Search PubMed⌕ Search

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.

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

At least 919 records · Page 51Linked to original sources
PubMed1983

Alpha-2 adrenergic receptor sensitivity and the mechanism of action of antidepressant therapy. The effect of long-term amitriptyline treatment.

It has been hypothesized that the mechanism of action of antidepressant treatments is related to their ability to decrease the sensitivity of the alpha-2 adrenergic autoreceptor. In order to assess alpha-adrenergic autoreceptor sensitivity, the effects of clonidine, the alpha-2 adrenergic receptor agonist, on plasma levels of the norepinephrine metabolite 3-methoxy-4-hydroxyphenethyleneglycol (MHPG), blood pressure (BP) and patient-rated sedation were measured in nine depressed patients before and during amitripytline treatment. Postsynaptic alpha-2 adrenergic receptor sensitivity was assessed by determining the growth hormone (GH) response to clonidine before and during treatment. Amitriptyline significantly attenuated the effects of clonidine on plasma MHPG, standing systolic BP, and sedation, indicating that alpha-2 adrenergic autoreceptors had become subsensitive. In addition, baseline plasma MHPG levels were significantly reduced. Amitriptyline had no effect on the GH response to clonidine.

Adolescent↗
PubMed1983

Subjective side-effects of amitriptyline and lithium in affective disorders.

The prevalence of subjective side-effects was studied in 258 control subjects, 65 drug-free depressive in-patients and 94 lithium-treated out-patients. It was shown that drug-free depressives reported more side-effects than both control subjects and lithium-treated patients. Side-effects were studied during amitriptyline therapy. Depressed patients on no medication complained of only slightly fewer side-effects than when they had received amitriptyline. There was a significant positive correlation of Hamilton depression scores and side-effects scores at baseline. Side-effects and affective morbidity over two years were investigated in 94 patients with recurrent affective disorders on long-term lithium therapy. Psychological variables were also investigated in 74 of these patients. Subjective side-effects reported by lithium-treated patients including those specific to lithium were related to their affective morbidity and personality variables. Patients on lithium complained significantly less of headache and unilateral headache than controls.

Amitriptyline↗
PubMed1976

Amitriptyline in the prophylaxis of migraine. Effectiveness and relationship of antimigraine and antidepressant effects.

Amitriptyline was evaluated as a prophylactic antimigraine agent in 110 patients with severe migraine. This agent improved the migraine more than 50 percent in 72 percent of patients and more than 80 percent in 57 percent of patients. Most of the 31 patients with less than 50 percent improvement had virtually no response. Depression, measured with the Zung Self-Rating Depression Scale, was absent in 40 patients, borderline in 53, and moderate to severe in 17. Overall, depression ratings improved minimally with therapy. There was a weak relationship between improvement in depression and improvement in migraine. Subgroups with a stronger correlation of these could not be found. This work suggests that amitriptyline is effective in migraine prophylaxis and that it has a primary effect on migraine that is relatively independent of its antidepressant action.

Amitriptyline↗
PubMedDate not supplied

Amitriptyline therapy increases electrocardiographic changes during reversal of neuromuscular blockade.

Induction of anesthesia is associated with an increased incidence of cardiac arrhythmias in patients maintained on amitriptyline medication. This study presents additional evidence showing that, in experimental animals (cats), amitriptyline treatment also produces significant ST-T wave and conduction abnormalities during neostigmine reversal of neuromuscular blockade.

Amitriptyline↗
PubMedDate not supplied

Therapeutic usefulness of amitriptyline in spastic colon syndrome.

The therapeutic efficacy of amitriptyline in irritable bowel was studied in a cross-over double-blind trial, employing fourteen patients whose symptoms were rated as Class II or worse on an arbitrarily-defined interval scale and who had not benefited from previous trials of anticholinergics, anticholinergic-sedative combinations, and bulk-forming agents. During the study, patients rated their own symptoms and the interviewer rated their symptoms using the same scale. Average scores for the patients while on drug showed significant improvement compared to pre-test level. No placebo or drug carry-over effects could be demonstrated. Inasmuch as amitriptyline is effective in this context at dosages subtherapeutic with regard to depression, the authors suggest that a central (perhaps anticholinergic) mechanism of action is responsible.

