Amitriptyline. A review of its pharmacological properties and therapeutic use in chronic pain states.

Abstract:

:Amitriptyline is a tricyclic antidepressant agent which also has analgesic properties. Whether its analgesic effects are linked to its mood-altering activity or attributable to a discrete pharmacological action (or a combination of both) is unknown. Clinical trials demonstrate that oral amitriptyline achieves at least a good or moderate response in up to two-thirds of patients with post-herpetic neuralgia and three-quarters of patients with painful diabetic neuropathy, neurogenic pain syndromes that are often unresponsive to narcotic analgesics. Amitriptyline has also demonstrated efficacy in heterogeneous groups of patients with chronic non-malignant pain. Other possible areas of use for amitriptyline are in patients with fibromyalgia or as an adjuvant for uncontrolled cancer pain, although evidence for the latter application is limited. Adverse events resulting from the antimuscarinic activity of amitriptyline (primarily dry mouth and sedation) are commonly reported, even at the low dosages used for the control of pain. Low starting doses and careful dosage titration may help to minimise these effects. Orthostatic hypotension and tachycardia, sometimes associated with tricyclic antidepressant agents, may also pose a problem in the elderly. In summary, amitriptyline has a valuable place in the treatment of chronic pain conditions that affect the elderly provided that the drug is used judiciously to minimise adverse effects. Importantly, amitriptyline remains the best studied of the antidepressant agents in post-herpetic neuralgia and diabetic neuropathy and is an important and effective treatment option in these syndromes.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Bryson HM,Wilde MI

doi

10.2165/00002512-199608060-00008

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

459-76

issue

6

eissn

1170-229X

issn

1179-1969

journal_volume

8

pub_type

杂志文章,评审
  • Use of Antibiotics in Chronic Obstructive Pulmonary Disease: What is Their Current Role in Older Patients?

    abstract::Chronic obstructive pulmonary disease (COPD) has considerable morbidity and mortality in the older adult population. The role of antibiotics in the management of acute exacerbations of COPD (AECOPD) is currently evolving. Despite only mild benefits, most patients with AECOPD in ambulatory settings receive antibiotics ...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-020-00786-7

    authors: Al-Hasan MN,Al-Jaghbeer MJ

    更新日期:2020-09-01 00:00:00

  • Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

    abstract:BACKGROUND:Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD:Within a common geriatric outpatient population, patients ...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-200825060-00005

    authors: van der Velde N,Meerding WJ,Looman CW,Pols HA,van der Cammen TJ

    更新日期:2008-01-01 00:00:00

  • Treating asthma in the older patient: is there a place for leukotriene modifiers?

    abstract::Asthma is a common airway disease found in people of all ages, although most studies of asthma therapies are focused on adolescent and young adults. Little information exists on the use of asthma therapeutics in the older patient (>65 years of age). The newest therapeutic class to be released in the US for the treatme...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200623060-00002

    authors: Grayson MH,Korenblat PE

    更新日期:2006-01-01 00:00:00

  • Treatment of Seizures in Older Patients with Dementia.

    abstract::The numbers of patients with dementia and patients with epilepsy are increasing in the global population. In fact, these two conditions are related, and it is estimated that at least 5-10% of seizures or epilepsy in older individuals (aged > 60 years) are caused by a neurodegenerative dementia. In the vast majority, o...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-020-00826-2

    authors: Cretin B

    更新日期:2020-12-14 00:00:00

  • Drug therapy of prostatic cancer.

    abstract::While hormonal therapy has been the usual and appropriate treatment of advanced or metastatic prostatic cancer for the past 50 years, the recent development of new therapeutic agents as medical alternatives to orchidectomy has drastically altered the options and perspectives in the treatment of this disease. Estrogens...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199101050-00003

    authors: Huben RP,Perrapato SD

    更新日期:1991-09-01 00:00:00

  • Is covert medication in Norwegian nursing homes still a problem? A cross-sectional study.

