amitriptyline / Generic mfg. - LARVOL DELTA

Predictive Factors and Treatment Effects of Neuromodulators in Chronic Refractory Cough. (PubMed, J Otolaryngol Head Neck Surg) - "Although previous studies have documented various treatment methods for CRC, no treatment method has proven fully effective.ObjectiveThis study investigated the treatment efficacy and adverse effects of neuromodulators (NM), Amitriptyline and Gabapentin, in the treatment of CRC, and the factors that predicted outcomes.DesignProspective data review.SettingPrivate otolaryngology clinic.ParticipantsThis study included 103 successive patients (72 female, 31 male) during the period between 2013 and 2023. Seventy percent of patients undergoing NM therapy experienced at least one adverse effect.Conclusion and RelevanceThe findings appeared to imply the therapeutic effects of neuromodulators on CRC, especially in patients presenting with chemical triggers. However, the adverse effect was a factor that may impact on application of this treatment method.Level of Evidence: 3."

Biomarker • Journal • Chronic Cough • Cough • Immunology • Otorhinolaryngology • Respiratory Diseases

Evaluation of the Effect of Aldehyde Oxidase Inhibitors on 6-Mercaptopurine Metabolism. (PubMed, Biol Pharm Bull) - "Thiopurines, such as 6-mercaptopurine (6-MP) and azathioprine, are converted to the inactive metabolites 6-thioxanthin (6-TX) and 6-thiouric acid (6-TUA)...The metabolism of 6-MP to 6-TX was strongly inhibited by AOX inhibitors (amitriptyline, chlorpromazine, clomipramine, clozapine, hydralazine, quetiapine, and raloxifene) in a reaction mixture containing human liver cytosol. The inhibition of 6-TX production rate by each AOX inhibitor was 60-70% at high concentrations, although the XO inhibitor febuxostat showed an inhibition rate of 10-30%...However, because of the lower activity of AOX in rats than that in humans, the contribution of AOX could not be assessed using in vivo experiments. Further studies are needed to evaluate the contribution of AOX to the therapeutic and adverse effects of thiopurines, both in clinical studies and in animal models of liver humanization."

Journal • Hematological Disorders

An Overview of the Systematic Reviews About the Efficacy of Fluvoxamine on Depression. (PubMed, Pharmaceuticals (Basel)) - "Comparisons with imipramine, clomipramine, amitriptyline, dothiepin, paroxetine, fluoxetine, citalopram, mianserin, nortriptyline, and moclobemide generally revealed no significant differences in efficacy. However, some reviews indicated that venlafaxine and mirtazapine were superior to fluvoxamine in certain outcomes, while fluvoxamine demonstrated greater efficacy than desipramine in one review. Sertraline and milnacipran showed mixed or review-quality-dependent results, with one low-quality review favoring milnacipran...While no single antidepressant was universally superior, fluvoxamine's unique pharmacological profile and favourable safety characteristics support its clinical utility. Further research is needed to explore its role in personalized treatment strategies and emerging therapeutic contexts, such as comorbid anxiety and post-traumatic stress disorder."

Journal • Review • CNS Disorders • Depression • Mental Retardation • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry

Unintentional amitriptyline overdose leading to coma and cardiac conduction impairment in an older adult: A case report. (PubMed, SAGE Open Med Case Rep) - "Following serum alkalization therapy with sodium bicarbonate, the patient's consciousness improved, her heart rate normalized, and QRS duration was shortened. This case underscores the importance of involving healthcare providers and family members in implementing robust safety measures to prevent unintentional medication errors caused by look-alike/sound-alike medications, particularly among older adults."