Adult↗
PubMed1980

Stimulus intensity control in depression: a study of the comparative effect of doxepin and amitriptyline on cortical evoked potentials.

The perceived intensity of a stimulus may be magnified during depression. Stimulus intensity control can be studied by means of cortical evoked potentials. In a study of 33 depressives, cortical evoked potentials were greater during depression than on recovery. The effect of doxepin on the amplitudes of evoked potentials of depressives was compared with that of amitriptyline. Doxepin reduced amplitudes. Amitriptyline had a similar, but non-significant effect.

Adolescent↗
PubMed1984

Sperm immobilizing potency of amitriptyline and imipramine: measured with transmembrane migration.

The inhibitory effect of amitriptyline and imipramine on human sperm motility was measured in vitro with a transmembrane migration method. The EC50 for amitriptyline and imipramine were 170 microM and 160 microM respectively. They were more potent than any other drug that had been tested on this pharmacological model. Transmembrane migration method was less sensitive than turbidimetric method to detect the sperm immobilizing effect of drugs.

Amitriptyline↗
PubMed1982

Cardiovascular changes and plasma drug levels after amitriptyline overdose.

Electrocardiographic and blood pressure parameters in 17 patients after amitriptyline overdose were reviewed in a retrospective study. Seven patients for whom baseline electrocardiograms (EKGs) were available showed significant increases in heart rate and QRS duration after overdose. Ventricular arrhythmias were observed in only one case, the sole fatality, who demonstrated the highest amitriptyline plus nortriptyline plasma level. Most patients experienced sinus tachycardia (88%) and hypotension (53%). Widened PR and QRS after overdose also were common. For the total group, postoverdose TCAD levels correlated with PR (r = .66, p less than .01) and QRS (r = .55, p less than .05) values, and with lowest observed systolic (r = -.60, p = .01) and diastolic blood pressure (r = .50, p less than .05) but not QTc or heart rate. The difference between the mean TCAD levels of subjects with lowest systolic blood pressure less than 100 mmHg and those with higher readings was significant at the 0.05 level.

Adolescent↗
PubMed1987

Treatment of ciguatera fish poisoning with amitriptyline and nifedipine.

Ciguatera fish poisoning is the most common fish poisoning in the United States. Symptoms involve the gastrointestinal, cardiovascular and neurological systems. No known treatment exists. We explore the therapeutic effect of amitriptyline in two patients and nifedipine in one patient. Amitriptyline demonstrated resolution of most symptoms except for heat/cold reversal in one patient and heat/cold reversal, pruritus and headache in the second patient. We then used nifedipine in the second patient and noted only the resolution of his headaches. We recommend further study of these agents for the treatment of ciguatera fish poisoning.

Adult↗
PubMed2006

Improved insulin sensitivity in 80 nondiabetic patients with MDD after clinical remission in a double-blind, randomized trial of amitriptyline and paroxetine.

OBJECTIVE: There is substantial evidence that depression constitutes a risk factor for type 2 diabetes mellitus. A recent study has shown that high salivary cortisol levels are associated with decreased insulin sensitivity in unmedicated, depressed patients. Further, antidepressive treatment might have differential effects on hypothalamus-pituitary-adrenal (HPA) system activity. Therefore, the aim of the present study was to examine whether insulin sensitivity improves during anti-depressive treatment in depressed patients with declining HPA system activity. METHOD: Eighty inpatients with an episode of major depressive disorder (DSM-IV criteria) were treated in a double-blind, randomized protocol with either amitriptyline or paroxetine over a period of 5 weeks. After 6 drug-free days, an oral glucose tolerance test was performed on day 1 and again 35 days after antidepressive treatment. For quantification of free cortisol levels, saliva was obtained daily at 8:00 a.m. during weeks -1 (washout) and 5. The study was conducted from May 2005 to December 2005. RESULTS: The insulin sensitivity index(Matsuda) increased in only those patients who remitted from major depressive disorder as a result of treatment with either antidepressant (F = 7.0, df = 1,74; p < .01), while correcting for body mass index. Further, cortisol concentrations declined in remitters and responders to amitriptyline (F = 2.1, df = 1,70; p < .05), but not in any other subgroup. CONCLUSION: Successful antidepressive treatment with either a selective serotonin reuptake inhibitor or a tricyclic substance increases the sensitivity to insulin in nondiabetic depressed patients. The herein presented longitudinal data do not exclude the HPA system as a major contributor to insulin resistance in depressed patients, but underscore the assumption of additional factors.