    abstract:BACKGROUND AND OBJECTIVE:The practice of hiding medicines in nursing home patients' food or beverages is described in only a few scientific papers. An earlier study conducted in 1999/2000 showed that covert medication was common in Norwegian nursing homes, with 11% of patients in regular nursing home units (RUs) and 17...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-200926040-00004

    authors: Kirkevold O,Engedal K

    更新日期:2009-01-01 00:00:00

  • Factors influencing the implementation of quality use of medicines in residential aged care.

    abstract:BACKGROUND:In response to concerns about, and issues pertaining to, medication use practices in residential aged-care facilities (RACFs), the Australian Pharmaceutical Advisory Council (APAC) established a working party on quality use of medicines (QUM) in nursing homes and hostels. The APAC is a representative ministe...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200421120-00005

    authors: Cheek J,Gilbert A,Ballantyne A,Penhall R

    更新日期:2004-01-01 00:00:00

  • High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect.

    abstract:BACKGROUND:Medication non-adherence can exacerbate disease severity, leading to impairments that interfere with self-care activities in older adults, and, ultimately, death. Elder self-neglect is the most common report to Adult Protective Services (APS) across the USA and is a significant risk factor for early mortalit...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-012-0007-2

    authors: Turner A,Hochschild A,Burnett J,Zulfiqar A,Dyer CB

    更新日期:2012-09-01 00:00:00

  • Vitreous haemorrhage in elderly patients: management and prevention.

    abstract::Vitreous haemorrhage can be caused by a disruption of normal retinal vessels, bleeding from diseased retinal vessels, bleeding from abnormal new vessels or extension of haemorrhage through the retina from other sources. In the elderly, vitreous haemorrhage usually occurs spontaneously and only occurs occasionally as a...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200320090-00003

    authors: Manuchehri K,Kirkby G

    更新日期:2003-01-01 00:00:00

  • Cutaneous Drug Reactions in the Elderly.

    abstract::Cutaneous adverse drug reactions comprise a significant proportion of all adverse drug reactions. They may mimic other dermatologic or systemic illnesses and may cause significant morbidity or mortality. Seven morphologic groups encompass the most commonly encountered cutaneous drug reaction syndromes: exanthematous (...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-017-0483-5

    authors: Young JWS,Shear NH

    更新日期:2017-09-01 00:00:00

  • Factors to Consider in the Selection of Dopamine Agonists for Older Persons with Parkinson's Disease.

    abstract::Dopamine agonists (DAs) are frequently used in the management of Parkinson's disease (PD), a complex multisystem disorder influenced substantially by age-related factors. Over 80% of PD patients present after age 60 years and may have clinical features exacerbated by age-related comorbidities or decline in physiologic...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-018-0629-0

    authors: Latt MD,Lewis S,Zekry O,Fung VSC

    更新日期:2019-03-01 00:00:00

  • The quality of quality measures: HEDIS® quality measures for medication management in the elderly and outcomes associated with new exposure.

    abstract:BACKGROUND:Clinical validation studies of the Healthcare Effectiveness Data and Information Set (HEDIS®) measures of inappropriate prescribing in the elderly are limited. OBJECTIVES:The objective of this study was to examine associations of new exposure to high-risk medication in the elderly (HRME) and drug-disease in...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-013-0086-8

    authors: Pugh MJ,Marcum ZA,Copeland LA,Mortensen EM,Zeber JE,Noël PH,Berlowitz DR,Downs JR,Good CB,Alvarez C,Amuan ME,Hanlon JT

    更新日期:2013-08-01 00:00:00

  • Optimal pharmacotherapeutic management of acute lymphoblastic leukaemia in the elderly.

    abstract::The main characteristic of acute lymphoblastic leukaemia (ALL) in the elderly is its dismal prognosis. However, other than a lower incidence of T-cell ALL and a greater likelihood of unfavourable chromosomal abnormalities, the clinical and biological characteristics of Philadelphia chromosome-negative (Ph-) ALL in the...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/11592850-000000000-00000

    authors: Rousselot P,Delannoy A

    更新日期:2011-09-01 00:00:00

  • Medication Exposure and Health Outcomes in Older Patients with End-Stage Kidney Disease: A Prospective Study Undertaken in New Zealand.

