatment arm of these trials included amitriptyline, imipramine, desipramine, doxepin and trimipramine. The pooled relative risk for clinical improvement with TCA therapy was 1.93 (95% CI: 1...

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  Gender differences in the association between antidepressant use and restless legs syndrome

Contradictory results have been reported for the association between antidepressant use and Restless Legs Syndrome (RLS). Our aim was to clarify the relationship and examine possible gender differences. We interviewed 1,693 veterans receiving primary care from the Cleveland VA Medical Center and obtained prescription drug information from their medical records. Overall, use of an antidepressant was associated with RLS for men (RR = 1.77, CI = 1.26, 2.48) but not for women (RR = 0.79, CI = 0.43, 1.47). Analyses of individual antidepressants revealed an association between RLS and fluoxetine for women (RR = 2.47, CI = 1.33, 4.56), and associations between RLS and citalopram, (RR = 2.09, CI = 1.20, 3.64), paroxetine (RR = 1.97, CI = 1.02, 3.79), and amitriptyline (RR = 2.40, CI = 1.45, 4.00) ...

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  [Membrane Transport, Structure, Function, and Biogenesis] Location of the Antidepressant Binding Site in the Serotonin Transporter: IMPORTANCE OF SER-438 IN RECOGNITION OF CITALOPRAM AND TRICYCLIC ANTIDEPRESSANTS

The serotonin transporter (SERT) regulates extracellular levels of serotonin (5-hydroxytryptamine, 5HT) in the brain by transporting 5HT into neurons and glial cells. The human SERT (hSERT) is the primary target for drugs used in the treatment of emotional disorders, including depression. hSERT belongs to the solute carrier 6 family that includes a bacterial leucine transporter (LeuT), for which a high resolution crystal structure has become available. LeuT has proved to be an excellent model for human transporters and has advanced the understanding of solute carrier 6 transporter structure-function relationships. However, the precise structural mechanism by which antidepressants inhibit hSERT and the location of their binding pockets are still elusive. We have identified a residue (Ser-43...

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  A Case Report of Amitriptyline Poisoning Successfully Treated With the Application of Plasma Exchange

Amitriptyline is a very frequently prescribed antidepressant agent and is very often involved in attempted suicides. Amitriptyline intoxication necessitates primary therapeutic approaches that include gastric irrigation and recurrent administration of activated charcoal. In the case of pronounced anticholinergic findings, physostigmine is of proven benefit and hypertonic sodium bicarbonate can be used to shorten the QRS duration and AV interval. In cases of a comatosed state, hemoperfusion and plasma exchange can be used. In this case report we present a case of severe amitriptyline poisoning that we successfully managed with plasma exchange. We confirmed a 59.5% reduction in the amitriptyline plasma level in our patient after a single plasma exchange session. She was discharged by the thi...

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  Peripheral neuropathy in HIV-positive patients at an antiretroviral clinic in Lilongwe, Malawi.

Authors: Beadles WI, Jahn A, Weigel R, Clutterbuck D Peripheral neuropathy (PN) is common in the setting of antiretroviral (ARV) programmes in resource-limited settings and poses significant challenges in assessment and management. A retrospective analysis was undertaken of prevalence and management of PN in a cohort of 3341 patients on highly active antiretroviral therapy. A first line ARV regimen containing stavudine (D4T) is used for clinically eligible patients. Amitriptyline is prescribed for symptom relief and in cases of persistent or escalating symptoms zidovudine (AZT) is substituted for D4T. Leg pain or numbness was reported in 1173 patients (35%). However, only 428 (13%) were given a diagnosis of PN, 228 (7%) were prescribed amitriptyline and 200 (6%) were switched to AZT. A...

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  Preventive migraine treatment.

Authors: Silberstein SD The pharmacologic treatment of migraine may be acute (abortive) or preventive (prophylactic), and patients with frequent severe headaches often require both approaches. Preventive therapy is used to try to reduce the frequency, duration, or severity of attacks. The preventive medications with the best-documented efficacy are amitriptyline, divalproex, topiramate, and the beta-blockers. Choice is made based on a drug's proven efficacy, the physician's informed belief about medications not yet evaluated in controlled trials, the drug's adverse events, the patient's preferences and headache profile, and the presence or absence of coexisting disorders. Because comorbid medical and psychologic illnesses are prevalent in patients who have migraine, one must consider c...

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  Arguments for the specificity of the antisuicidal effect of lithium

Conclusion Lithium has to be considered as a first line mood stabilizer in affective disorders, particularly in patients with a history of suicide attempts. Extreme caution is required when lithium is discontinued or a patient is switched to another mood stabilizer, because such a patient might have been protected against suicidal impulses in spite of an incomplete response as to the number and quality of depressive/manic episodes. Content Type Journal ArticleCategory Treatment OutcomeDOI 10.1007/BF03035132Authors B. Müller-Oerlinghausen, Jebensstr. 3 10623 Berlin Germany Journal European Archives of Psychiatry and Clinical NeuroscienceOnline ISSN 1433-8491Print ISSN 0940-1334 Journal Volume Volume 251 Journal Issue Volume 251, Supplement 2 / June, 2001 (Source:...

