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At least 739 records · Page 41Linked to original sources
PubMed1976

[Comparison of the effects of the anthracene derivative danitracen (WA335-BS) and amitriptyline in depressive patients (author's transl)].

9,10-Dihydro-10-(1-methyl-4-piperidylidene)-9-anthrol (danitracen, WA 335) is a substance with a stronger peripheral and partly central antiserotonin and antihistamine effect than cyproheptadine. In 5 different hospitals, WA 335 (3 X 1 mg/die) was investigated versus amitriptyline (3 X 50 mg/die) in a double-blind study in 116 depressive patients of different nosology. In the end of the investigation period (20 days), under WA 335 treatment 67.7% and under ami-riptyline treatment 66.7% of the patients showed an improvement of 50% = decrease in the Hamilton depression score. However, a decrease of 50% in the selfrating scale (von Zerssen) was only shown by 57% of the patients under WA 335 administration and 51% under amitriptyline administration. There were no significant differences seen as regards course and side effects of the two drugs. Like amitriptyline, WA 335 shows sedative properties at the beginning of therapy.

Adult↗
PubMedDate not supplied

[A case of metabolic interaction: amitriptyline, fluoxetine, antitubercular agents].

Polytherapy is often used in clinical practice. The drug associations may lead to pharmacokinetic and/or pharmacodynamic interactions, with clinical implications. The authors reported a quantified illustration of 2 types of interactions in a depressed patient: between antidepressants, amitriptyline and fluoxetine, between these antidepressants and antituberculosis. Firstly, when fluoxetine was added to amitriptyline, it was observed, as expected, an increase of the tricyclic and its metabolite plasma levels, despite a decrease of its dosage. Secondly, when antituberculosis were added to the 2 antidepressants, it was observed a decrease of the tricyclic drug plasma levels. These levels remained below the therapeutic window even when the tricyclic antidepressant dosage was increased. It seems that the fluoxetine interaction disappeared. The competition between the inhibitory effect of fluoxetine and the induction of rifampicin, on the metabolism of amitriptyline is discussed.

Adult↗
PubMed1994

Effects of epinephrine, norepinephrine, magnesium sulfate, and milrinone on survival and the occurrence of arrhythmias in amitriptyline poisoning in the rat.

OBJECTIVES: Cardiac depression is the main adverse effect of severe tricyclic antidepressant poisoning. The aim of this study was to compare the effects of several inotropic drugs on survival and the occurrence of arrhythmias in the treatment of amitriptyline poisoning. DESIGN: Nonrandomized, controlled intervention trial. SETTING: University laboratory. SUBJECTS: Eighty-six male Wistar rats anesthetized with pentobarbital and mechanically ventilated. INTERVENTIONS: Rats subjected to a 60-min continuous infusion of amitriptyline (1.25 mg/kg/min) were treated with a continuous infusion of either epinephrine, norepinephrine, milrinone, magnesium, epinephrine + magnesium, or norepinephrine + magnesium. MEASUREMENTS AND MAIN RESULTS: Without treatment, all animals exhibited arrhythmias on the electrocardiogram within 20 mins. All treatment drugs delayed the onset of arrhythmias, but significant differences were only observed after administration of epinephrine, epinephrine + magnesium sulfate, and norepinephrine + magnesium sulfate. All the inotropic drugs markedly increased survival. Sodium concentrations were unaffected by all treatments. In control animals, potassium concentrations increased during amitriptyline infusion. Norepinephrine treatment had no effect on potassium concentrations, whereas all other treatments resulted in decreased potassium concentrations. CONCLUSIONS: All inotropic drugs used in the study increased survival in tricyclic antidepressant poisoning in rats without increasing the risk of arrhythmias. Furthermore, epinephrine and norepinephrine + magnesium sulfate were effective in preventing arrhythmias, possibly due to improved hemodynamic performance or potassium homeostasis.

Amitriptyline↗
PubMedDate not supplied

[Psychotropic profile of essential antidepressants (amitriptyline, imipramine, desipramine, chlorimipramine): comparative study].

Comparative studies of the therapeutic activity of amitriptyline, imipramine, desipramine and chlorimipramine were studied in a group of 185 patients with endogenous depression. After standard 28-day treatment, the best results were obtained while using amitriptyline (improvement rate 67%, the greatest reduction in the Hamilton Depression Scale scored on 28-day of the treatment). The profile and characteristics of antidepressive action of all the drugs taken into consideration are comparable (including slightly more expressed sedative and deliberative effects of amitriptyline). Desinhibitive influence of desipramine and imipramine was not proved. Neither was tachythymoleptic activity of desipramine found. The study does not support the relation between the antidepressive action profile of tricyclic antidepressants and their influence on reuptake of monoamines (norepinephrine and serotonine).

Adult↗
PubMedDate not supplied

The influence of amitriptyline and flunarizine on catecholamine response to light in patients with migraine.

