SEARCH · Search PubMed

Results for “AMITRIPTYLINE”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources

PubMed1990

Amoxapine versus amitriptyline for continuation therapy of depression.

The efficacy of continuation therapy with tricyclic antidepressants has been established in a number of controlled trials. This study investigated the efficacy of continuation therapy with a relatively new antidepressant, amoxapine, using a double-blind controlled comparison with amitriptyline. Subjects met DSM-III criteria for major depressive disorder and were randomized to treatment with either amoxapine 400 mg (N = 47) or amitriptyline 300 mg (N = 45). The acute phase lasted up to 8 weeks. Responders were continued on the same drug at the same dose for a 16-week continuation phase. Some measures found more rapid onset for amitriptyline, which is inconsistent with findings from some prior studies. Amitriptyline was more effective in inducing full recovery. There was a trend for higher relapse rates on amoxapine, perhaps related to the fact that there were more partial responders entering continuation therapy from this group. Side effect rates were equivalent in the two drugs. However, physicians rated amoxapine's side effects as more frequently interfering with its therapeutic effect. These data suggest that amoxapine does not offer any clear advantage over amitriptyline for continuation therapy in patients who have major depressive disorder. Of potential clinical relevance is the finding that achieving full recovery in the acute phase may reduce the likelihood of relapse in the continuation phase, regardless of the type of antidepressant medication prescribed.

Adult↗

PubMedDate not supplied

The effect of ethanol on arterial blood pressure, central venous pressure and ECG in rabbits treated with the single or multiple dose of amitriptyline or imipramine.

Amitriptyline and imipramine given in the single dose insignificantly depressed the arterial blood pressure but significantly elevated the central venous pressure, prolonged the PQ interval and widened the QRS complex. After a prolonged daily treatment, the subsequent 21st dose of either antidepressant significantly depressed the arterial blood pressure; amitriptyline also depressed the central venous pressure. When given chronically, amitriptyline induced rhythm disturbances and the flattening of T-wave, while imipramine caused the widening of the QRS complex, block of the left bundle branch, changes in the T-wave amplitude, elevation in the ST interval. An intravenous infusion of ethanol potentiated those changes. The impairment of atrioventricular conduction occurred more frequently after administration of ethanol jointly with amitriptyline than with imipramine. Physostigmine salicylate elevated the depressed arterial blood pressure, aggravated the impairment of conduction and potentiated rhythm disturbances caused by the interaction of ethanol with antidepressants. In the above interactions with ethanol imipramine was less toxic than amitriptyline.

Amitriptyline↗

PubMed1988

Acute effects of sertraline, amitriptyline, and placebo on the psychomotor performance of healthy subjects over 50 years of age.

A double-blind, placebo-controlled, crossover study in 12 subjects (greater than or equal to 50 years) compared the effects of single oral doses of sertraline (100 mg) and amitriptyline (50 mg) with placebo as assessed by psychomotor function testing. Unlike sertraline and placebo, amitriptyline increased tracking error severity and impaired digit/symbol substitution. Sertraline slightly improved flicker frequency recognition. Both active drugs caused subjective drowsiness, although amitriptyline's effect was greater and of longer duration. Both drugs impaired subjectively assessed performance. Sertraline caused nausea, and amitriptyline, dry mouth; sertraline tended to increase supine systolic blood pressure. The authors conclude that sertraline has a considerably less detrimental effect on psychomotor performance and may have a slight activating effect not found with amitriptyline.

1-Naphthylamine↗

PubMed1987

A comparative double-blind controlled study of trimipramine and amitriptyline in major depression: lack of correlation with 5-hydroxytryptamine reuptake blockade.