    abstract:BACKGROUND:The impact of multiple medication exposure on health outcomes among older patients with end-stage kidney disease (ESKD) is unknown. OBJECTIVE:The objective of this study was to identify the impact of medicine exposure on hospitalisation rates and mortality in a prospective longitudinal observational study o...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-018-0582-y

    authors: Samaranayaka S,Walker RJ,Samaranayaka A,Derrett S,Schollum JWB

    更新日期:2018-11-01 00:00:00

  • Rosuvastatin in elderly patients.

    abstract::A progressive accumulation of atherosclerotic lesions beginning early in life puts elderly persons at a greater absolute risk of cardiovascular disease and coronary events than other segments of the population. HMG-CoA reductase inhibitor (statin) therapy has been shown to be both efficacious and well tolerated in mos...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200724110-00005

    authors: Davidson MH

    更新日期:2007-01-01 00:00:00

  • Mechanisms of age-related endocrine alterations. Part II.

    abstract::Aging is associated with a myriad of hormonal changes. The mechanisms underlying these changes are variable. Aging is associated with anatomic changes of the endocrine glands, notably as a result of programmed cell death, autoimmune mediated destruction of the gland, or neoplastic transformation of glandular tissue. A...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199303020-00004

    authors: Mooradian AD

    更新日期:1993-03-01 00:00:00

  • Population Pharmacokinetic/Pharmacodynamic Modeling of O-Desmethyltramadol in Young and Elderly Healthy Volunteers.

    abstract:BACKGROUND:Age-related changes in the concentration-effect relationship of (+)-O-desmethyl-tramadol [(+)-ODM], tramadol's active metabolite, are not documented in the elderly. OBJECTIVE:The objective of this study was to characterize, in elderly and young subjects, the (+)-ODM pharmacokinetic and pharmacodynamic relat...

    journal_title:Drugs & aging

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40266-019-00681-w

    authors: Robertson SS,Mouksassi MS,Varin F

    更新日期:2019-08-01 00:00:00

  • Treatment of Overactive Bladder in the Elderly Female: The Case for Trospium, Oxybutynin, Fesoterodine and Darifenacin.

    abstract::Overactive bladder (OAB) is a common constellation of lower urinary tract storage symptoms that causes a significant impact on a person's quality of life. The elderly may be disproportionally impacted by these symptoms due to concomitant poor mobility, comorbid conditions such as diabetes and heart failure, and polyph...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-015-0301-x

    authors: McFerren SC,Gomelsky A

    更新日期:2015-10-01 00:00:00

  • Age as a basis for healthcare rationing. Support for agist policies.

    abstract::It is inevitable that publicly funded, technically sophisticated medical treatments will be increasingly rationed. Other things being equal, there is a greater duty to use them to prolong the lives of younger than older people. Age is therefore an ethical rationing criterion. Denial of this may actually harm older peo...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-199609060-00003

    authors: Shaw AB

    更新日期:1996-12-01 00:00:00

  • Update on oral cyanocobalamin (vitamin B12) treatment in elderly patients.

    abstract::The objective of this review is to evaluate the usefulness of oral cobalamin (vitamin B12) treatment in elderly patients. PubMed was systematically searched for English and French articles published from January 1990 to January 2007. Prospective randomized studies (n=3), a systematic review by the Cochrane group (n=1)...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/0002512-200825110-00003

    authors: Andrès E,Vogel T,Federici L,Zimmer J,Kaltenbach G

    更新日期:2008-01-01 00:00:00

  • Potential Statin Overuse in Older Patients: A Retrospective Cross-Sectional Study Using French Health Insurance Databases.

    abstract:BACKGROUND:Although compelling evidence exists supporting statins (HMG-CoA reductase inhibitors) for secondary prevention in older patients with clinical atherosclerotic diseases, the same cannot be said for primary prevention. OBJECTIVES:The objectives of this study were to estimate the frequency of potential statin ...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-019-00695-4

    authors: Borne E,Meyer N,Rybarczyck-Vigouret MC,Blanchard O,Lombard M,Lang PO,Vogel T,Michel B

    更新日期:2019-10-01 00:00:00

  • Adverse drug reactions in an elderly hospitalised population: inappropriate prescription is a leading cause.

