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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of audio-video methods allowed the decrease of subjective factors influencing ratings of psychopathological phenomina. TV-stored interviews, recorded at separate days, may be compared almost simultaneously. In this study a rating of severity of depression was made of patients under antidepressive medication on days 0, 10, 20. (Mianserin was compared with Amitriptyline in a double-blind-trial). This method rendered it possible to detect significant differences between therapeutic profiles over time. The same result was reached independently by both investigators. The judgement of depression was based on a global impression and not on the evaluation of isolated psychopathological symptoms. No absolute measurement of depression was possible. The described method of a time-blind-analysis of TV-stored interviews constitutes a considerable progress in the assessment of a drug's profile in time, particularly if rating-scales are used in the same manner.
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PMID:[New diagnostic strategies in psychiatry by means of video-technique. I. The use of time-blind video analysis for the evaluation of antidepressant drug trials (author's transl)]. 79 Apr 10

A new method of evaluating the time course of an antidepressive drug effect is described. It has the advantage that the rater is "blind" as to the duration of the treatment (time-blind analysis). TV-stored tapes of interviews recorded during the drug trial were presented in a randomized sequence to raters who ranked each patient's tapes in terms of the degree of depression shown during the interview. Patients treated with Amitriptyline showed a continuous amelioration of depression throughout the drug trial while those treated with Mianserin showed an amelioration of depression that was not constant in time.
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PMID:Time-blind analysis of TV-stored interviews. An objective method to study antidepressive drug-effects. 79 78

Sixteen patients with primary depression were treated for 4 wk with amitriptyline. After clinical diagnoses were determined, patients entered a double-blind protocol (amitriptyline or placebo) and their clinical status was determined with the Hamilton Depression Rating Scale by raters blind to the drug type, its dosage and plasma levels. Amitriptyline (AT) and nortriptyline (NT) plasma levels were assayed twice weekly by gas chromatography-mass spectrometry. In the 16 patients, a negative correlation between the Hamilton Score and the mean total tricyclic level (p less than 0.01), as well as with individual plasma levels, was found at the end of the treatment period. When the group was divided into clinical responders and nonresponders, the mean total tricyclic (AT + NT) levels discriminated the two groups by day 12 (p less than 0.001) as well as at the end of the protocol (day 26, 88% of the patients were classified correctly if an arbitrary level of 200 ng/ml total tricyclic plasma level was chosen). These results strongly suggest the presence of a positive correlation between plasma levels and clinical improvement in patients with primary depression.
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PMID:Amitriptyline plasma levels and clinical response in primary depression. 92 85

Amitriptyline was evaluated as a prophylactic antimigraine agent in 110 patients with severe migraine. This agent improved the migraine more than 50 percent in 72 percent of patients and more than 80 percent in 57 percent of patients. Most of the 31 patients with less than 50 percent improvement had virtually no response. Depression, measured with the Zung Self-Rating Depression Scale, was absent in 40 patients, borderline in 53, and moderate to severe in 17. Overall, depression ratings improved minimally with therapy. There was a weak relationship between improvement in depression and improvement in migraine. Subgroups with a stronger correlation of these could not be found. This work suggests that amitriptyline is effective in migraine prophylaxis and that it has a primary effect on migraine that is relatively independent of its antidepressant action.
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PMID:Amitriptyline in the prophylaxis of migraine. Effectiveness and relationship of antimigraine and antidepressant effects. 94 66

A double blind comparison is reported of a new tetracyclic antidepressant, maprotiline, with amitriptyline and placebo in psychiatric outpatients. Amitriptyline was significantly more effective than placebo in its global effect on depression. Maprotiline emerged as neither inferior to amitriptyline nor superior to placebo. Methodological difficulties prevented an adequate assessment of the anxiolytic activity of maprotiline.
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PMID:A controlled trial of maprotiline (Ludiomil) in depressed outpatients. 110 77

A group of 250 patients with endogenous depression was studied. Amitriptyline proved to be the most effective drug (51% positive responses) followed by noxiptilin (50%), imipramine (42%), dibenzepin (43%). Clomipramine, desipramine, and nomifensine appeared to be the least effective. Demographic or clinical factors such as age, sex, type of affective illness, severity of depressive syndrome or its particular symptoms (depression, fear, anxiety, psychomotor impairment or biological rhythm alteration) did not show any potential for prediction of the treatment outcome. Worse therapeutic results were observed in patients who had already been given antidepressant treatment for the current depressive cycle before the assessment.
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PMID:[Results of using tricyclic antidepressive drugs in the treatment of endogenous depression (comparative analysis of 7 drugs)]. 168 87

