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At least 955 records · Page 53Linked to original sources
PubMed1986

Treating delusional depressives with amitriptyline.

Thirty-five delusional depressed patients were treated for either 28 or 35 days with amitriptyline. The 12 responders could not be differentiated from the nonresponders on a variety of demographic and clinical characteristics. Patients with amitriptyline+nortriptyline plasma levels above 250 ng/ml were significantly more likely to be responders than were patients with levels below that value (p less than .05). A review of the relevant literature revealed that, although some delusional depressives do respond to treatment with tricyclic antidepressants, the presence of delusions is a predictor of poor response to tricyclic antidepressants.

Adult↗
PubMed1987

Applications of column-switching technique in biopharmaceutical analysis. I. High-performance liquid chromatographic determination of amitriptyline and its metabolites in human plasma.

A new high-performance liquid chromatographic method for the determination of amitriptyline and its metabolites, nortriptyline, 10-hydroxynortriptyline and 10-hydroxyamitriptyline, in plasma is described which uses direct injection and a column-switching valve. The method is based on the enrichment of drugs on a reversed-phase concentration column, packed with Corasil RP. The enriched drugs were then separated, using back-flush mode on a bonded-phase CN column using an isocratic acetonitrile-acetate buffer (60:40, v/v) mobile phase. The validation of the method showed excellent sensitivity, precision and reproducibility. The limit of detection, using a 250-microliter direct injection of plasma, was between 5 and 10 ng/ml for each of the four drugs. The mean coefficient of variation for intra- and inter-assay was better than 5%. The method showed obvious advantages over conventional extraction procedures in terms of speed and ease of sample handling. The method has been successfully applied to the samples from patients receiving oral doses of amitriptyline.

Amitriptyline↗
PubMed1978

[Lofepramine: a comparative clinical study with amitriptyline].

Lofepramine, a new tricycle antidepressant, is compared with amitriptyline in a double-blind study. A brief pharmacological description of the drug is made emphasizing its low toxicity and anticholinergic peripheral effects, high plasmatic concentration levels and good tolerance and elimination in comparison with some other known tricycle antidepressants. Sixty depressive outpatients of a Mental Health Service in Lima, 5 male and 55 female, aging 16 to 65, 29 endogenous and 31 neurotic were studied with both drugs in a equimolar dosage. Through the chi square test, no statistical significance was found in maximal therapeutic response, Hamilton Depression Rating Scale scores, type of depression, and side-effects xerostomy which is lesser with lofepramine. A discussion of these results is made and it is concluded that in the present study lofepramine compared with amitriptyline has a similar therapeutic effect. Though not statistically significant, lofepramine seems to be better for neurotic depression and patients sensitive to anticholinergic side-effects.

Adjustment Disorders↗
PubMedDate not supplied

Determination of amitriptyline and its major basic metabolites in human urine by high-performance liquid chromatography.

A high-performance liquid chromatographic method for the routine, simultaneous determination of amitriptyline and its basic metabolites in human urine has been developed. 10-Hydroxylated metabolites are analyzed as their 10,11-dehydro analogs, and primary and secondary amines as their N-trifluoroacetyl derivatives. The use of gradient elution enables amitryptyline, nortriptyline trifluoroacetate, desmethylnortriptyline trifluoroacetate, and the corresponding 10, 11-dehydro analogs to be separated from both each other and from the internal standard used. In this way all six compounds may be conveniently measured in a single chromatogram, with good sensitivity and accuracy. Following administration of a single oral dose (25 mg) of amitriptyline hydrochloride to two human subjects, no unchanged drug was found in any of the urine samples analyzed up to 72 hr after dosing, and only small amounts of nortriptyline and desmethylnortriptyline were observed. 10-hydroxynortriptyline was the major biotransformation product (about 40% of the dose) in urine, with 10-hydroxyamitriptyline and 10-hydroxydesmethylnortriptyline present as minor metabolites. During 72 hr after administration, approximately 60% of the dose was recovered as these five metabolites.

Adult↗
PubMedDate not supplied

[Study of intravenous amitriptyline in acute depressions (author's transl)].