    abstract:OBJECTIVE:Adverse drug reactions (ADRs) represent a major public health problem in the aged. In order to better evaluate this problem in Brazil, this study was designed to assess the prevalence of ADRs in an elderly hospitalised population, identify the most common ADRs and the principal medications involved, evaluate ...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-200522090-00005

    authors: Passarelli MC,Jacob-Filho W,Figueras A

    更新日期:2005-01-01 00:00:00

  • The association of inappropriate drug use with hospitalisation and mortality: a population-based study of the very old.

    abstract:BACKGROUND AND OBJECTIVE:Inappropriate prescribing is an important and possibly preventable risk factor for adverse drug reactions (ADRs) in the elderly, and hospital-based studies have shown that a large proportion of admissions is a result of ADRs. However, little is known about how inappropriate drug use (IDU) affec...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.2165/00002512-200522010-00005

    authors: Klarin I,Wimo A,Fastbom J

    更新日期:2005-01-01 00:00:00

  • Current evidence for neuroprotective effects of nicotine and caffeine against Parkinson's disease.

    abstract::Parkinson's disease (PD) is the second most common neurodegenerative disorder affecting 1 to 3% of individuals over the age of 65 years. While effective therapy exists for treating the bradykinesia, rigidity and tremor associated with the disease, the cause is unknown. There is no treatment available to prevent or slo...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200118110-00001

    authors: Ross GW,Petrovitch H

    更新日期:2001-01-01 00:00:00

  • Management of Ambulatory Anesthesia in Older Adults.

    abstract::The number of older patients is increasing globally. Combined with the growing number of ambulatory surgeries, many older patients will undergo ambulatory surgery in the future. The ambulatory setting offers many advantages: early mobilization, higher patient satisfaction, lower costs, and a low incidence of several c...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-020-00803-9

    authors: Hansen J,Rasmussen LS,Steinmetz J

    更新日期:2020-12-01 00:00:00

  • Use of beta-adrenoceptor antagonists in older patients with chronic obstructive pulmonary disease and cardiovascular co-morbidity: safety issues.

    abstract::The incidence of and mortality from both chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) increase with age. In addition, the average age of patients with COPD and CVD is also increasing as a result of improvements in both pharmacological and non-pharmacological treatments. Coronary artery...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200825020-00005

    authors: Andrus MR,Loyed JV

    更新日期:2008-01-01 00:00:00

  • Effect of reproductive hormones and selective estrogen receptor modulators on mood during menopause.

    abstract::Periods of intense hormonal fluctuations have been associated with heightened prevalence and exacerbation of underlying psychiatric illness, particularly the occurrence of premenstrual dysphoria, puerperal depression and depressive symptoms during perimenopause. It has been speculated that sex steroids such as estroge...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200320020-00001

    authors: Soares CN,Poitras JR,Prouty J

    更新日期:2003-01-01 00:00:00

  • Sialorrhoea and drooling in patients with Parkinson's disease: epidemiology and management.

    abstract::Although often less recognized than motor symptoms, non-motor effects represent an important source of disability for many parkinsonian patients. Of these non-motor symptoms, sialorrhoea, defined as the inability to control oral secretions resulting in excessive saliva accumulation in the oropharynx, constitutes perha...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/0002512-200825120-00003

    authors: Merello M

    更新日期:2008-01-01 00:00:00

  • Interventions to Improve Medicines Management for People with Dementia: A Systematic Review.

    abstract:BACKGROUND:The importance of optimising medicines management for people with dementia has been emphasised through research and policy. However, evidence is currently lacking regarding how to achieve this in this patient population. OBJECTIVE:The aim was to assess the effectiveness of medicines management interventions...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-017-0505-3

    authors: McGrattan M,Ryan C,Barry HE,Hughes CM

    更新日期:2017-12-01 00:00:00

  • Antipsychotics in older patients. A safety perspective.

    abstract::Age is a major source of variation in drug response. Social, medical and physiological heterogeneity intertwines to complicate geriatric pharmacotherapy. Inappropriate and excessive use of medication may be the most significant treatable health problem in the elderly. Older people are especially sensitive to antipsych...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199506040-00006

    authors: Pollock BG,Mulsant BH

    更新日期:1995-04-01 00:00:00