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At least 937 records · Page 52Linked to original sources
PubMed1992

A double-blind placebo-controlled comparison of moclobemide and amitriptyline in the treatment of depression.

The objective of this study was to determine if moclobemide is an effective treatment for depression and if it is well tolerated by patients. A randomized, double-blind placebo-controlled trial was conducted in a tertiary ambulatory clinic which treats depression. Fifty-five patients participated. They fit the DSM-III-R criteria for major depressive episode, scored at least 18 on the 17 item Hamilton Rating Scale for Depression (HRSD), were between the ages of 18 and 65, and were not suffering from a major medical illness. After a one week washout period, patients were randomly selected to receive placebo, amitriptyline or moclobemide for up to six weeks. Moclobemide is a well-tolerated medication at therapeutic doses; it is globally as effective as amitriptyline in the treatment of major depression.

Adult↗
PubMed1963

A psychiatric and psychological study of amitriptyline (Elavil) as an antidepressant.

The antidepressant effects of amitriptyline (Elavil) were investigated by means of psychiatric assessment and psychological testing of 20 depressed patients who were compared, before and after treatment, with a placebo-treated control group of 14 similar patients. After three weeks on doses of 150 mg. per day, 13 out of 20 of the actively treated group were rated as improved, compared with only three out of 11 of the control group (p < .05). Clinical improvement was associated with changes on some objective tests. No persistent adverse side effects were observed. It was concluded that amitriptyline is an effective antidepressant.

Amitriptyline↗
PubMed1992

[Side effects of amitriptyline in relation to its plasma levels].

In a 21-day investigation in 15 patients with depression the authors investigated the incidence of undesirable side-effects in relation to plasma amitriptyline levels. The authors found the upper range of plasma concentrations when the patient's risk is minimal as regards serious undesirable complications. This upper limit is 350 micrograms/l; as compared with previous work, they consider amitriptyline levels from 150 to 350 350 micrograms/l safe and therapeutically effective. The authors consider investigation of plasma levels indicated in risk patients and in patients with an inadequate response to treatment.

Adult↗
PubMed1991

[Anacollagenase by the action of amitriptyline on Clostridium histolyticum collagenase].

Intraperitoneal injection of a mixture of collagenase (300 U) and amitriptyline (Laroxyl*, 3 mg) induce no lesions in contrast with the severe effects of collagenase alone. Also, a complete resistance to intraperitoneal collagenase injection is observed when preceded by 3 intramuscular injections of the same mixture (associated with Freund's incomplete adjuvant). This is due to the development of collagenase antibodies, as demonstrated by nephelometry and immunodiffusion. These facts show that amitriptyline neutralizes the enzymatic properties of collagenase, without alterring its antigenicity. We propose to call this new substance anacollagenase. Such a phenomenon has never been observed with a drug. However we got identical results with other tricyclic depressants (clomipramine, imipramine, doxepine, iprindole). The mechanism of the transformation of collagenase into anacollagenase is not yet explained.

Amitriptyline↗
PubMedDate not supplied

[Plasma amitriptyline level and its therapeutic effectiveness in patients with affective disorders].

57 patients treated with amitriptyline because of depressive syndrome in the course of affective disorder were studied. The drug level in plasma was measured weakly using a gas chromatograph. A non-linear correlation between the amitriptyline level in plasma and the clinical effect of the treatment was substantiated. The range of therapeutic effectiveness was determined between 68.0 and 185.0 ng/ml.

Adult↗
PubMedDate not supplied

[Trial of amitriptyline versus flunarizine as treatment of vestibular diseases. A preliminary study].

109 patients with vestibular disease were included in two different treatments with amitriptyline (Group A:53 patients with depressive symptoms), or flunarizine (Group B: 56 patients). Vertiginous symptoms, basic vestibular exploration, depressive disorder, cochlear symptoms, vegetative disorders and headache were evaluated. Among the patients treated with amitriptyline a significant decrease in the vertiginous symptoms were observed. The possible mechanism of action were analyzed too.

Amitriptyline↗
PubMed1991

Clinical usefulness of amitriptyline in fibromyalgia: the results of 23 N-of-1 randomized controlled trials.

Twenty-three double blind, randomized, multiple crossover trials (N-of-1 RCT) of amitriptyline were conducted in patients with fibromyalgia. The benefit of amitriptyline was assessed using a symptom questionnaire and count of tender points. To assess the usefulness of the method, the proportion of trials that provided a definite answer was examined. Completing the trial resulted in reaching a high degree of confidence in the final management decision in 74% of trials. In 35% of trials, results led to discontinuation of the drug which otherwise would have been continued indefinitely. The drug benefit, if present, was evident within first 2 weeks of therapy. We concluded that these results support the feasibility and usefulness of N-of-1 RCT in rheumatology practice.