Thirty-four hospitalized patients with major depression were enrolled in a 3-week double-blind parallel comparative study of trimipramine and amitriptyline. Following a 1-week washout period, patients randomly received one of the two drugs up to 100 mg twice daily on a fixed increment dosage schedule. Both treatments produced a rapid significant clinical improvement that occurred in a predominantly linear fashion. The pattern of improvement was very similar with both drugs. There was no significant correlation between plasma levels of trimipramine and desmethyl-trimipramine and clinical improvement. A negative correlation between amitriptyline plasma levels and clinical improvement was found, whereas a positive correlation occurred with the nortriptyline levels. Amitriptyline, and to a lesser extent trimipramine, prolonged intracardiac conduction. In the amitriptyline group only, this effect was accompanied by significant increases of heart rate and blood pressure. Platelet serotonin content was decreased by 57% by the amitriptyline treatment but remained unchanged in the trimipramine group. This finding constitutes the first clinical evidence that trimipramine does not exert its antidepressant effect through 5-hydroxytryptamine reuptake blockade. It is proposed that neuronal sensitization to 5-hydroxytryptamine might mediate the therapeutic effect of tricyclic antidepressant drugs.

Adult↗

PubMed1985

A double-blind controlled clinical trial of fluoxetine and amitriptyline in the treatment of outpatients with major depressive disorder.

Fluoxetine, a specific serotonin reuptake inhibitor, was compared to amitriptyline in the treatment of 51 outpatients with primary major depressive disorder. After a 1-week placebo washout, patients were randomly assigned to 5 weeks of treatment with fluoxetine or amitriptyline. Fluoxetine was found to have a therapeutic effect comparable to that of amitriptyline; however, the fluoxetine treatment group had a better Efficacy Index-Side Effects rating and a lower incidence of anticholinergic autonomic side effects. Four amitriptyline-treated patients had to discontinue the study because of serious side effects, while in the fluoxetine treatment group there were no terminations due to side effects. The amitriptyline-treated patients gained significantly more weight than the fluoxetine-treated patients.

Adult↗

PubMed1985

Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebo-controlled study.

The tricyclic antidepressant drug amitriptyline was evaluated as a short-term treatment of anorexia nervosa patients. In a 5-week double-blind, placebo-controlled study 11 patients were given amitriptyline and 14 received placebo. In addition, 18 patients who refused to participate in the drug trial and received only psychosocial treatment were used as an additional comparison group. Overall, patients in the three groups showed little improvement. No statistically significant differences favoring amitriptyline were found in any of the outcome variables. Plasma levels varied widely among patients receiving similar doses. No association was found between plasma levels and improvement in either psychiatric symptomatology or weight. Amitriptyline patients did not manifest any tendency for a reduction of depressive symptomatology. In addition, amitriptyline treatment was associated with substantial discomfort and adverse affects.

Adolescent↗

PubMed1984

Mechanism of reversal of toxic effects of amitriptyline on cardiac Purkinje fibers by sodium bicarbonate.

Alkalinization with NaHCO3 can effectively reverse ventricular arrhythmias caused by amitriptyline intoxication, but the mechanism is unclear. To test whether alkalinization per se is important or whether increases in extracellular Na concentration also contribute, we exposed Purkinje fibers to 500 ng/ml (1.8 microM) of amitriptyline and then superfused them with three different test solutions, viz. 1) high Na-Tyrode's, 2) high NaHCO3-Tyrode's and 3) high pH-low pCO2-Tyrode's. Amitriptyline significantly depressed action potential amplitude and Vmax without altering resting membrane potential and abbreviated action potential duration at all phases of repolarization. Effects on phase 0 were accompanied by a depression of conduction velocity. All three test solutions produced significant hyperpolarization and improvement in action potential amplitude and Vmax. However, the magnitude of improvement of phase 0 characteristics was significantly greater after high NaHCO3 and resulted in significant improvement of conduction velocity in fibers depressed by amitriptyline. The effects of amitriptyline on phase 0 were rate-dependent. Reversal of this effect by NaHCO3 was equally effective at all rates. Improvement of Vmax was partly related to a shift of the Vmax-membrane potential relationship in the depolarizing direction. NaHCO3 had minimal and variable effects on action potential duration. The results suggest that the beneficial effects of NaHCO3 are related to a reversal of drug effects on phase 0 characteristics and that this effect is due both to alkalinization and to increases in extracellular Na concentration.