Journal • Cardiovascular

Effectiveness of amitriptyline, duloxetine and pregabalin in pudendal neuralgia management: a comparative study (NeuPSIG 2025) - No abstract available

CNS Disorders • Neuralgia • Pain

Comparison of Duloxetine Supplemented With Pregabalin and Amitriptyline Supplemented With Pregabalin for the Treatment of Postherpetic Neuralgia: A Double-Blind, Randomized Crossover Trial. (PubMed, CNS Neurosci Ther) - P4 | "Duloxetine and amitriptyline have similar analgesic effects, and the difference is not statistically significant. The combination of pregabalin has good tolerability and better pain relief in PHN patients, thus providing clinically relevant benefits."

Clinical • Journal • CNS Disorders • Depression • Herpes Zoster • Neuralgia • Pain • Psychiatry • Varicella Zoster • Xerostomia

Amitriptyline Versus Placebo in Addition to Speech Pathology for Inducible Laryngeal Obstruction: A Double-blind Randomised Controlled Trial (ATS 2025) - "In this double-blind randomised controlled trial, speech pathology effectively reduced ILO symptoms, laryngeal hypersensitivity, the impact of voice problems on patients' quality of life and anxiety and depression scores, with no additional benefit from concurrent amitriptyline."

Clinical • CNS Disorders • Depression • Immunology • Mood Disorders • Otorhinolaryngology • Psychiatry • Pulmonary Disease

The Effects of Antidepressants on the Gut Microbiome: An Implication for a Perpetual Cycle of Depression and a Call for Nutritional Intervention? (APA 2025) - "The search terms included "gut microbiome" and "antidepressants" or "ketamine." Articles were selected based on predefined inclusion criteria, focusing on studies that investigated the impact of antidepressants on gut microbiota using human subjects, human cell lines, or animal models...Studies showed that SSRIs like fluoxetine and paroxetine reduced the abundance of gut bacteria such as Bacteroides and Firmicutes, while increasing others like Prevotella and Ruminococcus...Venlafaxine and amitriptyline were found to decrease beneficial gut bacteria such as Lactobacillus and increase inflammatory bacteria, potentially contributing to gut dysbiosis and depressive symptoms. Atypical antidepressants and MAOIs, such as aripiprazole and phenelzine, demonstrated potent antimicrobial effects... The review highlights a critical issue: antidepressants may not fully exhibit their therapeutic effects due to their negative impact on the gut microbiome,..."

CNS Disorders • Depression • Inflammation • Inflammatory Bowel Disease • Mental Retardation • Mood Disorders • Psychiatry

Comprehensive Obesity Treatment: Moving Beyond Lifestyle Change by Integrating Pharmacotherapy Into Your Practice (APA 2025) - "Commonly prescribed medications, such as antidepressants (e.g., mirtazapine, amitriptyline) and antihyperglycemics (e.g., glyburide, insulin) cause weight gain, and clinicians should review and consider alternatives...Compared to placebo, orlistat was associated with 3.1% greater weight loss, phentermine-topiramate was associated with 8.0% greater weight loss, naltrexone-bupropion was associated with 4.1% greater weight loss, liraglutide was associated with 4.7% greater weight loss, semaglutide was associated with 11.4% greater weight loss and tirzepatide 15 mg was associated with 12.4% greater weight loss...AOMs are effective adjunctive therapy to lifestyle changes for improved health outcomes. Instructional Level Introductory; Learning Objectives Objective One: Understand the principles of chronic weight management to treat obesity and weight-related complications Objective Two: Identify medications that promote weight gain and guide patient consideration of..."

Cardiovascular • CNS Disorders • Constipation • Depression • Diabetes • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Hypertension • Metabolic Disorders • Mood Disorders • Obesity • Psychiatry • Type 2 Diabetes Mellitus

Multidisciplinary Management of ARDS, Pulmonary Emboli, and Bronchopleural Fistula Following Multidrug Ingestion (ATS 2025) - "This was caused by an intentional polysubstance overdose, including amitriptyline, a tricyclic antidepressant (TCA)...It also highlights the life-sustaining role of ECMO in cases of pediatric respiratory failure. In this case VA-ECMO via central cannulation allowed the patient to be liberated from positive pressure ventilation and ultimately provided time for recovery."

