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At least 1,207 records · Page 67Linked to original sources
PubMed1977

Clinical trial comparison of two sustained release forms of amitriptyline.

A double-blind between-group trial was carried out in 50 depressed patients to compare the efficacy of two sustained release forms of amitriptyline--Lentizol and Tryptizol 75. Patients received either Lentizol 50 mg or Tryptizol 75 75 mg each evening for the first week of the trial, and these dosages were then doubled for a further four-week trial period, with the proviso that dosage for individual patients could be maintained at, or altered to, original level where considered necessary by the investigator. Lentizol gave equivalent therapeutic effect to Tryptizol 75 despite the fact that overall dosage was one-third less than in the case of the latter.

Adult↗
PubMed1978

A comparative double-blind trial of the new antidepressant caroxazone and amitriptyline.

On the grounds of pharmacological properties and preliminary clinical trials the efficacy of the new antidepressant caroxazone was compared to amitriptyline in the management of depression. Forty patients mostly suffering from a neurotic or anxious-neurotic depression were admitted to a double-blind trial. All patients completed the study. The Hamilton Rating Scale for Depression was used for the clinical assessment at the beginning, during and at the end of treatment. The trial lasted three weeks. A significant improvement was seen for both drugs after seven days on most symptom scores and on total symptom score. No significant differences were found either at seven days of at the end of treatment between the two drugs. There were no significant differences in the incidence and severity of side-effects. In conclusion, caroxazone appears as an effective and well tolerated drug in the treatment of depression.

Adjustment Disorders↗
PubMed1980

Clinical trial comparison of a sustained release form of amitriptyline with dothiepin.

A double-blind between-group trial was undertaken in fifty depressed patients to compare the efficacy of a sustained release form of amitriptyline (Lentizol) with dothiepin (Prothiaden) over a 5-week period. Patients fulfilling defined admission criteria were randomly allocated to treatment with evening dosage of either 50 mg of the sustained release preparation or 75 mg of dothiepin for the first week of the trial. Subject to review as necessary, these dosages were doubled at the end of the first week. Both drugs effected significant and appreciable improvement over the 5-week period, with the mean responses at the end of the trial retaining the same relative positions as at the beginning.

Adolescent↗
PubMed1981

A comparison of the therapeutic and cardiovascular effects of a single nightly dose of Prothiaden (dothiepin, dosulepin) and Lentizol (sustained-release amitriptyline) in depressed elderly patients.

This was a single-blind 4-week parallel group comparative trial in fifty depressed patients. Twenty-five patients received 50 mg of Lentizol, a sustained-release form of amitriptyline, and twenty-five received 75 mg of Prothiaden. Both groups took their drugs as a single night-time dose. Patient response was measured on a symptom check-list which was completed by the doctor and a self-rating depression scale. Tolerance was assessed by recording volunteered and observed side-effects and also by taking the pulse, blood pressure and an electrocardiogram before treatment and after 2 and 4 weeks. A statistically better response was seen with Prothiaden at each follow-up assessment (1, 2 and 4 weeks) compared to Lentizol as measured by both the symptom check-list and the self-rating scale. Less side-effects was also seen with Prothiaden. Minor changes were seen in the ECG records of two patients on Prothiaden and three on Lentizol. These changes were not associated with any clinical change in the patients' cardiovascular state. No consistent changes of any clinical significance were seen in the pulse and blood pressure recordings.

Aged↗
PubMed1985

Altered amitriptyline kinetics in a depressed patient with porto-caval anastomosis.

A case of altered kinetics of amitriptyline in a patient with porto-caval anastomosis and liver cirrhosis who showed an unusually strong sedative response to the drug, is presented. Therapy with tricyclic antidepressants should be initiated with lower doses and adjusted by plasma level monitoring in patients with liver by-pass.

Administration, Oral↗
PubMed1990

Toxicological findings after fatal amitriptyline self-poisoning.

A case of fatal self-poisoning with amitriptyline is reported. Both the drug and its metabolite nortriptyline were quantified in several post-mortem tissues and fluids, including vitreous humor. Results are discussed in the light of the existing literature.

Adult↗
PubMed1992

Clinical course, therapy, outcome and analytical data in amitriptyline and combined amitriptyline/chlordiazepoxide overdose.