Action Potentials↗

PubMed1983

Bupropion and amitriptyline in the treatment of depressed patients.

Bupropion, a specific dopamine reuptake inhibitor, was compared to amitriptyline in two multicenter studies involving 183 depressed outpatients and inpatients. Initial results from these ongoing studies provide additional evidence of the antidepressant activity of bupropion. At the end of the treatment periods (6 weeks for inpatients and 13 weeks for outpatients), bupropion appeared to be at least as effective as amitriptyline. However, bupropion exerted a slightly but nonsignificantly smaller overall therapeutic effect than amitriptyline during the first 4 weeks of drug treatment. Slight weight loss and dopaminergic side effects, such as insomnia, nausea/vomiting, and anorexia, were somewhat more common among bupropion-treated patients. Compared to bupropion, amitriptyline induced more weight gain and had more anticholinergic, antihistaminic, and antiadrenergic side effects. In view of its numerous sites of action, amitriptyline does not appear to be the ideal antidepressant. It remains to be demonstrated whether bupropion has any advantage over secondary amine tricyclic antidepressants, such as nortriptyline and desipramine.

Adolescent↗

PubMed1982

Amitriptyline-perphenazine and doxepin in depressed outpatients: a controlled double-blind study.

Amitriptyline-perphenazine (100/8-150/12 mg/day) and doxepin (100-150 mg/day) were compared for clinical efficacy and safety in a sample of 130 nonpsychotic depressed outpatients. Maximum study duration was 4 weeks; 19 amitriptyline-perphenazine and 29 doxepin patients completed less than or equal to 3 weeks of treatment and 45 amitriptyline-perphenazine and 37 doxepin patients completed 4 weeks of treatment. Patients in both groups showed significant improvement in depression, but amitriptyline-perphenazine produced greater improvement than doxepin on several measures of depressive symptomatology. The incidence of anticholinergic and sedative side effects was higher in the amitriptyline-perphenazine treated group.

Adult↗

PubMed1980

Cardiovascular effects of mianserin and amitriptyline in healthy volunteers.

10 healthy volunteers were randomized in two groups and treated with mianserin and amitriptyline for 6 days. Heart rate, arterial blood pressure, and blood levels of the drugs were measured daily. ECG and left-ventricular echocardiogram as a parameter of contractility were registered before as well as after 3 and 6 days of treatment with both drugs. The most striking result of our investigation was that amitriptyline-treated subjects showed a loss of myocardial contractility (-17% of the initial value) after 6 days of treatment; mianserin was ineffective in this respect. After both mianserin and amitriptyline an increase of the mean arterial blood pressure was observed; an increased heart rate was seen only in the amitriptyline group. No alterations in the parameters calculated from the ECG registrations were found in either group. The inability of mianserin to decrease cardiac contractility in the therapeutic dose range may favor this tetracyclic antidepressant over the tricyclic compound amitriptyline, especially in patients with cardiac disease.

Adult↗

PubMed1993

[A case of progressive supranuclear palsy showing marked improvements of frontal hypoperfusion, as well as parkinsonism with amitriptyline].

A patient with progressive supranuclear palsy (PSP) showing severe akinesia, postural instability and gait disturbance like frozen gait was treated with amitriptyline (30 mg/day). Four weeks after drug administration, we recognized tendencies for improvement on akinesia, postural instability, frozen gait and vertical gaze palsy. Thereafter, gait disturbance almost disappeared and slow motor response and depression also improved with the amitriptyline for 8 weeks. The changes of cerebral blood flow (CBF) with amitriptyline treatment were evaluated in this case by 123I-IMP single photon emission computed tomography. Before the treatment, clear reduction of CBF was shown in the frontal lobes, especially in the frontal cortices, while this frontal hypoperfusion markedly improved 6 weeks after the treatment. These results, showing marked improvements of frontal hypoperfusion, as well as parkinsonism with amitriptyline treatment, may imply possibilities that these symptoms of PSP result from the frontal hypoperfusion and the improvement of the hypoperfusion with amitriptyline is involved in the improvement of these symptoms.