Acute Respiratory Distress Syndrome • Cardiovascular • CNS Disorders • Depression • Pediatrics • Psychiatry • Pulmonary Embolism

Role of Ceramide in SARS-CoV-2 Spike Protein-amplified Acute Lung Injury (ATS 2025) - "ASM was inhibited by amitriptyline or endothelial-specific conditional Smpd1 knockout mice... In a model of S1-amplified ALI, characterized by excess Ang2, activation of ASM on endothelial cells may drive acute lung injury pathogenesis via formation of ceramide rich platforms on microvascular endothelial cells. Acknowledgements: Seyed Ali Mousavi-Aghdas, Katrina Kopf, and Arjun Singh are equal contributors to this abstract."

Acute Lung Injury • Acute Respiratory Distress Syndrome • Anesthesia • Infectious Disease • Inflammation • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

PAIN RELIEF IN CHRONIC PANCREATITIS – ROLE OF ENDOTHERAPY, PANCREATIC ENZYMES, ANTIOXIDANTS AND SURGERY (ESPGHAN 2025) - "Children with depression were given amitriptyline...PERT did not affect pain frequency or severity. Conclusions Pain relief in CP can be achieved with ERP in the majority with ductal hypertension."

Surgery • Cardiovascular • CNS Disorders • Depression • Hypertension • Pain • Pancreatitis • Psychiatry

Comparative efficacy of benzydamine and alternative mouthwashes in the management of oral mucositis: A systematic review of randomized control trials. (ASCO 2025) - "Amitriptyline mouthwash provided more pain relief than benzydamine in one trial... Benzydamine mouthwash significantly reduced the severity and incidence of oral mucositis, especially during later treatment phases. It remained effective even under high radiation doses. However, conflicting evidence with alternative mouthwashes suggests the need for further research to establish definitive management strategies for this common and debilitating condition."

Clinical • Review • Head and Neck Cancer • Mucositis • Oncology • Pain • Solid Tumor • Stomatitis

Insulin Resistance: The Role in Comorbid Type 2 Diabetes Mellitus and Depression. (PubMed, Neurosci Biobehav Rev) - "Tricyclic antidepressants, particularly amitriptyline and nortriptyline, worsen metabolic profiles by exacerbating IR, promoting weight gain, and inducing hyperglycemia, thereby increasing diabetes risk with prolonged use...Mirtazapine presents a paradoxical profile-while its appetite-stimulating effects often lead to weight gain (a known IR risk factor for IR), some evidence suggests potential β-cell function preservation, necessitating cautious use of mirtazapine in individuals with metabolic syndrome. Among selective serotonin reuptake inhibitors, fluoxetine and escitalopram demonstrate favorable metabolic effects, including improved insulin sensitivity and glycemic control, though hypoglycemia risk (particularly with concomitant sulfonylureas) warrants monitoring. Bupropion, a norepinephrine-dopamine reuptake inhibitor, uniquely promotes weight loss and enhances glycemic control, making it a first-line option for depression comorbid with obesity or T2DM. Agomelatine,..."

Journal • Review • CNS Disorders • Depression • Diabetes • Genetic Disorders • Hypoglycemia • Inflammation • Metabolic Disorders • Mood Disorders • Obesity • Psychiatry • Type 2 Diabetes Mellitus

The anticholinergic burden in patients with chronic kidney disease: Patterns, risk factors, and the link with cognitive impairment (ERA 2025) - "The results of our study emphasize the need for caution in the prescription of drugs with anticholinergic properties to patients with CKD."

