amitriptyline / Generic mfg. - LARVOL DELTA

Drugs for Migraine Prophylaxis. (PubMed, Dtsch Arztebl Int) - "The new prophylactic drugs against migraine are effective, well-tolerated, and especially useful for patients for whom traditional oral migraine prophylactic drugs and onabotulinum toxin A are ineffective, not tolerated, or contraindicated."

Journal • CNS Disorders • Migraine • Pain

Tricyclic Antidepressants suppress sleep in Caenorhabditis elegans. (PubMed, Sleep) - "This is the first high-throughput screen for chemicals modulating SIS. Elucidating the mechanism by which AMI and other chemicals regulate sleep will lead to new biological insights regarding the mechanisms of sleep."

Journal • CNS Disorders • Fatigue • Sleep Disorder

Amitriptyline Treatment of Adult CBA/CaJ Mice: Comparison of ABR Peak 1 Amplitudes After Exposure to Moderate or High Level Noise (ARO 2026) - "We have recently demonstrated that ABR thresholds elevated by high level noise exposure (110 dB x 8-16 kHz x 2 hr) is at least partially protected by intracochlear delivery of Fluvastatin (Depreux et al, 2024). These data will allow us to progress toward our goal of creating a dual drug combination for the protection of noise induced hearing loss . (Funded by the Office of the Assistant Secretary of Defense Affairs through the Hearing Restoration Research Program under Award number W81XWH-20-1-0484; and the Hugh Knowles Center, Northwestern University)"

Preclinical • Otorhinolaryngology

Survival Following a Tricyclic Antidepressant Overdose Presenting With Serotonin Syndrome-Like Symptoms and Critical Illness Polyneuropathy: A Case Report. (PubMed, Cureus) - "We report the case of a patient who ingested a lethal dose of amitriptyline, presented with serotonin syndrome-like neurological symptoms on arrival, and subsequently developed suspected critical illness polyneuropathy (CIP) during the clinical course...Clonazepam, levetiracetam, and cyproheptadine were administered, along with alkalinization therapy...Subsequently, limb weakness and nerve conduction study findings raised suspicion for CIP. This case highlights that tricyclic antidepressant intoxication can manifest with diverse neurological and neuromuscular complications, necessitating comprehensive management from the acute through chronic phases."

Journal • Acute Respiratory Distress Syndrome • Anesthesia • CNS Disorders • Depression • Infectious Disease • Metabolic Disorders • Movement Disorders • Pain • Pneumonia • Psychiatry • Pulmonary Disease • Respiratory Diseases

Cost-Effectiveness of Pregabalin, Duloxetine, and Milnacipran vs Amitriptyline for Moderate to Severe Fibromyalgia. (PubMed, JAMA Netw Open) - "Amitriptyline provided greater net benefit than milnacipran and the lower doses of pregabalin and duloxetine. These findings may help inform the selection of value-based treatments for moderate to severe FM."

HEOR • Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Efficacy and Safety of Melatonin in Migraine Prophylaxis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Curr Pain Headache Rep) - "Melatonin demonstrates benefits over placebo for reducing migraine burden and improving patient-reported outcomes, with a favourable safety profile. While amitriptyline remains more potent for several efficacy endpoints, melatonin represents a reasonable preventive option, particularly as an adjunct during titration of first-line agents. Further head-to-head trials with standardised dosing and longer follow-up are warranted."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Migraine • Pain

Migraine, associated treatments and risk of miscarriage: A matched cohort study and nested case-control study using the CPRD pregnancy register. (PubMed, Cephalalgia) - "Beta-blockers were not associated with a higher risk of miscarriage.ConclusionsMigraine and triptan, amitriptyline and NSAID exposure were all associated with higher risk of miscarriage. Further work is needed to understand the potential causative mechanisms."

Journal • CNS Disorders • Migraine • Pain

Neuroprotective Effect of D-Pinitol Against MPTP-Induced Parkinsonism in C57BL/6J Mice. (PubMed, Antioxidants (Basel)) - "D-Pinitol showed low antidepressant-like effects in the reserpine-induced chronic depression model, compared to amitriptyline (25 mg/kg p.o.). D-Pinitol protected MPTP-treated mice from motor impairment with similar effects to those shown by L-Dopa (25 mg/kg p.o.) as evaluated in different behavioral tests. The inhibition of oxidative stress markers, increase in dopamine levels, and avoidance of apoptosis in neuronal cells were the mechanisms by which D-Pinitol protects MPTP-treated mice from motor impairment."

Journal • Preclinical • CNS Disorders • Depression • Movement Disorders • Parkinson's Disease • Psychiatry

Streamlined dispersive solid phase extraction for determination of amitriptyline, cocaine, and benzoylecgonine in urine. (PubMed, J Pharmacol Toxicol Methods) - "The method was compared with the rapid immunoassay test on samples from patients with suspected intoxication, and was satisfactory, showing adequate sensitivity for the proposed application. The method using d-SPE/HPLC-DAD proved to be an appropriate technique to complement emergency toxicological analysis with a satisfactory total run time of 14 min for the detection of the 3 analytes of interest, which fits well into a fast-paced workflow."