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  Methodological aspects in the assessment of severity of depression by the Hamilton Depression Scale

Abstract  Observer-rating scales are used for the evaluation of drug trials in depression. One of the most widely used depression rating scales is still the Hamilton Depression Scale (HAMD), which was developed at the time when the first antidepressants were becoming available. Due to its construction it seems to have a specific focus on drug effects of classical antidepressants. As a result of different methodological analyses such as principal component analysis, the Rasch model and facet analysis, a differentiation between core symptoms reflecting the severity of depression and additional symptoms describing other aspects of the symptomatology of depression seems meaningful. The use of the HAMD 6-item score, described primarily by Bech, as the main efficacy criterion in ...

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  Tricyclic Antidepressants

This article covers how tricyclics work, allergies, pregnancy and breast-feeding, side effects common to the medication family, and interactions with drugs and alcohol. (Source: About.com Bipolar Disorder)

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  Clinical, Electrocardiographic, and Laboratory Findings in Children With Amitriptyline Intoxication.

Page: 170DOI: 10.1097/PEC.0b013e31819a8994Authors: Olgun, Hasim *; Yldrm, Zuhal Keskin +[latin dotless i][latin dotless i][latin dotless i]; Karacan, Mehmet *; Ceviz, Naci * (Source: Pediatric Emergency Care)

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  Anorexia nervosa

This study had a high withdrawal rate, which limits the conclusions that can be drawn. Categorisation unchanged (Unknown effectiveness). SSRIs Three systematic reviews added, which did not pool data, and which identified three RCTs comparing fluoxetine or citalopram versus placebo which were previously reported in this review. No new data added from the reviews. One RCT comparing fluoxetine plus CBT versus placebo plus CBT added which had a high withdrawal rate which limited any conclusions that could be drawn. Categorisation unchanged (Unknown effectiveness). Anxiolytic drugs (benzodiazepines, older-generation antipsychotics, atypical antipsychotics) No new RCTs added to the benefits or harms sections. One small RCT (not meeting Clini...

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  Coenzyme Q(10) and alpha-tocopherol protect against amitriptyline toxicity.

Authors: Cordero MD, Moreno-Fernández AM, Gomez-Skarmeta JL, de Miguel M, Garrido-Maraver J, Oropesa-Avila M, Rodríguez-Hernández A, Navas P, Sánchez-Alcázar JA Since amitriptyline is a very frequently prescribed antidepressant drug, it is not surprising that amitriptyline toxicity is relatively common. Amitriptyline toxic systemic effects include cardiovascular, autonomous nervous, and central nervous systems. To understand the mechanisms of amitriptyline toxicity we studied the cytotoxic effects of amitriptyline treatment on cultured primary human fibroblasts and zebrafish embryos, and the protective role of coenzyme Q(10) and alpha-tocopherol, two membrane antioxidants. We found that amitriptyline treatment induced oxidative stress and mitochondrial dysfunct...

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  Elavil Side Effects

Elavil - generic Amitriptyline - is a tricyclic antidepressant. This is a catalog of side effects for the medication Amitriptyline - brand names Elavil and Endep, which is sometimes prescribed for the treatment of bipolar disorder and other mental illnesses. (Source: About.com Bipolar Disorder)

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  Amitripyline Side Effects - Side Effects of Amitriptyline Elavil Endep

Members share their personal experiences with Elavil, Endep, Amitriptyline. First hand accounts of what side effects you can expect with Amitriptyline, Elavil and Endep. (Source: About.com Depression)

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  1-(m-Chlorophenyl)piperazine Induces Depressogenic-like Behaviour in Rodents by inhibiting the neuronal 5-HT(2A) receptors: Proposal of a Modified Rodent Anti-depressant assay.

In conclusion, this study provided ample evidence that the antagonism of 5-HT(2A) receptors underlies the depressogenic-like effect of mCPP. Finally, the mCPP induced depression-like behaviour in rodents is envisaged as a modified antidepressant assay to identify novel serotonergic antidepressants. PMID: 19269287 [PubMed - as supplied by publisher] (Source: European Journal of Pharmacology)

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  Guidelines on the management of fibromyalgia syndrome – A systematic review

Abstract: We compared the methodology and the recommendations of evidence-based guidelines for the management of fibromyalgia syndrome (FMS) to give an orientation within the continuously growing number of reviews on the therapy of FMS. Systematic searches up to April 2008 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, the Association of the Scientific Medical Societies in Germany (AWMF) and Medline were conducted. Three evidence-based guidelines for the management of FMS published by professional organizations were identified: The American Pain Society (APS) (2005), the European League Against Rheumatism (EULAR) (2007), and the AWMF (2008). The steering committees and panels of APS and AWMF were comprised of multiple disciplines enga...