The author has performed an open study of 27 patients with an acute depressive state, hospitalized and treated with slow intravenous perfusions of amitriptyline. Similar perfusions of chlorimipramine act certainly more rapidly on depression, but conversion to oral dose raises some problems regarding active dosis. Intravenous amitriptyline reduces latency, is more sedative and without major intolerance, such as hemodynamic. Conversion to oral diffused forms (Redomex diffucaps) consolidates the results obtained by parenteral administration, and the antianxiety component permits the use of this drug in monotherapy.

Acute Disease↗
PubMed1982

Response of postpsychotic depression to adjunctive imipramine or amitriptyline.

Case histories were reviewed of 25 patients with RDC diagnoses of schizophrenia or schizoaffective disorder who developed a clinical syndrome of depression subsequent to the resolution of their psychotic episodes. Of these patients, 14 were then treated with imipramine and 11 with amitriptyline in addition to their neuroleptic drugs. As a group, the patients did well--48% had a remission of depressive symptoms and an additional 32% improved. Psychotic exacerbation was noted in only one patient. Imipramine seemed more beneficial than amitriptyline in these patients.

Adult↗
PubMedDate not supplied

Quaternary ammonium-linked glucuronides of amitriptyline, imipramine, and chlorpromazine.

The quaternary ammonium-linked glucuronides of amitriptyline, imipramine, and chlorpromazine were shown to be conjugated in vitro using an immobilized rabbit hepatic microsomal enzyme preparation. It was shown that fast atom bombardment mass spectrometry could be used for direct characterization of these involatile, thermally labile metabolites. The quaternary ammonium-linked glucuronides of amitriptyline and imipramine were demonstrated to be present in urine from patients receiving therapeutic doses of these tricyclic antidepressants.

Amitriptyline↗
PubMed1980

Regulation of serotonin2 (5-HT2) receptors labeled with [3H]spiroperidol by chronic treatment with the antidepressant amitriptyline.

Recently, we reported that chronic administration of several antidepressants of different classes produced larger reductions in numbers of serotonin2 (5-HT2) receptors in rat brain labeled by [3H[spiroperidol than in beta adrenergic receptors. In the present study, we examine detailed properties of 5-HT2 receptor regulation by chronic treatment with amitriptyline. Chronic but not acute treatment with the tricyclic antidepressant amitriptyline reduces binding to 5-HT2 receptors by [3H]spiroperidol and beta adrenergic receptor binding of [3H]dihydroalprenolol in brain membranes. The decrease is time-dependent, gradually reversible and represents a change in the number of binding sites with no alteration in drug affinities for 5-HT2 receptors. The effect can be observed at daily doses of 2.5 mg/kg, similar to clinically effective doses in humans. At all doses and time intervals, the decrease in 5-HT2 receptors is more marked than the concurrent change in total beta adrenergic receptor binding. The properties of 5-HT2 receptor reduction after chronic antidepressant treatment indicate that this alteration could be associated with therapeutic response.

Amitriptyline↗
PubMed1984

A placebo-controlled, double-blind trial of amitriptyline in bulimia.

Bulimia is an eating disorder characterized by a pattern of episodic binge-eating. Patients with this eating disorder frequently demonstrate depressive symptoms when seen for evaluation. A familial association between bulimia and affective disorders has also been suggested. The authors report a placebo-controlled, double-blind trial of amitriptyline hydrochloride in a series of 32 female outpatients who satisfied DSM-III criteria for bulimia. The results of this study indicated that amitriptyline hydrochloride at a dosage of 150 mg at bedtime had significant antidepressant activity in this group of patients. Patients in both the placebo and active drug group also received a minimal behavioral treatment program in addition to drug therapy. Both groups demonstrated considerable improvement in eating behavior. The magnitude of this improvement was dramatic and not anticipated. The drug was well tolerated and was not associated with weight gain or increased carbohydrate craving.

Adult↗
PubMed1983

Comparison of the effects of bupropion and amitriptyline on cardiac conduction in depressed patients.

Tricyclic antidepressants may prolong cardiac conduction as a result of their direct cellular membrane depressant effects. These effects can be evaluated by careful quantitative assessment of the electrocardiogram (ECG). This study compared the ECG effects of bupropion and amitriptyline at therapeutically comparable doses. No significant changes were seen with bupropion in any of the ECG parameters measured (PR interval, QRS duration, QTc interval, and QRS height). Amitriptyline, however, caused a significant prolongation in PR interval (p less than .01) and QRS duration (p less than .05), as well as a decrease in QRS height (p less than .001). These results suggest that bupropion is less likely to cause cardiac conduction abnormalities in patients prone to such problems, or in those patients who overdose.

