Three antidepressants (amitriptyline,dothiepin, fluoxetine), with and without alcohol,compared with placebo on tests of psychomotor ability related to car driving

Eight female volunteers received acute doses of amitriptyline 50 mg (AMI), dothiepin 50 mg (DOT), fluoxetine 40 mg (FLU) or placebo both with and without a ‘social’ dose of alcohol (ALC) equivalent to 0·5 g/kg body weight absolute alcohol. Performance on a variety of tests of psychomotor ability and cognitive function (critical flicker fusion, choice reaction time, tracking, Maddox Wing and simulated car steering) were performed at 1·5 and 4 hours following treatment. AMI and DOT both with and without ALC impaired performance on a range of tests at either or both 1·5 and 4 hours, although the effects of AMI and AMI + ALC were more widespread and severe than those found with either DOT or DOT + ALC. FLU and FLU + ALC showed no evidence of impairment on any test at either the 1·5 or the 4 hours assessments. The results suggest that there are differences between the experimental substances, at the doses used, in their intrinsic potential for impairing aspects of psychomotor performance and cognitive function.     

Strain-specific effects of antidepressants on escape deficits induced by inescapable shock

The effects of several antidepressants (desmethylimipramine, amitriptyline and bupropion) on escape deficits induced by inescapable shock were assessed in four strains of mice. The extent of the escape interference engendered by inescapable shock varied across strains of mice. These deficits of escape performance were differentially affected by the drug treatments across strains. Repeated administration of desmethylimipramine eliminated the escape interference in A/J, but did not affect the performance in Balb/cByJ, C57BL/6J or CD-1 mice. Bupropion, in contrast, had a modest effect only in CD-1 mice. Unlike these compounds, the 5-HT reuptake blocker, amitriptyline, was found to influence escape performance irrespective of whether the drug was acutely or chronically applied. It is suggested that (a) the relative contributions of various mechanisms subserving the escape interference may vary across strains of mice, hence accounting for the strain-specific effects of the drug treatments, and (b) various antide-pressants influence performance by affecting different components of the behavioral output, some of which may be apparent after acute treatment while others are expressed only after repeated treatment with the compound.     

Effects of acute and chronic anti-panic drug administration on conflict behavior in the rat

The present studies were undertaken to evaluate further the utility of the Conditioned Suppression of Drinking (CSD) conflict pardigm as an animal model for the study of panic disorder and anti-panic agents. In daily 10-min sessions, water-deprived rats were trained to drink from a tube which was occasionally electrified (0.5 mA). Electrification was signalled by a tone. Desipramine (DMI), amitriptyline (AMI), or phenelzine (PHEN) was administered both in acute (10-min pre-treatment) and chronic (twice daily for up to 9 weeks) regimens. Acute administration of DMI, AMI or PHEN over a wide range of doses resulted in no change or a decrease in the number of shocks accepted and a decrease in water intake at higher doses. In contrast, chronic administration of each agent resulted in a gradual (2–4 week latency) increase in the number of shocks received in CSD sessions over the course of several weeks of testing. This time-dependent increase in punished responding in the CSD observed during chronic anti-panic drug treatment parallels the time-dependent reduction in the severity and frequency of panic attacks in panic disorder patients receiving chronic antidepressants. Thus, the CSD paradigm might serve as an animal model for the study of panic disorder and potential anti-panic agents.     

The effect of a lipid suspension on amitriptyline disposition

A 5-h infusion of a lipid suspension or saline was given on separate occasions to four healthy volunteers taking amitriptyline. Mean plasma levels of amitriptyline plus nortriptyline were 14% higher at the end of the lipid infusion but the difference was not statistically significant. Infusion of a lipid suspension is unlikely to materially affect the severity of amitriptyline intoxication.     

Effects of chronic lithium,amitriptyline, and electroconvulsive shock,on calcium channel binding in a rat brain homogenate

The effect of chronic lithium (0.1% in the diet for 28 days), amitriptyline (10 mg/kg SC daily for 14 days), and electroconvulsive shock (ECS) (given 5× under halothane anaesthesia on alternate days) on the binding of the L-type calcium channel antagonist (+)-(³H)-PN 200-110 to rat cortical and hippocampal homogenates and the binding of the N-type calcium channel antagonist (¹²⁵I)-ω-conotoxin to rat cortical homogenates was measured. These treatments did not alter the number or affinity of the binding sites for either ligand, suggesting that it is unlikely that the actions of chronic lithium, amitriptyline, and ECS affect calcium channel binding.     