Adult↗
PubMed1984

Evaluation of amitriptyline use for depression when prescribed by internists and psychiatrists.

The efforts involved in structuring and implementing a drug utilization review (DUR) program that was designed to assess the use of amitriptyline for depression when prescribed by internists and psychiatrists is described. In-depth audit criteria were used to identify deviations from the criteria for each group. An immediate goal of this amitriptyline DUR program is to apply the results of the study toward the implementation of a targeted, multifaceted educational program. The design of the DUR program should emphasize the individual needs of each of the two study groups.

Amitriptyline↗
PubMedDate not supplied

Fatal cholestatic jaundice associated with amitriptyline.

A 75-year-old woman was admitted with a two-week history of anorexia and vague abdominal pain. She had been taking amitriptyline 75 mg at night for depression for four months before her admission. On presentation she was jaundiced, but with no stigmata of chronic liver disease. Initial liver function tests showed a slightly raised bilirubin, but were otherwise normal. Over the next three weeks her bilirubin concentration continued to rise without evidence of biliary obstruction on ultrasound examination. Her condition continued to deteriorate, and she later developed renal failure consistent with hepatorenal syndrome. Seven weeks after admission she died following a large gastrointestinal bleed. At autopsy, liver histology confirmed pure cholestasis consistent with amitriptyline ingestion.

Aged↗
PubMedDate not supplied

A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia. An analysis of outcome measures.

OBJECTIVE: To study the efficacy and tolerability of amitriptyline and nortriptyline in a Brazilian population with fibromyalgia and to evaluate the instruments used to measure the efficacy of the treatment. METHODS: A total of 118 fibromyalgia patients were randomly assigned to 3 groups: amitriptyline (AM, n = 40), nortriptyline (NOR, n =38) and placebo (PL, n = 40), and were blindly given 25 mg at bedtime of the assigned treatment for 8 weeks. Clinical evaluation before and at the end of the study included the number of tender points (NTP), FIQ score (FIQ), and global improvement as reported by the patients on a verbal scale (VSGI). RESULTS: The 3 groups were comparable at baseline for all the parameters studied. After 8 weeks, the 3 groups improved in all parameters: (36.5% AM, 26.7% NOR and 24% PL patients improved on FIQ; 13.9% AM, 19.5% NOR and 8.57% PL patients improved on NTP; 86.5% AM, 72.2% NOR and 57.6% PL patients improved on VSGI). Only the AM group differed from the PL group on VSGI. Side effects were noted among the groups, but none were serious (16 in the AM group, 31 in the NOR group, and 25 in the PL group). CONCLUSION: All three groups improved after treatment. Only the patient's subjective global assessment of improvement differed between the AM patients and the PL group (p < or = 0.03). In fibromyalgia, placebo groups are important in drug trials. Different measures of therapeutic effect are not better than the patient's self assessment.

Adolescent↗
PubMedDate not supplied

Determination of amitriptyline in plasma samples by high-performance liquid chromatography.

A simple and selective high-performance liquid chromatographic method for the determination of amitriptyline in human plasma has been developed. For plasma samples, the protein was removed with 1 M NaOH and 0.7 M ZnSO4. aqueous solutions. The chromatographic separation was performed on an analytical mbondapak C18 column (250 3.9 mm, i.d) with an isocratic mobile phase consisting of phosphate buffer-acetonitrile-triethylamine (65:35:0.1 v/v/v) adjusted to pH 5.1. Clomipramine was used as an internal standard. Using ultraviolet detection at 239 nm, the detection limit for amitriptyline in plasma was 5 ng/ml. No interferences were found with tricyclic antidepressant drugs, which allows this method to be used in clinical studies. The calibration curve was linear over the concentration range 5-200 ng/ml. The recovery was complete for plasma. The inter-day and intra-day assay coefficients of variation were found to be less than 10%.

Amitriptyline↗