Adult↗
PubMed1977

Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine.

The pain of diabetic peripheral neuropathy responds poorly to current modes of treatment. We treated eight patients with this disorder whose pain was refractory to standard regimens but who experienced remarkable pain relief within two to five days after treatment with fluphenazine hydrochloride, amitriptyline hydrochloride, or a combination of the two. In four patients whose regimens were discontinued, pain recurred within two days and again remitted on reinstitution of the drug regimens. These findings suggest that fluphenazine alone or in combination with amitriptyline may be of benefit in treating the painful peripheral neuropathy associated with diabetes.

Adult↗
PubMed1991

[Acute adult respiratory distress syndrome (ARDS) in a patient with amitriptyline poisoning].

A case of "adult respiratory distress syndrome" after amitriptyline overdosage is reported. Amitriptyline is rapidly absorbed from the intestinal tract and the drug is concentrated in the tissues, particularly the brain, heart and lungs. It is suggested that in large quantities it may inhibit surfactant production and thus cause the clinical picture described. The ventilatory treatments are discussed. It seems that inversed ratio ventilation (IRV) has something to offer, avoiding the use of high oxygen fractions in inspired air and high peak airway pressures. Our patient improved with IRV.

Adult↗
PubMed1990

Myotonic dystrophy: quantification of muscle weakness and myotonia and the effect of amitriptyline and exercise.

The purpose of this study was to quantify the degree of muscle weakness and myotonia in 12 patients with myotonic dystrophy (MD), and to quantitatively determine the effects of a four- to six-month therapeutic trial of amitriptyline. Patients had exercised with weights for one or more years. Some had shown initial improvement in muscle strength, but had reached a plateau; others had not improved when the study began. Muscle weakness was quantified by comparing the five-second maximum voluntary contraction (MVC) in newtons (N) per kg (body weight) of 12 patients and 20 healthy subjects. Knee extensor, elbow flexor, and first dorsal interosseous (FDI) muscles were compared. Myotonia was quantified by measuring relaxation times (RTs) at the end of the five-second MVC produced by FDI, as the time taken for the MVC to decrease by 50% and 75% (referred to as 1/2 and 3/4RT). The results were as follows: (1) the mean muscle strength of each of the three muscles of the patients was significantly (p less than .001) reduced compared with healthy subjects; and (2) 1/2 and 3/4RT means of the patients (vs healthy subjects) were significantly prolonged (p less than .01). Eight of the patients participated in a therapeutic trial of amitriptyline. Therapeutic effects were quantified by measuring muscle strength, 1/2 and 3/4RT, and percent change in evoked muscle action potential (MAP) from the FDI muscle after a ten-second MVC, to determine change in excitability. Mean muscle strength of FDI improved from .27 to .33N/kg, (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1990

The interaction of amitriptyline, doxepin, imipramine and their N-methyl quaternary ammonium derivatives with subtypes of muscarinic receptors in brain and heart.

The interaction of amitriptyline, doxepin, imipramine and their N-methyl quaternary derivatives with muscarinic receptors was investigated in the brain and heart. The potency of the tricyclic derivatives for inhibiting the binding of 11[[2-[(diethylamino) methyl]-1-piperidinyl]acetyl]-5,11-dihydro-6H-pyrido[2,3-b] [1,4] benzodiazepine-6-one to M2 muscarinic receptors in cerebral cortex was similar to that measured in competitive binding experiments with the nonselective muscarinic antagonist [3H]N-methylscopolamine in the corpus striatum and heart. Moreover, the tricyclic derivatives antagonized muscarinic receptor-mediated inhibition of adenylate cyclase activity with similar potency in the corpus striatum and heart, and there was good agreement between the affinities of the tricyclic derivatives when measured by radioligand binding and by antagonism of the adenylate cyclase response. Our results show that amitriptyline, doxepin and imipramine lack selectivity for subtypes of the muscarinic receptor.

Adenylyl Cyclase Inhibitors↗
PubMed1990

Amitriptyline treatment of agitation associated with anoxic encephalopathy.

A 43-year-old man exhibited agitation and nondirected aggression related to anoxic encephalopathy after a myocardial infarction. These symptoms abated upon treatment with amitriptyline, only to return upon its inadvertent discontinuation. The drug was well tolerated, in contrast to neuroleptics, which are frequently associated with serious side effects in this population. Although further experience is needed, amitriptyline may be an effective treatment option in agitation associated with anoxic encephalopathy.

Adult↗
PubMedDate not supplied

[The effect of amitriptyline on the reorganization of the temporal dynamics of forced swimming in rats during stimulation and exclusion of the corpus striatum].