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  Guidelines on the management of fibromyalgia syndrome - A systematic review.

Authors: Häuser W, Thieme K, Turk DC We compared the methodology and the recommendations of evidence-based guidelines for the management of fibromyalgia syndrome (FMS) to give an orientation within the continuously growing number of reviews on the therapy of FMS. Systematic searches up to April 2008 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, the Association of the Scientific Medical Societies in Germany (AWMF) and Medline were conducted. Three evidence-based guidelines for the management of FMS published by professional organizations were identified: The American Pain Society (APS) (2005), the European League Against Rheumatism (EULAR) (2007), and the AWMF (2008). The steering committees and panels of APS and AWMF were co...

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  Cost Effectiveness of Venlafaxine Compared with Generic Fluoxetine or Generic Amitriptyline in Major Depressive Disorder in the UK.

Page: 173DOI: 10.2165/00044011-200929030-00004Authors: Lenox-Smith, Alan 1; Greenstreet, Liz 1; Burslem, Kate 1; Knight, Chris 2 (Source: Clinical Drug Investigation)

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  Topiramate versus amitriptyline in migraine prevention: a 26-week, multicenter, randomized, double-blind, double-dummy, parallel-group noninferiority trial in adult migraineurs.

CONCLUSIONS: In this noninferiority study, topiramate was at least as effective as amitriptyline in terms of reducing the rate of mean monthly migraine episodes and all prespecified secondary efficacy end points. Topiramate was associated with improvement in some quality-of-life indicators compared with amitriptyline and was associated with weight loss and improved weight satisfaction. PMID: 19393844 [PubMed - indexed for MEDLINE] (Source: Clinical Therapeutics)

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  Cost Effectiveness of Venlafaxine Compared with Generic Fluoxetine or Generic Amitriptyline in Major Depressive Disorder in the UK

(Source: Clinical Drug Investigation)

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  Comment on: Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies & Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy

(Source: Rheumatology)

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  Comment on: Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy: reply

(Source: Rheumatology)

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  Meta-analysis of duloxetine vs. pregabalin and gabapentin in the treatment of diabetic peripheral neuropathic pain

Conclusions: From the few available studies suitable for indirect comparison, DLX shows comparable efficacy and tolerability to GBP and PGB in DPNP. Duloxetine provides an important treatment option for this disabling condition. (Source: BMC Neurology)

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  Dynamic optimization of chronic migraine treatment: Current and future options

Comparator studies that assess treatment effects in a clinical setting have improved the understanding of the efficacy and tolerability of prophylactic treatments for chronic migraine (CM). It is premature to recommend device-based treatments, such as occipital nerve stimulation, vagal nerve stimulation, and patent foramen ovale closure for CM, because clinical trials are in the preliminary stages. Physical therapy techniques, like applying heat or cold packs, ultrasonography, and electrical stimulation, have been shown to lessen pain. Nonpharmacologic treatments, including cognitive behavioral therapy, stress management, and biofeedback, have been investigated and proved effective in some areas of pain management, including migraine. However, pharmacologic interventions may be necessary f...

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  Amitriptyline/methyl alcohol: Diabetic ketoacidosis masking amitriptyline and methyl alcohol intoxication in a child with type 1 DM: case report

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  Amitriptyline/methyl alcohol: Diabetic ketoacidosis masking amitriptyline and methyl alcohol intoxication in a child with type 1 DM: case report.

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  Kinetic and pharmacological properties of [3H]-histamine transport into cultured type 1 astrocytes from neonatal rats

Conclusions:  Astrocytes participate in the clearance of extracellular histamine by electrodiffusion and active transport by a yet not identified carrier. Taken up histamine can be converted to tele-methylhistamine within astrocytes thus indicating the involvement of astrocytes not only in clearance but also in the inactivation of histamine. Content Type Journal ArticleDOI 10.1007/s00011-009-8103-4Authors D. Osredkar, University of Ljubljana Department of Pharmacology and Experimental Toxicology, Faculty of Medicine Si-1000 Ljubljana SloveniaT. Burnik-Papler, University of Ljubljana Department of Pharmacology and Experimental Toxicology, Faculty of Medicine Si-1000 Ljubljana SloveniaB. Pečavar, University of Ljubljana Department of Pharmacology and Experimental Toxico...

