Discriminative stimulus control with imipramine: Transfer to other anti-depressants

Discriminative stimulus control with the tricyclic anti-depressant imipramine was attempted in three groups of rats; two of which were subjected to artificially stressful conditions. Only the unstressed group were shown capable of discriminating between the stimulus properties of intraperitoneal 10 mg/kg imipramine and saline in a two-lever, food-motivated operant task. Discriminative performance with decreasing doses of imipramine was shown to be dose-responsive. The ability to discriminate the interoceptive cue produced by imipramine was observed to transfer to a 10 mg/kg dose of both amitriptyline and desmethylimipramine. The results suggest a common tricyclic anti-depressant cueing property.     

Tricyclic plasma levels in depressed outpatients treated with amitriptyline

Seventy-four patients were treated with 150 mg/day amitriptyline (AT) to determine possible correlations between clinical improvement, demographic variables, and AT and nortriptyline (NT) plasma levels. Plasma level determinations after 2 and 6 weeks of treatment revealed that moderately significant correlations existed between AT plasma levels and clinical improvement, dosage intake, age, weight, sex, and coffee intake. Some of these findings were more pronounced after 2, and some after 6 weeks of treatment.     

Cerebrospinal fluid levels of amitriptyline, nortriptyline, imipramine and desmethylimipramine. Relationship to plasma levels and treatment outcome

Fifty-five (55) depressed patients were treated with amitriptyline (AMI) or imipramine (IMI). Concentrations of AMI, IMI, and their metabolites, nortriptyline (NT) and desmethylimipramine (DMI), were measured in cerebrospinal fluid (CSF) and plasma at steady state by gas chromatography mass spectrometry (GC/MS). Highly significant correlations between CSF and plasma levels of AMI, NT, IMI, and DMI were found (r greater than 0.75; P less than 0.0001 in all cases). There were no significant sex, diagnostic subgroup, or geographic difference in any of the drug parameters measured. An evaluation of the relationship between CSF levels of drug variables and clinical response showed essentially no significant correlations between these various parameters. The results obtained do not support the concept of a 'therapeutic window' for levels of plasma NT in AMI-treated patients. Furthermore, the highly significant correlations between CSF and plasma compartments in terms of drug and metabolite levels would argue against the need to measure CSF levels of these parameters in clinical practice. Plasma level measurements should be equally informative, and simpler to obtain.     

弥可保联合阿米替林、强的松早期治疗带状疱疹神经痛

目的探讨弥可保联合阿米替林、强的松早期治疗带状疱疹神经痛的效果。方法随机将 4 5例患者分为治疗组 (n =2 9)及对照组 (n =16 )。所有患者均给予皮肤科常规治疗、抗病毒、口服卡马西平 ,治疗组加用弥可保、阿米替林及强的松。采用视觉模拟评分法 (VAS)评定病人的疼痛程度及治疗结果。治疗结束后 ,随访 6个月。结果治疗组VAS评分及带状疱疹后遗神经痛 (PHN)发生率明显低于对照组 (P <0 0 1,P <0 0 5 )。结论弥可保联合阿米替林、强的松早期治疗带状疱疹神经痛可防止PHN的发生     

Mechanisms of amitriptyline induced hypothermia in the rat.

Effects of amitriptyline on rectal temperature of male rats were studied at the ambient temperature of 25 degrees C. Drugs were administered intraperitoneally. Amitryptyline elicited a dose related hypothermia. The hypothermia was attenuated by phenoxybenzamine 10 mg/kg, haloperidol 2 mg/kg, diphenhydramine 5 mg/kg, atropine 20 mg/kg, and cyproheptadine 5 mg/kg. Propranolol, at a dose of 5 mg/kg, had no effect on the hypothermia. Theophylline 50 mg/kg and dibutyryl cyclic AMP 20 mg/kg inhibited the hypothermia produced by anitriptyline. Pretreatment with parachloroamphetamine (PCA), 2 or 5 mg/kg daily for 3 days, strongly antagonized the hypothermia. In addition, pretreatment with parachlorophenylalanine (PCPA), 100 mg/kg daily for three days, reduced the brain 5-hydroxytryptamine (5-HT) concentration to 20% of the control level and completely blocked the hypothermia response. When brain 5-HT concentration recovered to 50% of the control level in PCPA treated rats following the administration of 10 mg/kg 5-hydroxytryptophan (5-HTP) the hypothermia induced by amitriptyline was restored. However, the administration of 5-HT, 5 mg/kg, to PCPA treated rats did not increase brain 5-HT concentration or restore the amitriptyline induced hypothermia (AIH). Results suggest that amitriptyline interacts with several transmitter substances to produce hypothermia. Since the ability of amitriptyline to produce hypothermia was correlated with brain 5-HT content, 5-HT might play an important role in the mediation of AIH.     