A total of 103 cases of amitriptyline (AT) overdose (group 1) and 81 cases of overdose with a fixed combination of AT and chlordiazepoxide (CDE) (group 2), treated at our Intensive Care Unit or reported to our Poison Information Center between 1985-1990, were evaluated with respect to clinical course, symptoms and outcome, as well as efficacy of therapy. The mean amount of AT was considerably higher in group 1 compared to group 2 (13 mg kg-1 vs 7.7 mg kg-1). The most frequent symptoms in both groups were impaired consciousness, anticholinergic symptoms, seizures, arrhythmia and hypotension. Respiratory insufficiency necessitated respirator therapy in 63 of the patients. Two patients in group 1 and one patient in group 2 did not survive. Therapy included primary detoxification by gastric lavage and repeated administration of activated charcoal. In four of eight patients with cardiac conduction disturbances, hypertonic sodium bicarbonate led to a significant reduction in QRS duration and AV interval. Physostigmine was effective in eight of 14 patients with pronounced anticholinergic symptoms. No effect was observed in the other six patients. Haemoperfusion, which was performed in five patients, led to rapid improvement of coma after initiation of therapy in four patients. The clinical efficacy of haemoperfusion in AT overdose despite the high volume of distribution of AT deserves further investigation. The rather high average overdose of AT implies that large package sizes of AT were available to the patients. A major step towards prevention of serious AT overdose would be the prescription of package sizes containing a total of less than 500 mg AT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Amitriptyline-related peripheral neuropathy relieved during pyridoxine hydrochloride administration.

Tricyclic antidepressants rarely cause peripheral neuropathy. In fact, this class of drugs has been used to control the symptoms of pain and paresthesia that accompany peripheral neuropathy. We report peripheral paresthesias that occurred in a 39-year-old female during five years of amitriptyline administration. The patient's symptoms were relieved by oral pyridoxine hydrochloride, associated with elevated plasma pyridoxal phosphate.

Adult↗
PubMed1976

Double-blind comparison of 3-times daily and single night dosage of amitriptyline, with special reference to side-effects.

Forty-one depressed in-patients completed a 4-week trial in which they were given 150 mg amitriptyline either as 3 daytime doses or as a single dose at bedtime (placebo was given at the other times). There was no significant difference in efficacy, as measured by Hamilton and Wakefield scales. Complaints of dry mouth and blurred vision increased in both groups; increased complaints of a "hung-over feeling" after waking occurred in those having the bedtime dose, but fewer of these gained wieght during the trial.

Adult↗
PubMed1980

Comparison of the efficacy of sustained-release amitriptyline with maprotiline in the treatment of depressive illness.

Forty consecutive psychiatric patients referred to hospital with a diagnosis of depressive illness were randomly allocated to double-blind treatment with either 50 mg sustained-release amitriptyline or 75 mg maprotiline in night-time dosage. The dosage was doubled after 1 week. Rating scale assessments were carried out regularly over a 5-week period. The results indicated that there was a significant improvement with both drugs which occurred at approximately the same speed and to the same extent. Side-effects were complained of by approximately as many patients on both forms of treatment.

Adult↗
PubMed1990

A double-blind comparison of oral amitriptyline and low-dose intramuscular flupenthixol decanoate in depressive illness.

Fifty-seven hospital out-patients with depressive symptoms were studied in a double-blind manner for up to 4 weeks, 30 whilst being treated with intramuscular flupenthixol decanoate (5 to 10 mg/fortnight) and 27 with oral amitriptyline (75 to 150 mg/day). The results of assessment using the Hamilton Rating Scale for Depression, the Leeds Self-Rating Scale for Depression and the Clinical Global Impressions severity scale showed that both therapies were effective in resolving depression in the patients studied. The two treatments were well tolerated and side-effect profiles were similar, dry mouth, faintness/dizziness and drowsiness being the most frequently reported adverse events. Extrapyramidal signs were seen in similar numbers of patients in each treatment group. One patient from each of the two groups was withdrawn from therapy before the end of the study because of adverse events.

Administration, Oral↗
PubMed1978

Trials of lithium, chlorpromazine and amitriptyline in schizoaffective patients.

Two drug trials in schizoaffective patients are reported. Nineteen "schizomanic" patients were treated for one month, on a double blind basis, with chlorpromazine or lithium and 41 "schizodepressive" patients with amitriptyline, chlorpromazine or both. In the schizodepressive patients there was a trend to a better response to chlorpromazine, but drug response generally was poor, only 20 per cent of patients recovering within the month. In the schizomanic patients lithium seemed as effective as chlorpromazine, which supports the view that these patients were suffering from a variant of mania.