Journal

Management of neuropathic pain: Don't lose hope! (PubMed, Rev Prat) - "The therapeutic section covers first-line treatments, such as antidepressants (duloxetine, amitriptyline) and antiepileptics (gabapentin, pregabalin), emphasizing dosage and patient management in primary care. This multimodal approach is crucial for effective management, especially in chronic cases, while referral to pain specialists is recommended for complex or refractory cases. By adopting these strategies, GPs can offer significant relief to patients with neuropathic pain, improving their quality of life and reducing the burden on the healthcare system."

Journal • Review • CNS Disorders • Neuralgia • Pain

Tricyclic Antidepressants as Prospective α-Synucleinopathy Fighters: Evidence of Protein Binding and Antiaggregation Activity. (PubMed, ACS Chem Neurosci) - "Here, we report the finding that clinically approved tricyclic antidepressants imipramine, amitriptyline, and doxepin bind directly to monomeric α-synuclein and inhibit its fibrillation, a key process in Parkinson's pathology...Moreover, simulations show that a single ligand molecule frequently engages in simultaneous salt-bridge and π-stacking interactions, unlike some previously studied α-synuclein binders. Our findings position tricyclic antidepressants as promising scaffolds for targeting α-synuclein and demonstrate the efficiency of molecular dynamics approaches for the description of interactions between small drug molecules and IDPs."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

MACS-2: Efficacy of Two Doses of Duloxetine & Amitriptyline in Interstitial Lung Disease-related Cough (clinicaltrials.gov) - P2 | N=25 | Recruiting | Sponsor: Mayo Clinic | Trial completion date: Dec 2025 ➔ Oct 2026 | Trial primary completion date: Dec 2025 ➔ Oct 2026

Trial completion date • Trial primary completion date • Cough • Interstitial Lung Disease • Pulmonary Disease • Respiratory Diseases

MACS-1: Efficacy of Two Doses of Duloxetine and Amitriptyline in Subjects With Refractory Chronic Cough (clinicaltrials.gov) - P2 | N=50 | Recruiting | Sponsor: Mayo Clinic | Trial completion date: Dec 2025 ➔ Dec 2026 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Chronic Cough • Cough • Pulmonary Disease • Respiratory Diseases

Severe, Unremitting Piriformis Syndrome Following Yoga and Pilates: A Case Report. (PubMed, Cureus) - "She began to show clinical improvement only after her duloxetine dose was increased back to 60 mg and amitriptyline was added, with full pain recovery occurring three weeks thereafter. The use of psychiatric medication for pain management in patients with PS or other sport-related injuries must be investigated further. This case underlines the importance of addressing holistic factors in managing musculoskeletal pain syndromes."

Journal • CNS Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry

Comparative effects of pharmacological interventions in the prophylactic treatment of tension-type headache: systematic review and network meta-analysis. (PubMed, Ann Med) - "Amitriptyline 100 mg presented more reduction of monthly headache days than placebo at 4 and 8 weeks (4 weeks: MD -6.59, 95% CrI -11.22 to -0.64; 8 weeks: MD -6.14, 95% CrI -10.27 to -0.87)...Given the low to very low certainty of evidence, high risk of bias, and high heterogeneity, more studies are needed. PROSPERO (CRD42025639586)."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Pain

Dose-dependent pharmacological mechanisms within the Neuroscience-based Nomenclature: a new concept to facilitate neuroscience-based prescribing. (PubMed, Lancet Psychiatry) - "Using the Neuroscience-based Nomenclature (NbN) framework, which classifies drugs by pharmacology and modes of action, we identified ten agents demonstrating DDDP in a comprehensive expert-based consensus process: amisulpride, amitriptyline, aripiprazole, brexpiprazole, cariprazine, doxepin, mirtazapine, quetiapine, risperidone, and trazodone...Understanding these differences supports more rational prescribing (eg, increasing dopamine partial agonist doses beyond the optimal range might reduce efficacy). DDDP, within the NbN framework, offers a neuroscience-based approach to more precise psychopharmacology."

Journal • Review • NBN

Evaluating efficacy of pregabalin in diabetic peripheral neuropathy pain management. (PubMed, Korean J Pain) - "Search terms included "pregabalin," "diabetic," "peripheral," "neuropathy," and "pain." Experimental groups varied from amitriptyline, duloxetine, carbamazepine, venlafaxine, and Xiaoketongbi Formula (XF). In terms of adverse effects, pregabalin was more tolerated among patients, though side effects were generally mild. Pregabalin remains an effective option for DPN pain management and is considered noninferior to current monotherapies and combination therapies."