Amitriptyline↗
PubMed1983

[Endomorphins and experimental analgesic action of amitriptyline].

The analgesic effect of several doses of amitriptyline was studied in rats. The lower doses of the tricyclic compound showed clear analgesic properties whereas the higher doses remained ineffective. Naloxone, deprived of effect when administered alone, reduced the antinociceptive action of amitriptyline. These results suggest that the analgesic properties of the tricyclic compound could involve endorphin central systems.

Amitriptyline↗
PubMed1980

[EEG and the action of TRH: comparison with amitriptyline].

A comparative evaluation of the EEG provocative action of TRH and amitriptyline was performed on 15 epileptic patients. TRH slightly increased the EEG abnormalities of 6 patients without giving important side effects. Amitriptyline was effective on 11 patients, but in two instances, gave rise to an epileptic fit.

Adolescent↗
PubMed1983

Electrocardiographic effects of tranylcypromine vs. amitriptyline.

The authors compared ECG changes during the course of treatment with a tricyclic antidepressant (amitriptyline) or a monoamine oxidase inhibitor (tranylcypromine) in 22 adult psychiatric patients. Amitriptyline-treated patients showed increased heart rate, PR, QRS, and QTc intervals. Tranylcypromine-treated patients showed no significant changes in ECG parameters. The clinical significance of the differing pattern of ECG effects for tricyclic antidepressants and monoamine oxidase inhibitors is discussed.

Adult↗
PubMed1982

Comparative teratogenicity of chlordiazepoxide, amitriptyline, and a combination of the two compounds in the fetal hamster.

A combination of chlordiazepoxide and amitriptyline maternally administered as a single intraperitoneal injection on day 8 of gestation in the fetal hamster produced predominantly central nervous system anomalies including exencephaly and encephalocoele. In addition, omphalocoele, spinal flexion, and microcephaly were noted. A dose response relationship was found in which a maternal dose range of 13/33 mg/kg--33/83 mg/kg chlordiazepoxide/amitriptyline produced 7-92 percent fetal anomalies. Combination drug dose levels up to 23/58 mg/kg produced no maternal mortality. However, higher levels did result in a marked dose dependent mortality rate. The teratogenic potential of the combined drugs is much more pronounced than that of either drug administered alone since chlordiazepoxide at a maternal dose range of 280/3100 mg/kg produced 3-55 percent fetal anomalies, and amitriptyline at a maternal dose range of 60-100 mg/kg produced 6-45 percent fetal anomalies. The majority of these aberrant fetal developmental entities also were classifiable as exencephaly and encephalocoeles. Dose-dependent maternal mortality was observed at all dose levels for each drug administered separately.

Abnormalities, Drug-Induced↗
PubMed1978

Jaundice and eosinophilia associated with amitriptyline.

Eosinophilia and jaundice occured in a depressed patient treated with amitriptyline, an association which is previously unreported. These complications cleared with withdrawal of the drug. This clinical picture should be added to the known hepatic complications of amitriptyline.

Amitriptyline↗
PubMed1982

A double blind comparative study of mianserin and a fixed combination of amitriptyline plus chlordiazepoxide.

A double-blind comparative trial was carried out in 64 depressed out-patients, comparing mianserin with a fixed combination of amitriptyline + chlordiazepoxide. Both preparations proved to be equally effective at the end of the trial, but the mianserin group showed a considerable therapeutic improvement at the end of the second week, in comparison to the other group. With regard to side-effects, mianserin produced by far less side-effects than the combination of amitriptyline + chlordiazepoxide. It was concluded that mianserin should be considered as one of the most suitable drugs for the treatment of depressed out-patients.

Adolescent↗
PubMed1982

A double-blind comparative clinical study of amoxapine and amitriptyline in depressed, hospitalised patients.

A double blind controlled trial involving 37 inpatients whose depression was judged clinically to require antidepressant medication revealed that amoxapine and amitriptyline was approximately equal in efficacy. In average daily doses of 139.7 mg and 123 mg respectively, there seemed little difference in speed of action, or in the frequency of side effects, though amoxapine had less central nervous system stimulating consequences (tremors and restlessness) than did amitriptyline.

Adolescent↗