黛力新与阿米替林治疗脑卒中后抑郁的疗效比较

目的探讨黛力新与阿米替林治疗脑卒中后抑郁的临床疗效及安全性和对神经功能康复的影响。方法将80例脑卒中后抑郁患者随机分为黛力新组40例和阿米替林组40例。在治疗脑卒中的基础上,黛力新组口服黛力新治疗,早中各服用1片,阿米替林组服用阿米替林(中、晚)50～150 mg,疗程为6周。于服药治疗前及服药后2、6周末采用汉密尔顿抑郁量表和TESS量表评定抑郁疗效及不良反应,采用爱丁堡-斯堪的那维亚卒中量表评定神经功能缺损的程度。结果治疗6周末,黛力新组及阿米替林组显效率分别为85.0%和65.0%,有效率分别为95.0%和77.5%,神经功能康复率分别为87.6%和83.8%。汉密尔顿抑郁量表评分,黛力新组治疗2周末及6周末均较治疗前明显下降(P0.01),阿米替林组较治疗前亦明显下降(P0.05)。爱丁堡-斯堪的那维亚卒中量表评分两组治疗6周末均较治疗前均明显下降(P0.01)。两组不良反应比较差异有统计学意义(P0.05),黛力新组不良反应轻微。结论黛力新组治疗卒中后抑郁与阿米替林组疗效相当,起效快,安全性高,不良反应轻微,依从性好,加速患者神经功能的康复。     

氟西汀与阿米替林治疗抑郁症临床研究

目的探讨盐酸氟西汀治疗抑郁症的疗效、安全性和社会功能。方法将40例抑郁障碍患者随机分为盐酸氟西汀治疗组(甲组)和阿米替林治疗组(乙组)各20例,并对两组结果进行临床对照研究,疗程8周;采用汉密顿抑郁量表(HAMD)、药物副作用量表(TESS)评定疗效和副作用,用功能大体评定量表(GAF)评定患者治疗后社会功能情况。结果两组抗抑郁起效时间、疗效差异无显著性(P>0.05)。结论盐酸氟西汀和阿米替林治疗抑郁障碍均有明显疗效,但盐酸氟西汀治疗安全性好,依从性好,社会功能有显著的改善。     

阿米替林对功能性消化不良症状及胃动力的作用

研究功能性消化不良（ＦＤ）患者的胃排空和胃电特性以及阿米替林对ＦＤ的疗效。方法：用双同位素标记ＳＰＥＣＴ技术和体表胃电图检测４２例ＦＤ患者服用小剂量阿米替林前后胃运动功能的变化。结果：ＦＤ组和对照组液相排空曲线相似,半排空时间（Ｔ５０）差异无显著性;ＦＤ组固相Ｔ５０较对照组显著延长,胃电节律紊乱率及餐后振幅降低率较对照组显著增加。阿米替林治疗４周后,ＦＤ患者的临床症状显著改善,但胃排空异常率及胃电     

Trial of amitriptyline for relief of pain in amputees: results of a randomized controlled study

OBJECTIVE: To evaluate whether amitriptyline is more effective than placebo in improving phantom limb pain or residual limb pain. DESIGN: Randomized controlled trial of amitriptyline for 6 weeks. SETTING: University hospital. PARTICIPANTS: Thirty-nine persons with amputation-related pain lasting more than 6 months. INTERVENTION: Six-week trial of amitriptyline (titrated up to 125 mg/d) or an active placebo (benztropine mesylate). MAIN OUTCOME MEASURES: Analyses were conducted to examine whether there was a medication group effect on the primary outcomes (average pain intensity) and secondary outcome measures (disability, satisfaction with life, handicap). RESULTS: No significant differences were found between the treatment groups in outcome variables when controlling for initial pain scores. CONCLUSIONS: Our findings do not support the use of amitriptyline in the treatment of postamputation pain.     

Cianopramine and amitriptyline in the treatment of depressed patients — a placebo-controlled study

3-Cyano-imipramine (cianopramine) is a potent and selective inhibitor of serotonin uptake into synaptosomes. In a double-blind trial, 60 patients with various types of depression fulfilling the DSM-III criteria of depressive episodes were treated with either cianopramine (n=20, mean daily dose 3.3±0.6 mg) amitriptyline (n=20, mean daily dose 86.4±21 mg) or placebo (n=20) orally. According to the ratings of the Hamilton Scale of Dpression and clinical global evaluations, both active drugs showed statistical superiority over placebo (P<0.02). The frequencies of anticholinergic side effects in the cianopramine group were comparable to those of the placebo group and were less than in the amitriptyline group. The findings suggest that cianopramine is a promising new antidepressant.