Amitriptyline↗
PubMed1979

Amitriptyline: comparison of three different dosage schedules in neurotic depression.

Three groups of neurotic depressed patients were treated with amitriptyline, one group receiving the customary three daily doses, another a single dose in the morning, and the third a single dose at night. All three groups showed significant decrements of total scores on the Hamilton Scale for Depression and the Zung Self-Rating Depression Scale without significant differences. Patients taking the drug at night showed a lower incidence of side effects.

Adjustment Disorders↗
PubMed1986

Imipramine and amitriptyline plasma concentrations and clinical response in major depression.

Plasma drug concentrations and clinical response were measured in two groups of hospitalised depressed patients, who received amitriptyline or imipramine double-blind, in a dosage of 250 mg for four weeks. Virtually no significant linear or curvilinear relationships were found between any plasma measure and any measure of clinical response. Modest but significant direct relationships were found between age and concentration of parent drugs but not demethylated metabolites. Blood drug level measurement therefore appears to be of little value in monitoring drug treatment of depressed in-patients.

Age Factors↗
PubMed1991

Differential action of amitriptyline on neurons in the trigeminal nucleus.

We studied the effect of amitriptyline (AMI) on neurons in the spinal trigeminal nucleus caudalis in cats anesthetized with alpha-chloralose. The IV injection of 1.0 to 4.0 mg/kg AMI had a differential effect on the inhibitory mechanisms controlling the responses of these neurons. AMI significantly enhanced the segmental inhibition (SI) of wide dynamic range (WDR) neurons but had little or no effect on low-threshold mechanoceptive neurons. AMI also facilitated the SI of some nociceptive specific (NS) neurons and the periventricular inhibition of some WDR and NS neurons, but these effects were not statistically significant. Our observations suggest that AMI exerts its antineuralgic effect by enhancing the ability of SI to prevent excessive firing of WDR neurons. This supports the notion that neuropathic pain is caused by dysfunction of inhibitory mechanisms in the CNS.

Action Potentials↗
PubMed1998

Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial.

UNLABELLED: OBJECTIVE (BACKGROUND): Amitriptyline (AT) is a standard therapy for postherpetic neuralgia (PHN). Our hypothesis was that nortriptyline (NT), a noradrenergic metabolite of AT, may be more effective. METHODS: A randomized, double-blind, crossover trial of AT versus NT was conducted in 33 patients. RESULTS: Thirty-one patients completed the trial. Twenty-one of 31 (67.7%) had at least a good response to AT or NT, or both. We found no difference with regard to relief of steady, brief, or skin pain by visual analog scales for pain and pain relief; mood; disability; satisfaction; or preference between the two drugs. Intolerable side effects were more common with AT. Most patients (26/33) were not depressed, and most responding showed no change in rating scales for depression despite the occurrence of pain relief. CONCLUSIONS: We concluded that this study provides a scientific basis for an analgesic action of NT in PHN because pain relief occurred without an antidepressant effect, and that although there were fewer side effects with NT, AT and NT appear to have a similar analgesic action for most individuals.

Aged↗
PubMed1995

The relationship between the pharmacological effect of amitriptyline based on an improved forced-swimming test and plasma concentration in rats.

The relationship between the plasma concentration of amitriptyline (AMI) and its pharmacological effect was investigated in rats. The plasma concentration of AMI was maintained constantly from 5 h to 7 d after intraperitoneal infusion by the implantation of an osmotic minipump with an adjusted release rate of 20 mg/kg/d of AMI. Neither the plasma or brain concentrations of AMI in a 24-h infusion group were significantly different as compared with those in the 7-d group. The pharmacological effect of AMI was measured by our improved forced-swimming test. When AMI (dose of 20 and 50 mg/kg/d) was infused, the pharmacological effect in both infusion groups of rats was increased significantly at each dose in comparison to that of the control rats (p < 0.05). With 10 mg/kg/d infusion, the effect in the 7-d group increased significantly as compared with that of the control (p < 0.05), although the effect in the 24-h group did not change. The effect was increased in both groups with an increase of dose. When the effect was plotted to the area under the plasma concentration-time curve (AUC), the effect approached a limiting value (12 micrograms/ml.h). Therefore, it was suggested that 12 micrograms.ml/h as the AUC for AMI was enough to obtain a maximum AMI pharmacological effect in rats. From these results, we concluded that the AUC for AMI may be a useful index to evaluate its pharmacological effect, rather than the plasma concentration.

Amitriptyline↗