阿米替林治疗间质性膀胱炎的临床研究

目的 探讨阿米替林治疗间质性膀胱炎的有效性和安全性. 方法 采用前瞻性研究.间质性膀胱炎患者54例,病程19～72个月,平均(40.7±11.6)个月.口服阿米替林治疗,起始剂量25 mg/次,每晚1次.1周后,若症状不缓解,可加量至50 mg/次;再观察1周,若症状仍不缓解,则可加量至75 mg/次;维持能够缓解症状的最小剂量,总疗程3个月.观察用药前及用药3个月后患者的临床症状(每日排尿次数、最大排尿容量、尿痛程度评分)和O'Leary-Sant间质性膀胱炎问卷表评分及生活质量评分情况.并记录不良反应发生情况. 结果 ①用药3个月后每日排尿次数明显减少,治疗前后分别为(28.5±8.4)和(15.6±3.3)次;最大排尿容量明显增加,治疗前后分别为(108.7±62.2)和(171.0±53.9)ml;尿痛程度评分明显下降,治疗前后分别为6.4±1.5和2.2±1.5,上述指标用药前后相比,差异均有统计学意义(P<0.01).②患者用药3个月后问卷评分和生活质量评分均明显减少,治疗前后分别为26.9±4.0和13.7±5.7及5.5±0.5和2.5±0.6;用药前后比较,差异有统计学意义(P<0.01).③45例在服药第1个月内有不同程度的困倦,43例1个月后自行缓解,2例由于困倦严重且不能缓解而停药.10例服药3个月后体质量增加(5.8±1.8)kg.11例有轻度便秘症状,可以耐受.9例有口干症状,可以耐受.3例出现重度排尿困难,停药后改为其他方法治疗. 结论 阿米替林口服治疗能有效缓解间质性膀胱炎患者的临床症状,改善生活质量,且耐受性及安全性好.     

帕罗西汀与几种常用药治疗抑郁症的对照研究

抑郁症是复杂的精神疾病,药物干预是缓解抑郁症患者症状、提高患者生活质量的有效手段,帕罗西汀是临床中广泛应用的药物之一。本文对帕罗西汀和文拉法辛、阿米替林、米氮平等药物治疗抑郁症的用药量、疗程、显效率、总有效率、不良反应和起效情况等方面的对照研究作一综述,以评价各药物对抑郁症的疗效及安全性,为临床安全合理用药提供参考。     

西酞普兰与阿米替林治疗脑梗塞后抑郁症对照研究

目的探讨西酞普兰与阿米替林治疗脑梗塞后抑郁症的疗效与安全性。方法将48例脑梗塞后抑郁症患者随机分成西酞普兰组与阿米替林组治疗8周,应用汉密尔顿抑郁量表（HAMD）和副反应量表（TESS）评定疗效及安全性。结果西酞普兰与阿米替林疗效相当,但西酞普兰起效快,不良反应轻,而阿米替林副反应大。结论西酞普兰治疗脑梗塞后抑郁症疗效好,起效快,不良反应轻,可作为脑梗塞后抑郁的一线用药。     

文拉法辛与阿米替林预防偏头痛的对照研究

目的以阿米替林为对照,评价盐酸文拉法辛胶囊预防偏头痛的疗效及安全性。方法79例偏头痛患者随机分成盐酸文拉法辛组（n=40）和阿米替林组（13=39）,盐酸文拉法辛组服用盐酸文拉法辛胶囊75mg／d,阿米替林组服用阿米替林75mg／d,疗程均为3月。治疗前、治疗1个月、2个月和3个月后分剐评价患者的头痛发作次数、严重程度和头痛持续时间,以及治疗后1个月、2个月和3个月的不良反应发生情况。结果经盐酸文拉法辛和阿米替林治疗1月、2月及3月后,患者的头痛发作次数、严重程度及持续时间均显著改善,差异有统计学意义;同时治疗2个月疗效好于1个月,治疗3个月疗效好于2个月;两组患者治疗前后各时点头痛发作次数、严重程度、持续时间比较无统计学差异。但阿米替林不良反应发生率显著高于盐酸文拉法辛,分剐是77．8％和21,差异有统计学意义。结论盐酸文拉法辛预防偏头痛疗效确切,安全性好。     

齐拉西酮合并阿米替林治疗难治性抑郁症的临床研究

目的观察齐拉西酮合并阿米替林治疗难治性抑郁症的疗效和毒副作用。方法根据入院顺序分层随机法,将60例难治性抑郁症患者平均分为研究组（齐拉西酮＋阿米替林）和对照组（阿米特林＋安慰剂）,在治疗前、治疗后4、8、12周末分别用汉密尔顿抑郁量表（HAMD）、总体疗效量表（CGI）和副反应量表（TESS）评定疗效和毒副作用。结果治疗4周后研究组HAMD总分及各因子分比治疗前明显降低,且治疗因子分显著低于对照组,治疗后4、8、12周末TESS评分,4周末研究组高于对照组,8、12周末两组无显著差异。结论齐拉西酮合并阿米替林治疗难治性抑郁症疗效确切。