Amitriptyline (AT) relieves some patients with postherpetic neuralgia (PHN). Many patients suffer side effects and better therapies are necessary. The aim of this study was to evaluate the efficacy of maprotiline (MT) (noradrenergic) compared to AT (mixed noradrenergic and serotonergic) in this disorder. Thirty-five patients entered a randomized, double-blind, crossover trial of these two agents. We found that MT relieved PHN in many patients but was not as effective as AT. Side effects were troublesome with both agents. Relief of steady pain, brief pain and pain on tactile stimulation occurred. Four groups of responses were identified. Some patients reported relief with both agents, some with neither agent and others with only one of the drugs. Most patients were not depressed and analgesia was observed to occur without change in depression ratings in most patients who responded. This result provides evidence that in some patients AT may act via a selective noradrenergic mechanism in relieving PHN and that individuals may differ in the balance and type of neurotransmitters inhibiting pain. Selective noradrenergic agents may be effective if AT fails.
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PMID:Amitriptyline versus maprotiline in postherpetic neuralgia: a randomized, double-blind, crossover trial. 173 71

Despite increasing knowledge of the neurochemical bases of the action of the tricyclic drugs, little is known about the sequence of psychological effects which precede recovery in drug-responsive patients. This research was aimed at identifying the specific behavioural effects associated with the therapeutic action of amitriptyline in depression. The design involved measurement (post-hoc) of weekly changes in a severely depressed placebo-resistant group who recovered with drug treatment, compared with a group of similar patients treated for the equivalent four weeks, who showed minimal to no clinical response. The research strategy, in accordance with a dose-response paradigm, was to determine which of the early changes in emotion and behaviour found in treatment responders were systematically associated with plasma concentrations of amitriptyline or its major metabolite. Amitriptyline was found to act within seven days on the components of anxiety and on hostility in the responders, and on sleep disorder in all patients. After 12 to 14 days of treatment these effects increased, with improvements in other significant components distinguishing the responders from the non-responders. At the 12th to 14th treatment days when a steady state concentration of drug in plasma was approached, reductions in anxiety and hostility and in certain somatic components correlated significantly with plasma concentrations of amitriptyline. Implications of the findings for clarifying the specificity of clinical actions of the tricyclic drugs, and for understanding the psychobiological dynamics underlying rapid drug-induced recovery in depression, were explored.
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PMID:Identifying the specific clinical actions of amitriptyline: interrelationships of behaviour, affect and plasma levels in depression. 194 49

From 1976 to 1980, there were 3,193 admissions due to acute drug overdosage at the resuscitation centre of the Rudolf-Virchow-Hospital, Free University of Berlin. The frequency and the characteristics of selfpoisoning with antidepressants and low-potency neuroleptic drugs (mainly perazine and thioridazine) were determined. These drugs were involved in 92 cases (3%) during this five-year period. Amitriptyline--in combination with a benzodiazepine--was the most common antidepressant taken by the patients. Ten of the patients required assisted ventilation. Complete ECG recordings were carried out in 24 patients. The most common abnormality was a prolonged QTc interval (21 patients) followed by a QRS duration of 0.11 seconds or longer (17 patients). Sinus tachycardia was present in half of the cases. In no cases did the medical records describe convulsions or cardiac arrhythmias requiring special treatment. The percentage of patients showing ECG changes and respiratory depression was higher when other drugs such as ethanol were ingested along with antidepressants than when only antidepressants were taken. One patient died after six weeks in hospital due to a complicated abscess. From 1976 to 1980, the incidence of antidepressant selfpoisoning was relatively low compared with findings from other studies. Data from other studies suggest that, in the period 1980-1987, there was an increase in the incidence of antidepressant selfpoisoning, at least in the West Berlin and Munich areas. However, these figures are much lower than those reported by British, American, and Australian authors.
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PMID:Tricyclic neuroleptic and antidepressant overdose: epidemiological, electrocardiographic, and clinical features--a survey of 92 cases. 196 53

The effects of the tricyclic antidepressants amitriptyline and clomipramine on intraventricular conduction, effective refractory period and incidence of ventricular arrhythmias induced by programmed stimulation, were studied in the dog heart after myocardial infarction. Amitriptyline, at doses of 1 to 3 mg/kg, significantly slowed ventricular conduction of the infarcted zones in a frequency-dependent and a dose-dependent manner. Amitriptyline, at doses of 2 and 3 mg/kg, slightly slowed conduction in normal zones. The effective refractory period was prolonged by amitriptyline at a dose of 2 mg/kg. Amitriptyline increased the incidence of ventricular arrhythmias induced by programmed stimulation. On the other hand, the depressant effect of clomipramine, at doses of 1 to 3 mg/kg, on the conduction of infarcted zones was lower than that of amitriptyline, whereas the severely depressed conduction in the infarcted zone was obviously slowed by clomipramine. The incidence of ventricular arrhythmias did not significantly increase with clomipramine. From the present results, clomipramine seems to have a lower cardiac toxicity than amitriptyline, although clomipramine produces a slight depression of conduction in infarcted zones.
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PMID:Comparison of the cardiac electrophysiologic effects of amitriptyline and clomipramine in the dog after myocardial infarction. 224 10


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