Amitriptyline↗

PubMedDate not supplied

Reversal of multidrug resistance by amitriptyline in vitro.

Amitriptyline, a tricyclic antidepressant, was able to reverse the multidrug resistance efflux pump of human colon cancer subline SW 620 and multidrug resistant (mdr) mouse lymphoma cells by decreasing rhodamine 123 efflux. The inhibitory effect of amitriptyline on the efflux pump was dose dependent. An investigation was made of the effects of mouse tumour necrosis factor (TNF) alpha and interferon (IFN) gamma on the efflux pump activity of mdr cells together with amitriptyline compared to the par cells (mdr-). After long-term cytokine pretreatment of mdr cells, the amitriptyline was more effective, due to some synergism between the amitriptyline and TNF-alpha.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMedDate not supplied

The effect of amitriptyline on the cell-mediated immunity of stressed rats.

The effects of single and repeatedly administered amitriptyline (10 mg/kg ip) on the ability of the splenocytes of the restraint-stressed (for 2.5 h) Sprague-Dawley rats to induce the Graft versus Host (GvH) reaction in vivo and to respond to the concanavalin A (Con A) stimulation in vitro were studied. In acute experiments single immobilization, amitriptyline administration, or single amitriptyline treatment of the previously stressed rats did not change the reactivity of splenocytes to both mitogen and alloantigens. On the other hand, in the "chronic" experiment, when rats were stressed 2.5 h daily for five days with or without concurrent amitriptyline treatment, a statistically significant decrease in the reactivity of splenocytes to Con A and increase in the reactivity to alloantigens were visible only in the stressed, but not in stressed, amitriptyline treated animals.

Amitriptyline↗

PubMed1996

Amitriptyline, a combined serotonin and noradrenaline re-uptake inhibitor, reduces exteroceptive suppression of temporal muscle activity in patients with chronic tension-type headache.

Although reflexes in human jaw muscles have been extensively studied, the neurotransmitters involved in the regulation of these reflexes are not well known. The aim of the present study was to investigate whether amitriptyline, a combined serotonin and noradrenaline re-uptake inhibitor, modulates the late exteroceptive suppression period (ES2) of temporal muscle activity in chronic tension-type headache. ES2 was recorded with a previously evaluated method and assessed by a blinded observer in 35 patients with chronic tension-type headache. Thereafter, ES2 was recorded in 27 of these patients during a double-blind, placebo-controlled, 3-way crossover trial investigating the prophylactic effect of amitriptyline, the selective serotonin re-uptake inhibitor citalopram, and placebo. ES2 duration was significantly shorter during treatment with amitriptyline than during placebo, P = 0.02, while ES2 duration only tended to be shorter during treatment with citalopram, P = 0.34. ES2 was not significantly correlated to the prophylactic effect of amitriptyline or to a range of clinical and experimental pain parameters. Our results demonstrate that amitriptyline reduces ES2 and indicate that ES2 is modulated by serotonergic as well as noradrenergic neuronal pathways.

Adult↗

PubMed1997

[Treatment chronic pain with amitriptyline. A double-blind dosage study with determination of serum levels].

The aim of this study was to find an optimal analgesic dose of amitriptyline, and at the same time examine whether a therapeutic window existed for this analgesic effect. 85 patients with chronic, non-malignant pain were included in a double-blind treatment regime with four doses of amitriptyline (10, 25, 50 or 100 mg). A blood sample was taken at steady state. The results showed 25 mg amitriptyline to have a good analgesic and sleep regulatory effect. The four different doses of amitriptyline did not show any significant difference in efficacy. No therapeutic window was found, but one cannot exclude that it exists. Low-dose amitriptyline, as a non-addictive drug, is a good alternative in the treatment of chronic pain, independent of co-morbid depression.