Clinical • Alzheimer's Disease • Chronic Kidney Disease • Cognitive Disorders • Mental Retardation • Nephrology • Psychiatry • Renal Disease

EVALUATING THE SAFETY OF PHARMACOTHERAPY FOR IRRITABLE BOWEL SYNDROME: A META-ANALYSIS (DDW 2025) - "AEs were more varied for tricyclics (indicated for IBS global symptoms); for example, compared to placebo the three most common AEs with associated risk increases were drowsiness (14%), dry mouth (12%), and weight gain (9%) for amitriptyline, dry mouth (22%), flushing (18%), and constipation (17%) for desipramine, and fatigue (15%), dry mouth (3%) and blurry vision (1.5%) for doxepin...The NNH for linaclotide, lubiprostone, plecanatide, tegaserod, and tenapanor (indicated for IBS-C) was 27 (p < 0.01), 53 (p = 0.59), 58 (p < 0.01), 59 (p = 0.03), and 17 (p <0.01) respectively. The NNH for alosetron and eluxadoline (indicated for IBS-D) was 16 (p < 0.01) and 32 (p < 0.01). Ramosetron and rifaximin (indicated for IBS-D) had a negative risk difference, with the rate of withdrawal due to AEs higher in the placebo arm, so NNH was a negative, although statistically insignificant, value... Tricyclics, alosetron, and tenapanor are associated with a higher..."

Retrospective data • Constipation • Fatigue • Gastrointestinal Disorder • Xerostomia

Comparing Efficacy of Gabapentin and Amitriptyline in Chronic Pain Management: A Systematic Review of Randomized Controlled Trials (ISPOR 2025) - "This systematic review demonstrated that gabapentin has comparable or superior efficacy to amitriptyline in chronic pain management. Future research should focus on specific subpopulations to determine whether certain groups respond better to one medication and assess the long-term effectiveness of the studied drugs and other first-line treatments for chronic pain to gain a more comprehensive understanding of optimal pain management strategies."

Clinical • Review • Pain

Reliability of Multicentric Extracted EMR Data: Quantifying Amitriptyline Use in Elderly Patients - A POLAR_MI Study. (PubMed, Stud Health Technol Inform) - "High inter-rater reliability (Krippendorff's Alpha = 0.9814) confirmed data validity. Our approach demonstrated the feasibility of using standardised FHIR specifications for robust, privacy-compliant evidence generation in large-scale pharmacovigilance studies."

Journal

Stochastic dynamics mass spectrometric quantification and 3D molecular structural analysis of tricyclic antidepressant in marine dissolved organic matter. (PubMed, Environ Geochem Health) - "The quantitative determining and 3D structural analysis of species within the innovative approach assessing the relation D''SD = f(DQC) shows the following performances:;r|= 0.99797 (carbamazepine),;r|= 0.99962 (scandoside), and;r|= 0.99999 (amitriptyline) in marine organic matter, respectively. The study solves the most enduring problem of monitoring of pharmaceutics pollution causing for eco-toxicological and human health risk of antibiotic resistance and affect on microbial communities; thus, illustrating best performances reported, so far of;r|= 0.99999-0.99962 via innovative stochastic dynamics equations for exact processing of mass spectrometric variables and obtaining of highly reliable quantitative and 3D structural analyses of degradation and synthetic carbamazepines exhibiting diverse oxidized products at very low analyte concentrations within 0.28 ng L-1-1 ng.(mL-1) in marine organic matter which is the most complex natural chemical..."

Journal

Migraine Headache Prophylaxis. (PubMed, Am Fam Physician) - "First-line medications include propranolol, metoprolol, topiramate, divalproex, valproate, and calcitonin gene-related peptide receptor antagonists...Amitriptyline and venlafaxine are considered second-line medications due to a greater number of adverse events and less supporting evidence, respectively. OnabotulinumtoxinA (Botox) injection is approved for chronic migraine prophylaxis...Cognitive behavior therapy, acupuncture, neural stimulators, and exercise are supported by varying levels of evidence and can be used individually or in combination with pharmacotherapy. Alternative agents, including feverfew, magnesium, and melatonin, have shown effectiveness and are generally well tolerated."