The effect of amitriptyline on catecholamine (CA) response to light of 20 migrainous patients was studied. The drug was given orally, 36 mg daily (12 mg x 3), for ten days. Before therapy, the migraineurs responded to light by an increase in epinephrine (E) excretion and not by the rise in norepinephrine (NE) excretion, noticed in controls. The NE excretion of migrainous subjects underwent very often a depression after photostimulation. Amitriptyline therapy prevented the post-photic rise in E excretion of migraineurs, without influencing significantly the variation in NE excretion produced in them by light. In other 8 migrainous subjects the effect of flunarizine, a selective calcium channel blocker, on CA response to light was tested. The dosage was of 5 mg daily, for ten days. Flunarizine had similar effects to those displayed by amitriptyline; the drug prevented the rise in E excretion produced by light without normalizing the NE response to light of migrainous subjects. The results suggest that the efficiency of these two drugs in migraine prophylaxis is connected with the ability of these substances to block the E discharge produced in migraineurs by light or by other stimuli. The interpretation is all the more likely as propranolol, another drug applied in migraine prophylaxis also blocks the post-photic E discharge of migraineurs.

Amitriptyline↗
PubMed1993

Dysesthetic ("essential") vulvodynia. Treatment with amitriptyline.

Twenty patients with chronic vulvar burning (vulvodynia) who had relief of symptoms only after treatment with low-dose amitriptyline were studied retrospectively. These patients had several factors in common, which suggested a possible neurologic component to their symptoms. The dosage of amitriptyline (initiated at 10 mg, gradually increased to 40-60 mg daily) was not sufficient to treat depression, but was in the range effective for other cutaneous dysesthesias. This study defines dysesthetic ("essential") vulvodynia, and describes a typical profile and symptom pattern for patients most likely to respond to treatment with amitriptyline (an average age of 66 with vulvodynia for three years). Dysesthetic vulvodynia appears to be a subset different from vulvar vestibulitis and other types of vulvodynia that are less responsive to treatment with tricyclic antidepressants.

Adult↗
PubMedDate not supplied

[The effect of amitriptyline on the pathological crying and other pseudobulbar signs].

The efficacy and tolerability of amitriptyline on the pathologic crying and other pseudobulbar signs were investigated in 22 consecutive patients diagnosed mostly as ALS. The occurrence and intensity of pathologic crying, dysarthria, dysphagia, jaw reflex and primitive reflexes (snout, palmo-mental and oral), were assessed before and after 3 and 6 weeks of amitriptyline treatment. The drug administered in low dose (30-100 mg, mean 64 +/- 17.6 mg) significantly decreased the frequency of pathologic crying in 17 patients after 3 weeks and in 20 patients after 6 weeks of treatment. There were no changes in the intensity of the other pseudobulbar signs. Only few mild and transient side effects were observed. The authors conclude, that amitriptyline is an effective treatment of pathologic crying in ALS patients.

Adult↗
PubMed1977

Electrocardiographic findings in patients undergoing amitriptyline treatment.

Fifteen depressed patients were treated with amitriptyline in a dosage ranging from 75 mg to 200 mg/day for a minimum of three weeks, two of which were at a fixed dosage. Plasma samples were drawn 12 to 16 hours after the bedtime dose of medication for determination of amitriptyline and its metabolite nortriptyline. Electrocardiograms were taken prior to treatment and after three weeks of drug treatment. The only abnormality noted prior to treatment was bradycardia in one patient. After treatment, two patients exhibited nonspecific T-wave abnormalities. Otherwise, the electrocardiograms were unremarkable. A significant increase in heart rate (p less than 0.001) was noted. The mean increase in rate was sixteen beats per minute. Those patients having a rate change greater than sixteen beats per minute had significantly higher amitriptyline levels (p less than 0.05), and total tricyclic antidepressant levels (p less than 0.05), than those patients having a mean rate increase less than sixteen. While tricyclic antidepressants can produce multiple cardiac effects, the risk of cardiac morbidity and mortality is relatively low in patients undergoing tricyclic antidepressant treatment with moderate dosages.

Adolescent↗
PubMed1977

Studies of excretion in rabbit milk after administration of carbon-14 labelled amitriptyline and nortriptyline.

The excretion with rabbit milk has been investigated after subcutaneous administration of carbon-14 labelled amitriptyline and nortriptyline. The amounts of drug material in suckling neonates from nursing rabbits dosed repeatedly with the two drugs were also measured. It was found that the concentrations of radioactivity in milk were of the same size as the concentration in serum. The concentrations of radioactivity in the organs of neonates, which had received milk from rabbits dosed for five days with either amitriptyline or nortriptyline were considerably below those found in the corresponding organs of the dam. Amitriptyline administration to the dams seems to lead to higher concentrations in the organs of the offspring than does nortriptyline administration.

Amitriptyline↗
PubMed1998

Differential effects of chronic administration of the antidepressants amitriptyline and rolipram on adenylyl cyclase activity.

Significant increases were observed in guanylylimidodiphosphate- and fluoride-stimulated adenylyl cyclase activities in synaptic membrane preparations from rat cerebral cortex subsequent to the repeated administration of rolipram and amitriptyline. The potency of GppNHp-dependent inhibition of adenylyl cyclase was decreased by chronic treatment with rolipram but not by amitriptyline treatment. These findings suggest that chronically administered rolipram and amitriptyline share the augmentation of adenylyl cyclase activity by different actions on post-receptor signaling.

