米氮平和阿米替林治疗躯体形式障碍对照研究

目的探讨米氮平治疗躯体形式障碍的疗效及安全性。方法对80例躯体形式障碍患者分别用米氮平或阿米替林治疗8周。采用汉密尔顿抑郁量表（HAMD）及副反应量表（TESS）评定药物疗效及不良反应。结果米氮平与阿米替林疗效相当，起效快，米氮不良反应轻微。结论米氮平治疗躯体形式障碍疗效肯定，不良反应小。     

A controlled study of a specific MAO A reversible inhibitor (R011-1163) and amitriptyline in depressive illness

A double blind comparative study of amitriptyline and a new reversible MAO A inhibitor R011-1163 was conducted in 25 depressed inpatients over 4 weeks. Response to treatment was assessed with the Hamilton depression rating scale, the Carroll depression self rating scale and the Visual analogue scale. Both drugs produced significant changes in depressive symptomatology (P less than 0.01, MANOVA) and there were no statistically significant differences between drugs (P greater than 0.05 MANOVA). Side effects were of mild to moderate severity with dry mouth the most commonly reported side effect of amitriptyline and vague, generalised headache in patients, treated with R011-1163.     

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.     

阿米替林合并认知疗法治疗精神分裂症后抑郁的对照研究

目的　评价阿米替林合并认知疗法对精神分裂症后抑郁的治疗效果。方法　将符合CCMD 3诊断标准的 86例精神分裂症后抑郁患者随机分为治疗组和对照组 ,治疗组给予阿米替林合并认知治疗 ,对照组织给予阿米替林治疗 ,疗程 12周。采用汉密尔顿抑郁量表 (HAMD)、简明精神病量表(BPRS)、阴性症状量表 (SANS)评定临床疗效 ,采用副反应量表 (TESS)评定副反应。结果　在治疗的 4、8、12周末 ,HAMD评分治疗组优于对照组 ,显效率分别为 83 95 %和 6 1 90 % (u =5 .83,P <0 0 5 )。结论　阿米替林与认知治疗组结合治疗精神分裂症后抑郁疗效好于单用阿米替林治疗。     

西酞普兰治疗老年抑郁症对照研究

目的：探讨西酞普兰治疗急性期老年抑郁症的有效性及安全性。方法：收集各类抑郁急性发作、年龄≥60岁的患者进行西酞普兰和阿米替林单盲对照治疗，治疗8周。疗效及安全性评定采用17项汉密顿抑郁量表和副反应量表。结果：70例完成观察，其中西酞普兰组34例，阿米替林组36例。治疗第2周时，西酞普兰组有效率显著较高。在第8周时两组疗效差异无显著性。西酞普兰组的不良反应明显较少。结论：西酞普兰见效较快，不良反应较少，适合于老年抑郁症特别是伴有躯体疾病患者的急性期治疗。     

汉族志愿者阿米替林代谢与异喹呱羟化代谢的关系

8名男性健康志愿者po阿米替林100 mg后,以阿米替林及其3种代谢物的血浓度曲线下面积(AUC₀^∞)计算阿米替林的脱甲基化代谢及羟基化代谢能力。结果提示个体间阿米替林及其3种代谢物的AUC差异很大。其中7名志愿者测定异喹呱羟化代谢表型,6例为异喹呱强代谢者,1例为弱代谢者。尿中异喹呱的羟化代谢率与阿米替林的羟基化代谢率、阿米替林和10-羟基阿米替林的AUC₀^∞呈显著相关。阿米替林总血浆清除率与异喹呱羟化代谢率呈弱相关。此结果表明阿米替林和异喹呱的羟化代谢可能由同一酶控制,阿米替林的羟基化代谢和脱甲基化代谢可能为两个独立的代谢途径。     

Concentration of Tricyclic Antidepressants in Plasma,Heart and Skeletal Muscle after their Intravenous Infusion to Anaesthetized Rabbits

Abstract: In order to compare the toxic concentrations of four different tricyclic antidepressants in the heart and plasma, 5 mg/kg of amitriptyline, doxepin, nortriptyline or protriptyline were infused intravenously over 5 min. into anaesthetized rabbits. The concentrations of the antidepressants five minutes after the termination of the infusion were measured by gas chromatography in the plasma, heart ventricles, and femoral muscle. On average, the concentrations in the heart were 40 to 200 times higher than those measured in plasma, the concentration of protriptyline being highest. The heart/plasma concentration ratios were higher for protriptyline and amitriptyline than for nortriptyline and doxepin. The toxicity of the antidepressants correlated neither to their heart concentrations nor to their heart/plasma concentration ratios. It seems that the different acute cardiotoxicity of tricyclic antidepressants cannot be explained by their different concentrations in the plasma or in the heart muscle only, but they seem to have different toxic potencies.     

Effects of amitriptyline on serum glutamate and free tryptophan in rats

Summary In rats, chronic amitriptyline (14 days, 10 mg/kg, IP) administration resulted in a significant increase in the serum glutamate concentration and concomitant increase in the serum free tryptophan. In contrast, amitriptyline had no effect on the total serum tryptophan or CSF glutamate level. The data confirmed that antidepressant drugs may induce an increase of the serum glutamate concentration in depressive patients.