Journal • Review • CNS Disorders • Migraine • Mood Disorders • Pain • Psychiatry

Effectiveness of AI-Guided Exercise and Pain Neuroscience Education for Fibromyalgia (FIBROIA) (clinicaltrials.gov) - P=N/A | N=50 | Recruiting | Sponsor: Marco Antonio Morales Osorio | Not yet recruiting ➔ Recruiting | Trial completion date: Jul 2025 ➔ Jul 2026 | Trial primary completion date: Apr 2025 ➔ Apr 2026

Enrollment open • Trial completion date • Trial primary completion date • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

MRP-HAND: Multiprofen-CC to Reduce Pain in Hand Arthritis (clinicaltrials.gov) - P3 | N=42 | Not yet recruiting | Sponsor: McMaster University

New P3 trial • Immunology • Osteoarthritis • Pain • Rheumatology

SELECTIVE SEROTONIN REUPTAKE INHIBITORS AND TRICYCLIC ANTIDEPRESSANTS USE IN INFLAMMATORY BOWEL DISEASE PATIENTS MAY BE ASSOCIATED WITH POOR CLINICAL OUTCOMES (DDW 2025) - "Subjects were stratified into groups using commonly prescribed selective serotonin reuptake inhibitors (SSRI) (fluoxetine, citalopram, escitalopram, paroxetine, sertraline), tricyclic antidepressants (TCA) (amitriptyline, doxepin, imipramine, nortriptyline, desipramine), or monoamine oxidase inhibitors (MAOI) (selegiline, isocarboxazid, phenelzine, tranylcypromine) for at least one year. Herein we showed that SSRI and TCA use in IBD patients is associated with poor clinical outcomes in terms of requiring steroid therapy, hospitalization, and death. Some studies have suggested that this may be due to SSRI-induced dysbiosis which may lead to gut inflammation. MAOI use was not associated with statistically significant worsened outcomes however this may be due to insufficient power."

Clinical • Clinical data • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Pain • Psychiatry • Ulcerative Colitis

CYCLIC VOMITING SYNDROME AMONG PEDIATRIC PATIENTS IN THE UNITED STATES: PATIENT CHARACTERISTICS, TREATMENT PATTERNS, AND HEALTHCARE RESOURCE UTILIZATION (DDW 2025) - "Cyproheptadine (27.5%) and amitriptyline (12.7%) accounted for nearly all prophylaxis treatment, aligning with first-line recommendations for patients under and over 5 years of age, respectively. Guideline-recommended abortive medications sumatriptan and ondansetron were used by 5.7% and 61.4% of patients...Although patients eventually receive guideline-based treatments, diagnostic delays are experienced by most pediatric patients with CVS. Improved awareness of CVS should improve this gap in care."

Clinical • HEOR • CNS Disorders • Depression • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Mood Disorders • Pain • Pediatrics • Psychiatry • Rare Diseases

CYCLIC VOMITING SYNDROME AMONG ADULTS IN THE UNITED STATES: PATIENT CHARACTERISTICS, TREATMENT PATTERNS AND HEALTHCARE RESOURCE UTILIZATION (DDW 2025) - "Guideline-recommended prophylactic medications for moderate-to-severe CVS (i.e., amitriptyline, topiramate, aprepitant, zonisamide and levetiracetam) were used by 0.5%–13% of patients at any time post-diagnosis. Guideline-recommended abortive medications sumatriptan and ondansetron were used by 8.3% and 72.4% of patients...Conclusion : This study highlights the significant clinical burden and HCRU associated with CVS in the US and the need to improve access to evidence-based treatments, and it suggests potential underreporting of CVS in healthcare records post-diagnosis. The novel use of NLP provided deeper insights into symptomatology and revealed the substantial length of diagnostic delay experienced by most patients with CVS."

Clinical • HEOR • CNS Disorders • Depression • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Mood Disorders • Pain • Psychiatry • Rare Diseases