Adenylyl Cyclases↗
PubMed1976

A sensitive method for the determination of amitriptyline and nortriptyline in human plasma.

A highly sensitive and reproducible GLC technique for the quantitation of amitriptyline and nortriptyline is described. The lower limit of detection is less than 1 ng/ml. 5 ng/ml samples (3 ml aliquots) can be accurately quantified (C of V less than 5%). Steady state data are reported together with data on amitriptyline and nortriptyline levels obtained in a volunteer who ingested a single oral dose (25 mg) of amitriptyline (Elavil).

Adult↗
PubMed1992

Minaprine in depression. A controlled trial with amitriptyline.

Minaprine (200 mg daily, either once or divided b.d.) was compared with amitriptyline (25-50 mg t.d.s.) over six weeks in 144 patients with major depression. Significant reductions in HRSD scores at the end of six weeks' treatment were recorded with both dose regimes of minaprine and with amitriptyline, with no significant differences between them. There was a significantly greater incidence of drowsiness and dry mouth with amitriptyline than with minaprine.

Adult↗
PubMed1979

Treatment of secondary depression in schizophrenia. A double-blind, placebo-controlled trial of amitriptyline added to perphenazine.

The combination of antidepressants and neuroleptics has been widely recommended and commonly used clinically for the schizophrenic patient who becomes depressed. However, the value of the combination for these patients has not been clearly demonstrated. This report presents results of a double-blind, randomized, placebo-controlled clinical trial designed to evaluate the combination of perphenazine and amitriptyline hydrochloride with that of perphenazine alone in the treatment of 35 ambulatory chronic schizophrenic patients in whom depressive symptoms developed. Results showed that the addition of amitriptyline to perphenazine, when compared with perphenazine alone, was more effective in reducing symptoms of depression after four months of treatment, but less effective in reducing thought disorder. The study concludes that the value of adding an antidepressant to the usual neuroleptic in the treatment of secondary depression in schizophrenia should be reviewed.

Adolescent↗
PubMed1986

Anorexia nervosa. Treatment efficacy of cyproheptadine and amitriptyline.

Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a significant decrease in the Hamilton depression ratings.

Adolescent↗
PubMed1998

Nonaqueous capillary electrophoretic separation and thermo-optical absorbance detection of five tricyclic antidepressants and metabolism of amitriptyline by Cunninghamella elegans.

We developed a technique based on nonaqueous capillary electrophoresis and laser-based thermo-optical absorbance detection to assay five antidepressants with similar structures and mass-to-charge ratios. A mixture of methanol and acetonitrile with ammonium acetate was essential to achieve baseline resolution of these compounds. We investigated the effects of ammonium acetate concentration, temperature, applied voltage, and capillary length on separation efficiency. The nonaqueous capillary electrophoresis and laser-based thermo-optical absorbance detection technique was used to study the metabolism of amitriptyline by Cunninghamella elegans. Sample preparation procedures were simplified for fast screening of the parent drug and its metabolites. Reproducible electropherograms were obtained from replicate cultures of C. elegans growing in the presence of amitriptyline.

Amitriptyline↗
PubMed1987

Jejunal ulceration and stricture due to wax-matrix potassium chloride tablets and amitriptyline.

A 68-year-old woman presented with abdominal distention of several weeks duration and an acute small bowel obstruction. For several years she had been prescribed amitriptyline 150 mg/d, L-thyroxine 100 micrograms/d, and digoxin 0.25 mg/d. For the previous year she had been taking hydrochlorothiazide 50 mg/d and wax-matrix KCl 20 mEq/d for hypertension. At surgery a "napkin-ring" stricture of the midjejunum was found. It had microscopic features consistent with KCl local toxicity. It is speculated that delayed gastrointestinal motility secondary to amitriptyline predisposed this patient to wax-matrix KCl toxicity and that this potential side effect be considered when prescribing wax-matrix KCl.

Aged↗
PubMed1988

Sleep apnea following withdrawal of amitriptyline.

A 41-year-old man developed sleep apnea following abrupt cessation of amitriptyline. Cessation of antidepressants may result in excessive release of acetylcholine, which increases REM sleep. This in turn increases disordered breathing time and decreases nocturnal oxygenation. Sleep apnea did not recur when amitriptyline was reinstated and later gradually discontinued.

Adult↗
PubMedDate not supplied

A double-blind clinical trial of mianserin versus amitriptyline: differentiation by adverse symptomatology.

A 6-week double-blind comparison of mianserin, a new antidepressant, and amitriptyline allowed us to explore the problem of demonstrating main effect differences in drug/drug trials when the focus is primarily only upon efficacy or upon common adverse symptomatology. Statistical analyses of standard psychiatric rating scales revealed no significant treatment differences, while both treatment groups exhibited significant parallel improvement across time. Examination of treatment emergent symptoms indicated that, while it evoked fewer anticholinergic symptoms than amitriptyline, mianserin exhibited a different profile of adverse symptomatology. The usefulness of a measure of the benefit/risk ratio was described as a means of clarifying drug/drug comparisons.

Adult↗