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  Self-Management, Amitriptyline, and Amitripyline plus Triamcinolone in the Management of Vulvodynia

Journal of Women's Health , Vol. 0, No. 0: 1-7. (Source: Journal of Women)

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  Roles of polymorphic enzymes CYP2D6 and CYP2C19 for in vitro metabolism of amitriptyline at therapeutic and toxic levels

Abstract  The metabolism of the tricyclic antidepressant amitriptyline was studied in vitro in the presence of the main metabolite nortriptyline to simulate the steady state with amitriptyline and nortriptyline present in the ratio 1:1. The metabolism of the active metabolite nortriptyline in the presence of amitriptyline was also studied. The contribution of cytochrome P450 (CYP) 2D6, CYP2C19, and CYP3A4 was assessed by in vitro experiments at therapeutic (5 μM) and toxic (50 μM) concentrations for amitriptyline or nortriptyline with human liver microsomes (HLM). The results indicated that nortriptyline acted as a competitive inhibitor at the steady-state concentrations, lowering the amitriptyline metabolism, and thus changed the importance of different metabolic pathways...

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  Amitriptyline: Tonic-clonic seizures and ventricular fibrillation following poisoning in an infant: case report

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  Amitriptyline: Tonic-clonic seizures and ventricular fibrillation following poisoning in an infant: case report.

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  Evaluation of risk factors for elevated tricyclic antidepressant plasma concentrations

To quantify the effect of clinical and demographic factors on the risk of elevated and toxic tricyclic antidepressant (TCA) plasma concentrations (Cp) and to describe the rates of elevated and toxic TCA Cp.This matched, case-control study was conducted among adult patients enrolled in a group model HMO who had a TCA Cp laboratory measurement and purchased at least one TCA prescription for either amitriptyline or nortriptyline during the 70 days preceding the TCA Cp measurement. Predictive models of experiencing an elevated or toxic Cp were created using multivariate conditional logistic regression.At least one Cp was drawn in 1057 unique patients with a TCA purchase. Of these, 18.4% (194/1057) patients (cases) had an elevated TCA Cp and were matched to 716 non-elevated Cp patients. Additio...

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  How do general practitioners in Thailand diagnose and treat patients presenting with anxiety and depression?

Conclusion: Compared to psychiatrists, GPs were more likely to diagnose anxiety than depression in patients with the same set of symptoms. They also preferred to use amitriptyline to treat depression, and prescribed the drug at a low dose. GPs in Thailand should be encouraged to prescribe fluoxetine for treatment of depression because it is safer and more convenient to use than tricyclic antidepressants. (Source: Psychiatry and Clinical Neurosciences)

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  Treatment of severe amitriptyline intoxication with plasmapheresis

Tricyclic antidepressant poisoning is one of the most common causes of serious intoxication. Here, we report a 2-year-old girl with severe amitriptyline (70 mg/kg) intoxication. She was in comatose, had generalized tonic clonic seizure, ventricular tachycardia, and wide QRS complexes. Although she did not respond to classical therapies, very good clinical response to plasmapheresis was obtained and she developed no complications. Thus, plasmapheresis may be an effective treatment modality in poisoning with drugs, which bind to plasma proteins with high affinity. J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc. (Source: Journal of Clinical Apheresis)

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  Amitriptyline overdose: Brugada ECG pattern following intentional overdose, treated with sodium bicarbonate: case report

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  Amitriptyline overdose: Brugada ECG pattern following intentional overdose, treated with sodium bicarbonate: case report.

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  Clinical diagnosis and treatment of suspected neuropathic pain in three dogs.

Authors: Cashmore R, Harcourt-Brown T, Freeman P, Jeffery N, Granger N Three dogs were referred to The Queen's Veterinary School Hospital at University of Cambridge for chronic behavioural or locomotor disorders associated with pain. All three had been unsuccessfully treated with conventional analgesics, including non-steroidal anti-inflammatory drugs, glucocorticoids and opiate agonists, prior to referral, with minimal or no response. They were investigated by neurological examination plus conventional ancillary diagnostic tests and therapeutic drug trials. Ruling out other causes of pain and applying previously well-described criteria, each case was diagnosed as consistent with neuropathic pain, a poorly recognised condition in domestic dogs. Treatment with the tricyclic antidepressa...

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  Daily pharmacologic prophylaxis of episodic migraine

Patients with high frequencies of migraine, high disability or impact from migraine, and frequent users of acute migraine medications merit migraine prophylaxis in the form of daily medication. The choice of migraine-preventive medication is best based on the opportunity to treat multiple concomitant disorders as well as migraine with 1 medication. Migraine-preventive medications, at best, work in approximately half of patients to reduce migraine frequency by about 50%, so careful establishment of expectations with use of headache diaries is crucial for therapeutic success. Treatment should always begin with low doses and be gradually increased to optimal dosing, which then should be maintained for 2 to 3 months to evaluate effectiveness. Medications with the best evidence for efficacy in ...

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