Adult↗

PubMed2006

Intra-oral orthosis vs amitriptyline in chronic tension-type headache: a clinical and laser evoked potentials study.

BACKGROUND: In the present study, we examined clinical and laser-evoked potentials (LEP) features in two groups of chronic tension-type headache (CTTH) patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. METHODS: Eighteen patients with diagnosed CTTH participated in this open label, controlled study. A baseline evaluation was performed for clinical features, Total Tenderness Score (TTS) and a topographic analysis of LEPs obtained manually and the pericranial points stimulation in all patients vs. healthy subjects. Thereafter, patients were randomly assigned to a two-month treatment by either amitriptyline or intra-oral appliance. RESULTS AND DISCUSSION: Both the intra-oral appliance and amitriptyline significantly reduced headache frequency. The TTS was significantly reduced in the group treated with the appliance. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment.Both therapies were effective in reducing headache severity, the appliance with a prevalent action on the pericranial muscular tenderness, amitriptyline reducing the activity of the central cortical structures subtending pain elaboration CONCLUSION: The results of this study may suggest that in CTTH both the interventions at the peripheral and central levels improve the outcome of headache.

Journal Article↗

PubMed1993

Propranolol and amitriptyline in prophylaxis of migraine. Pharmacokinetic and therapeutic effects.

OBJECTIVES: To determine if the effectiveness of propranolol hydrochloride and amitriptyline hydrochloride are correlated with blood levels and/or with standardized test of pharmacologic effect and to determine which clinical variables are predictors of response to one or the other medication. DESIGN: Three-month modules of treatment with each drug and placebo in a randomized crossover design. Headache scores from daily diaries were calculated at monthly intervals, as were simultaneous blood levels of drug, supine and standing blood pressure, pulse rise with exercise, and salivary flow. SETTING: Outpatient headache clinic at the University of Kansas Medical Center, Kansas City. PATIENTS: Thirty consecutive patients with a history of frequent migraine. MAIN OUTCOME MEASUREMENTS: From headache scores, patients were classified as either propranolol responders, amitriptyline responders, or nonspecific responders. Clinical variables as predictors of response to medications were studied, as were effects on frequency, duration, and/or severity of headache. RESULTS AND CONCLUSIONS: No significant correlations were found between changes in headache score and blood level of drug or change in any of the physiologic measurements. Amitriptyline significantly reduced the severity, frequency, and duration of headache attacks; propranolol reduced the severity of attacks only. Amitriptyline response was correlated with female gender and baseline headaches of shortest duration and of highest frequency. Propranolol response was associated with attacks of greatest duration at baseline and with low pulse rise with exercise at baseline. Nonspecific response was associated with male gender and most frequent headaches by history.

Adolescent↗

PubMed1975

Amitriptyline-perphenazine interaction in ambulatory schizophrenic patients. A controled study of drug interaction.

In a double-blind placebo, controlled clinical study, lasting 12 weeks, 48 male and 48 female ambulatory schizophrenic patients were randomly assigned to one of four treatments: placebo; amitriptyline hydrochloride, 125 mg/day; perphenazine, 20 mg/day; or amitriptyline-perphenazine, 20 mg/day. Treatment groups contained an equal number of male and female patients. Perphenazine alone or in combination was substantially more effective in reducing psychopathological disorder than was the placebo, but there was no evidence to indicate the superiority of the amitriptyline-perphenazine combination over perphenazine alone. Amitriptyline alone was not substantially better than placebo and could not be considered an efficacious medication for the maintenance treatment of these patients. Less response to treatment was made by patients with longer-term records of prior hospitalization.

Adult↗