Latest research on Amitriptyline

Amitriptyline hydrochloride is a dibenzocycloheptene-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, amitriptyline does not affect mood or arousal, but may cause sedation. In depressed individuals, amitriptyline exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as amitriptyline, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Amitriptyline may be used to treat depression, chronic pain (unlabeled use), irritable bowel syndrome (unlabeled use), diabetic neuropathy (unlabeled use), post-traumatic stress disorder (unlabeled use), and for migraine prophylaxis (unlabeled use).

Latest findings

The patient continued to experience persistent, fractious pruritus, despite the use of 1st and 2nd generation anti-histamines, triple doses of H2 receptor antagonists, and Amitriptyline. [source, 2016]
An informal review and comparison of overlapping DPWG and CPIC guidelines during the system’s development phase revealed slight discrepancies in the recommendations for certain CYP2C19 and CYP2D6 haplotypes and tricyclic antidepressants (e.g. “Initiate therapy with recommended starting dose” vs. “Reduce dose by 25% and monitor plasma concentration or select alternative drug” for CYP2D6*9/*9 and Amitriptyline). [source, 2016]
The antidepressant types were divided into three categories: i) selective serotonin reuptake inhibitors including Citalopram, esCitalopram, fluoxetine, Paroxetine, and Sertraline, ii) newer antidepressants such as Bupropion, Venlafaxine, and Mirtazapine, and iii) older anti-depressants such as Amitriptyline, Clomipramine, Imipramine, Milnacipran, Nortriptyline, tianeptine, and Trazodone. [source, 2016]
Several pharmacological therapies for insomnia have been formulated, including benzodiazepine receptor antagonists (BzRAs) (eg, benzodiazepines and nonbenzodiazepine sedative-hypnotics, such as Zolpidem, Zaleplon, and Eszopiclone), Melatonin, Melatonin-receptor agonists, and various antidepressant medications including Quetiapine, Amitriptyline, Mirtazapine, and Trazodone. [source, 2016]
Additional covariate information regarding age, gender, marital status, education levels, family size, house possession, disease history, current use of anti-depressants medications (including Nortriptyline, Amitriptyline or Imipramine, fluoxetine, Citalopram, Fluvoxamine and Sertraline) and dietary supplements (including intake of iron, Calcium, vitamins and other dietary supplements) was obtained using self-administered questionnaires. [source, 2016]
These drugs are Chlorpromazine, Diazepam, Alprazolam, Amitriptyline, Haloperidol, fluoxetine and vitamin B1 (Thiamine). [source, 2016]
All patients were administered with Propranolol (40-80 mg), tricyclics (Amitriptyline or Nortriptyline 25-50 mg), and antiepileptic drugs (Valproate, Topiramate, or Gabapentin) for prophylaxis of migraine attacks based on the opinion of a responsible physician before the intervention. [source, 2016]
Metabolic incubations for the drugs Amitriptyline (AMI) and Buspirone (BUS) were performed in 100 mM potassium phosphate (KPi) buffer at pH 7.4 with the cytosolic fraction containing 100 nM of BM3 mutant at a 40-μM substrate concentration. [source, 2016]
Besides one case report where a life-threatening Dextromethorphan intoxication was associated with interaction with Amitriptyline in a poor CYP2D6 metabolizer [37], no reports have been published about the interactions of any two or more of these drugs. [source, 2016]
Patients for whom complications have been encoded into depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), and patients who were prescribed antidepressants (tricyclics, including Amitriptyline, Imipramine, Nortriptyline, Clomipramine, and amoxapine; tetracyclics, including maprotiline and mianserin; selective serotonin reuptake inhibitors [SSRIs], including Paroxetine, Fluvoxamine, and sertraline; serotonin Noradrenaline reuptake inhibitors [SNRIs], including Milnacipran and duloxetine; or others, including Trazodone, sulpiride, and Mirtazapine) were categorized in the depressive state group. [source, 2016]