Amitriptyline (10 mg/kg daily for 2 weeks) produces reorganization of the rhythmic structure of forced swimming in rats with a decrease of the rhythmical index of depression. The antidepressant attenuates also steady behavioral shifts and the associated depression in the animals' behavior after discontinuation of prolonged electrostimulation of the striatal body. The electrolytic damage of the striatal body disorganizes temporary dynamics of swimming and these shifts are enhanced by the antidepressant. It is supposed that the specific action of amitriptyline depends on modification of pacemaker striatal function.

Amitriptyline↗
PubMedDate not supplied

The effect of combined treatment with ethanol and imipramine or amitriptyline on rabbit EEG.

The effect of combination of imipramine or amitriptyline acute or chronic treatment with ethanol on EEG was studied in rabbits with electrodes chronically implanted into the frontal cortex, dorsal hippocampus and midbrain reticular formation. In addition, to study the effect of the treatment on development of tolerance to ethanol, a group of rabbits receiving ethanol with antidepressants was additionally injected iv with ethanol once a week. Single doses of both the antidepressants did not alter the effect of acute administration of ethanol on EEG, but imipramine and amitriptyline potentiated the ethanol-induced changes in the EEG recorded from the midbrain reticular formation in rabbits receiving ethanol chronically and in the period of abstinene. The antidepressants did not change the development of tolerance to ethanol.

Amitriptyline↗
PubMedDate not supplied

Amitriptyline metabolites in human urine. Identification of phenols, dihydrodiols, glycols, and ketones.

From the urine patients being treated with amitriptyline, drug metabolites were extracted by adsorption to polystyrene. Nonconjugated compounds and aglycones liberated by enzymic hydrolysis were purified separately by repeated TLC and characterized by physicochemical and chemical methods. Besides the known E- and Z-10-hydroxy derivatives of amitriptyline (AT), nortriptyline (NT), and their primary amine analogue, two isomeric 10,11-dihydroxy compounds could be identified in each series. Metabolites with an oxo function in position 10 occurred in minor quantities. The phenols 2-hydroxy-NT and 2,11-dihydroxy-NT, as well as the 1,2-dihydrodiol derived from NT, were regularly present, while the corresponding tertiary amines as well as 3-hydroxy-AT and -NT were detected occasionally in very small amounts.

Amitriptyline↗
PubMed1988

The influence of panic attacks on response to phenelzine and amitriptyline in depressed outpatients.

A total of 169 depressed outpatients completed a 6-week double-blind study designed to compare the relative efficacy of a tricyclic antidepressant (amitriptyline) with a monoamine oxidase inhibitor (phenelzine). Various "target" symptoms reported to predict preferential response to monoamine oxidase inhibitors were assessed. The major finding within the whole patient sample, based on results from serial self-report and interviewer-rated scales, was that phenelzine-treated patients showed greater improvements in anxiety symptoms than did patients treated with amitriptyline. Because of the heterogeneity of the sample, patients were classified into homogeneous subgroups of clinical interest. Data analyses of these subgroups detected important drug treatment differences not discernible by analysis of data from the overall sample. Panic attacks and corresponding anxiety symptoms were reported by about one third of the patients, more often by patients with major depression than with minor depression. Patients who reported "spells of terror or panic" responded preferentially to phenelzine on several measures, particularly on items measuring anxiety. Results suggest that phenelzine may be a preferred drug for treating depressed patients with panic attacks.

Adolescent↗
PubMed1988

Double-blind placebo-controlled trial of amitriptyline among depressed patients in general practice.

Depressed patients in general practice were included in a double-blind placebo-controlled six-week trial of amitriptyline (median dose 125 mg). The patients were relatively mildly ill and satisfied diagnostic criteria for depression and treatment with antidepressants in routine practice. Amitriptyline was found to be considerably superior to placebo after six weeks and significantly so as early as two weeks after the start of treatment. The effects of the antidepressant were on the core symptoms of depression, and were apparent in all but the most mildly ill patients. The findings suggest that tricyclic antidepressants are of considerable therapeutic benefit to depressed patients in general practice.

Adolescent↗
PubMed1987

Amitriptyline produces dose-dependent supersensitivity of a central cholinergic mechanism.

The discontinuation of tricyclic antidepressants (TCAs) can produce symptoms suggesting cholinergic overdrive. The authors previously proposed that these withdrawal states are the consequence of TCA affected cholinergic system supersensitivity. Evidence that chronic treatment with amitriptyline produces dose-dependent supersensitization of a central cholinergic mechanism is now presented. Core temperature is subject to a hypothalamic muscarinic mechanism. The thermic response of adult male rats to oxotremorine was telemetrically measured after 7 days of treatment with saline or amitriptyline 3, 10, and 20 mg/kg given intraperitoneally twice daily. Treatment with the TCA produced dose-dependent enhancement of oxotremorine-induced hypothermia. The data support the hypothesis that at least some TCA withdrawal phenomena involves supersensitization of muscarinic systems.

Amitriptyline↗