Journal • Review • Diabetic Neuropathy • Neuralgia • Pain • Peripheral Neuropathic Pain

Bilateral Sphenopalatine Ganglion Block in the Management of Headache Associated With Subarachnoid Hemorrhage: Case Report. (PubMed, Pain Med Case Rep) - "SPG blocks show promising potential in the management of persistent headaches following SAH. An initial noninvasive transnasal approach, followed by more invasive techniques when necessary, may provide substantial pain relief and improve patient quality of life. Further research is needed to validate these findings and optimize treatment protocols."

Journal • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • CNS Disorders • Epilepsy • Hematological Disorders • Hematological Malignancies • Leukemia • Migraine • Oncology • Pain • Subarachnoid Hemorrhage • Thrombocytopenia

Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6 and CYP2C19 and tricyclic antidepressants. (PubMed, Eur J Hum Genet) - "For CYP2D6 poor metabolisers (PM), dose reductions are advised for amitriptyline (reduction to 60% of the normal dose), clomipramine (reduction to 50% of the normal dose for the indication depression or in case of side effects at the normal dose for the other indications), doxepin (reduction to 40% of normal dose), imipramine (30% of the normal dose), and nortriptyline (40%)...The DPWG classifies CYP2D6 genotyping for all five TCAs and CYP2C19 genotyping for clomipramine in patients with anxiety disorders or OCD, and for imipramine as being "potentially beneficial". Genotyping prior to treatment can be considered on an individual patient basis."

Biomarker • Journal • CNS Disorders • Depression • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • CYP2C19

From Years of Pain to a Name: Fibromyalgia Uncovered. (PubMed, Cureus) - "Effective pharmacologic options include duloxetine, milnacipran, pregabalin, and amitriptyline. However, after ruling out the common causes for diffuse chronic pain, fibromyalgia was diagnosed. This case illuminates the importance of clinicians being patient advocates throughout the journey and listening attentively to patients' concerns even when laboratory results and imaging appear unremarkable."

Journal • Bipolar Disorder • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Depression • Dermatology • Fatigue • Fibromyalgia • Gastrointestinal Disorder • Hidradenitis Suppurativa • Immunology • Major Depressive Disorder • Melanoma • Mood Disorders • Musculoskeletal Pain • Nephrology • Oncology • Pain • Post-traumatic Stress Disorder • Psychiatry • Renal Disease • Rheumatology • Solid Tumor

Limited bioconcentration of water-associated pharmaceutical active compounds through short-term exposure in signal crayfish (Pacifastacus leniusculus). (PubMed, Environ Toxicol Pharmacol) - "This study examined tissue-specific distribution of five PhACs - bicalutamide, amitriptyline, furosemide, daidzein and sertraline - in signal crayfish (Pacifastacus leniusculus) after 96-hour exposure and an equal depuration period. The lack of detectable residues indicates minimal bioconcentration, likely due to physicochemical properties (low log Kow), rapid metabolism and efficient excretion. Results underscore the need for longer exposures and metabolite-focused studies to better assess environmental fate, tissue kinetics and potential risks of PhAC mixtures in freshwater invertebrates."

Journal

Neuropathy of the infraorbital area following rapid palatal expansion: A case report. (PubMed, Medicine (Baltimore)) - "This case illustrates that MARPE, while effective and generally safe, can occasionally induce neuropathic complications extending beyond palatal branches to involve the infraorbital pathway. Mechanical stress redistribution in skeletally mature patients likely contributes to this outcome. Careful monitoring for atypical sensory changes, early recognition, and timely pharmacological intervention are essential to optimize prognosis. Further research is warranted to clarify biomechanical mechanisms and risk factors for trigeminal nerve injury during orthodontic maxillary expansion."

Journal • Neuralgia • Pain • Xerostomia

Comparative effects of antidepressants on cocaine-induced hyperthermia in rats: a preclinical study. (PubMed, Neurosci Lett) - "Mirtazapine may be a safer antidepressant option for managing depression in cocaine users because of its capacity to suppress hyperthermia without enhancing monoamine reuptake inhibition. Notably, caution should be exercised when prescribing monoamine oxidase inhibitors and SNRIs to this population. However, further clinical studies are required to validate these findings."

Journal • Preclinical • CNS Disorders • Depression • Psychiatry

Diagnosis and management of migraine in adults: a population-based study in England. (PubMed, BJGP Open) - "The majority of headache presenting to primary care remains undifferentiated/unclassified. Only one-third of patients diagnosed with migraine receive triptans or preventive medication. Acute medication overprescription is common and preventive medicines are poorly optimised."

Journal • CNS Disorders • Migraine • Pain • Preventive care

Sublingual cyclobenzaprine (Tonmya) for fibromyalgia. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology