amitriptyline / Generic mfg. - LARVOL DELTA

MULTIMODAL ANALGESIA for Refractory NEUROPATHIC PAIN in End-Stage SÉZARY SYNDROME: A case report. (ASA 2025) - "The anesthesiology painteam implemented a multimodal regimen consisting of amitriptyline, gabapentin,oral morphine, and dipyrone. No adverse effects were observed. Pain remained well-controlled until the patient'speaceful death, without the need for sedation or cardiopulmonary resuscitation.This case highlights the pivotal role of the anesthesiology pain team in oncologic care and demonstrates the effectiveness of early multimodal analgesia in restoring comfort and dignity to terminal patients."

Case report • Clinical • Anesthesia • Cutaneous T-cell Lymphoma • Neuralgia • Pain • Sezary Syndrome

Functional impact of new repressors of radioiodide uptake (ATA 2025) - "Of the tested drugs, 3 significantly inhibited NIS function in TPC-1-NIS cells: Enalapril, amitriptyline and sulindac (66%, 50% and 58% suppression; p = 0.0021, 0.0005 and 0.0087, respectively)...Our preliminary work identifies and validates 3 commonly prescribed drugs which inhibit radioiodide uptake, with clear potential impact on patient outcomes."

Solid Tumor • Thyroid Gland Carcinoma

Functional impact of new repressors of radioiodide uptake (ATA 2025) - "Of the tested drugs, 3 significantly inhibited NIS function in TPC-1-NIS cells: Enalapril, amitriptyline and sulindac (66%, 50% and 58% suppression; p = 0.0021, 0.0005 and 0.0087, respectively)...Our preliminary work identifies and validates 3 commonly prescribed drugs which inhibit radioiodide uptake, with clear potential impact on patient outcomes."

Solid Tumor • Thyroid Gland Carcinoma

An audit of Gabapentinoid prescribing patterns in patients attending a chronic pain clinic in a university teaching hospital in England. (NeuPSIG 2025) - "NICE had published guidelines for management of neuropathic pain in the UK with both gabapentin and pregabalin recommended as 1st line along with amitriptyline and duloxetine. However with increasing awareness about the long term side-effects of these gabapentinoids and in absence of good robust evidence of efficacy, there has been gradual shift in prescribing pattern, moving away from the recommended maximum daily dose for both these agents. Our audit suggested about 1/3 of the patients attending the clinic were already on these medications and where deemed appropriate, pregabalin was initiated instead of Gabapentin because of the better pharmacological profile."

Clinical • Addiction (Opioid and Alcohol) • CNS Disorders • Neuralgia • Pain • Sleep Disorder

Patient-reported outcomes as predictors of response to pharmacotherapy in patients with painful diabetic neuropathy: secondary results from the OPTION-DM trial (NeuPSIG 2025) - "These were: amitriptyline supplemented with pregabalin (AP), duloxetine supplemented with pregabalin (DP), and pregabalin supplemented with amitriptyline (PA). Our models explained 39% (R2) of response of patients to the AP pathway (n=100; predictors: pain interference, burning qualities, discomfort, DN4 score, rumination, anxiety), 18% of response of patients to the DP pathway (n=95; predictors: pain interference, physical health impression), and 18% of response of patients to the PA pathway (n=104; predictors: discomfort and DN4 score). These preliminary results show that the response to combination treatment may partly depend on pain characteristics that can be collected before treatment. The lower predictive value of the DP and PA models (R² = 18%) compared to AP (R² = 39%) may reflect differing mechanisms of action or lower patient-reported symptom specificity within those arms. These findings suggest that patients with high pain interference and sensory..."

Clinical • Patient reported outcomes • CNS Disorders • Mood Disorders • Neuralgia • Pain • Peripheral Neuropathic Pain • Psychiatry

Evaluation of a hNav1.9 screening cascade for analgesic drug discovery (NeuPSIG 2025) - "Endogenous Nav1.9 currents were recorded from isolated rat dorsal root ganglion neurons (DRG) using manual patch clamp technique. Various NaV inhibitors (A-803467, Amitriptyline, ICA-121431, Lidocaine, TC-N 1752, Tetracaine, tetrodotoxin and VX-548) were tested against human and rat NaV1.9 using the novel automated patch clamp assay. A comprehensive screening cascade has been developed, capable of supporting potential drug discovery programs and species selectivity studies via high-throughput screening, as well as mechanistic studies of native NaV1.9 using manual patch clamp."

Addiction (Opioid and Alcohol) • CNS Disorders • Pain • Psychiatry • NAV1

Analysing the impact of gabapentinoid reclassification on prescribing rates of antidepressants recommended for neuropathic pain treatment in the UK (NeuPSIG 2025) - "A previous analysis exploring the impact of reclassification on gabapentinoid prescribing rates, showed a significant decrease in Defined Daily Dose (DDDs - assumed average daily doses of drugs for an adult) levels post-reclassification for gabapentin in Scotland, and significant negative changes in trend post-reclassification for pregabalin in Scotland, England and Wales[3]. The ITSA results suggest no significant difference in amitriptyline and duloxetine prescribing trends pre- and post-reclassification across the UK, with trends continuing to rise. This implies that gabapentinoid reclassification did not directly affect the prescribing rates of amitriptyline and duloxetine. This may inform future policy and guideline changes, to limit unnecessary and inappropriate prescribing of amitriptyline and duloxetine, additionally to other first-line neuropathic pain medication."

CNS Disorders • Neuralgia • Pain

Delayed treatment of Rolipram-PgP nanotherapeutics reduces neuropathic pain in a rat moderate thoracic sub-acute SCI model (NeuPSIG 2025) - "Current treatment includes medications like gabapentin, pregabalin, and amitriptyline, but these only benefit about 20% of those injured. Delayed Rm-PgP treatment groups showed lower pain levels compared to untreated SCI group even though it was not significantly different and showed similar BBB scores compared to untreated SCI group. Delayed Rm-PgP treatment at 7 DPI reduced number of CGRP + and ED1 + cells and increased Arg1 + cells compared to untreated SCI rats. Rm-PgP treatment at 7 DPI also showed improved neuronal cell survival and increased spared myelin volume."

Preclinical • CNS Disorders • Neuralgia • Pain

Effectiveness of amitriptyline, duloxetine and pregabalin in pudendal neuralgia management: a comparative study (NeuPSIG 2025) - "Although preliminary, these results seem to confirm the role of amitriptyline, duloxetine and pregabalin as effective medications in the treatment of chronic pudendal neuralgia."

CNS Disorders • Musculoskeletal Pain • Neuralgia • Pain

Mirtazapine 30 mg as a Potential New Therapy for the Treatment of Laryngeal Sensory Neuropathy. (PubMed, J Voice) - "Mirtazapine 30 seems to be a practical therapy choice for LSN. More research is required to compare the results of this treatment protocol with those of other medications used to treat LSN, including systemic drugs or local interventions such as superior laryngeal nerve block injections, to provide additional context and validation for our findings."

Journal • Cough • Otorhinolaryngology • Pain • Respiratory Diseases

Influence of amitriptyline therapy on T cell phenotype in chronic pain patients. (PubMed, Biomed Pharmacother) - "Our results revealed that amitriptyline interferes with production of the pro-inflammatory cytokine interferon (IFN)-γ and elevates the anti-inflammatory cytokine interleukin (IL)-10 as well as frequencies of immunosuppressive regulatory T cells, in particular in patients with improved pain after therapy. Hence, amitriptyline therapy affects the adaptive immune response, which might contribute to pain relief through an immune-mediated mechanism."

Journal • Pain

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 | Initiation date: Jul 2025 ➔ Dec 2025

Enrollment open • Trial initiation date • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Poisonings with antidepressants (PubMed, Lakartidningen) - "Amitriptyline, clomipramine, venlafaxine and bupropion had PSIs surpassing all other antidepressants by nearly an order of magnitude and comprised almost 80% of 101 serious poisonings. Both the SPIC and the NBFM cohorts demonstrate that the risk of severe toxicity from overdose is not uniform among antidepressants. The toxicity profile of the respective substance needs to be considered when antidepressants are prescribed."

Journal

Treatment patterns in women with breast cancer and endocrine therapy-related menopausal symptoms: a cohort study from the United States, United Kingdom, and Germany. (PubMed, Menopause) - "Continuation rates with available treatments for menopausal symptoms in women receiving endocrine therapy for breast cancer treatment/prevention are very low. This indicates a clear unmet need for safe, effective, and well-tolerated treatments in this patient population."

Journal • Breast Cancer • Oncology • Solid Tumor

Novel 2D MXenes biocomposite for the removal of emerging organic contaminants from wastewater. (PubMed, J Appl Biomater Funct Mater) - "Polyfluoroalkyl substances (PFAS), dyes, antibiotics (tetracycline, sulfonamides, and ciprofloxacin), amitriptyline, verapamil, carbamazepine, 17α-ethinyl estradiol, antibiotic resistance genes (ARGs), diclofenac, ibuprofen heavy metals, and other contaminants have all been claimed to be eliminated by MXenes. Recent studies propose the formulation of MXene-based biocomposites, which not only harness the high surface area and electrical conductivity of MXenes but also integrate biodegradable components to promote eco-friendliness. This work explores the potential of novel 2D MXenes biocomposites in addressing the critical challenge of wastewater treatment, focussing on their efficiency, and sustainability in removing emerging contaminants."

Journal • Review

Severe, refractory restless legs syndrome responding to hyperbaric oxygen therapy: a case report (WSS 2025) - "At the time of hyperbaric oxygen therapy (HBOT) initiation, she was taking buprenorphine patch 5 mcg/h weekly, amitriptyline 25 mg nocte, agomelatine 25 mg daily, gabapentin 600 mg daily, and zopiclone 7.5 mg nocte. This case highlights the potential for HBOT to serve as a novel adjunctive therapy for patients with refractory RLS, particularly when conventional treatment options have been exhausted. If further validated, HBOT may offer a promising avenue for improving quality of life in this challenging patient population."

Case report • Clinical • CNS Disorders • Insomnia • Movement Disorders • Respiratory Diseases • Restless Legs Syndrome • Sleep Apnea • Sleep Disorder

Neurosarcoidosis presentation with refractory neuropathic pain: A case report (WASOG-AASOG 2025) - "Medications attempted but unsuccessful in managing symptoms included gabapentin, amitriptyline, mexiletine, steroids, and opiates. Immunomodulatory disease management included oral prednisone, methotrexate, and infliximab...This patient meets the criteria for probable neurosarcoidosis, with pathologic confirmation of systemic granulomatous disease and a typical neurologic presentation. Limited published data and a lack of therapeutic alternatives exist for patients with severe PNS involvement, aside from corticosteroids. These patients require a multi-modal approach, and further research is needed to improve treatment options and prevent worsening disability."

Case report • Clinical • Addiction (Opioid and Alcohol) • Immunology • Neuralgia • Pain • Sarcoidosis

Effective Control of Neuropathic Pain With Amitriptyline in Neuromyelitis Optica Spectrum Disorder: A Case Report. (PubMed, Cureus) - "The patient was treated with methylprednisolone pulse therapy, followed by maintenance immunosuppressive therapy with inebilizumab and prednisolone, resulting in neurological improvement. This case highlights the potential of amitriptyline as an effective treatment for NP in NMOSD, a common and often resistant symptom in this condition. Given the complex mechanisms underlying NMOSD-related pain, individualized management strategies that include pharmacological agents like amitriptyline are crucial for improving patient quality of life (QOL), and further research is needed to optimize these approaches."

Journal • CNS Disorders • Musculoskeletal Pain • Neuralgia • Neuromyelitis Optica Spectrum Disorder • Pain • Rare Diseases

Physiologically-Based Pharmacokinetic Modeling Predicts Altered Maternal Pharmacokinetics of Amitriptyline during Pregnancy (WFSBP 2025) - " A PBPK model, including AMI, but also its active metabolite nortriptyline (NOR), was developed to investigate pregnancy-induced pharmacokinetic changes in AMI treated pregnant women. We added valuable information on AMI pharmacokinetics during pregnancy (similar sum serum concentrations of AMI+NOR, but increased AMI concentration and decreased NOR concentration). For clinical practice the treating physician should be aware that despite active moiety serum concentration comparable to before pregnancy, tolerability may be affected due to increased AMI serum concentrations and as consequence increased anticholinergic effects."

PK/PD data • CNS Disorders • Depression • Psychiatry

Botulinum Toxin-A, Generating a Hypothesis for Orofacial Pain Therapy. (PubMed, Toxins (Basel)) - "Each require tailored prophylactic pharmacotherapy, such as carbamazepine, gabapentin, pregabalin, amitriptyline, metoprolol, and topiramate. In addition, the advantage of BoNT-A for providing a safe sustained effect after a single application for chronic pain prophylaxis is discussed, as opposed to the daily use of current conventional prophylactic medications. Finally, we summarize the clinical applications of BoNT-A for chronic orofacial pain therapy."

Journal • Review • CNS Disorders • Migraine • Musculoskeletal Diseases • Musculoskeletal Pain • Neuralgia • Pain

Comparison of the effectiveness of first-line preventive treatment of migraine in primary care: study protocol for a pragmatic clinical trial (PREMI study). (PubMed, Trials) - P4 | "There are epidemiological, clinical and pharmacological sex-differences in migraine which may result in differences in the use of migraine preventive drugs. However, the effectiveness of the most frequent preventive treatment and the differences in effectiveness and safety between women and men have not yet been studied. Moreover, as new expensive drugs have been authorized for preventive treatment, indicated when the usual drugs have failed, assessing the effectiveness and safety of the usual oral preventive drugs through a clinical trial is especially important. We also plan to evaluate their cost-effectiveness, and the clinical trial will count on an active contribution from patients through an app designed for this purpose, which may help in the management of the disease in the future."

Clinical • Journal • CNS Disorders • Migraine • Pain

Effects of antidepressant exposures on a stream detrital food chain: Microbial decomposers and invertebrate detritivores. (PubMed, Ecotoxicol Environ Saf) - "Thus, fluoxetine and amitriptyline exhibited different bottom-up effects on the detrital food chain by acting on distinct microbial enzymes. Consequently, this study demonstrates that antidepressants disrupt key ecosystem processes, impacting nutrient cycling and freshwater ecosystem health."

Journal

Prolonged Prophylactic Migraine Therapy Associated With Reduction in Frequency and Severity of Cyclic Vomiting Syndrome Episodes: A Retrospective Review (ACG 2025) - "Prophylactic therapies included amitriptyline, propranolol, topiramate, and candesartan. Of 54 patients with CVS, 16 met inclusion criteria. Mean episode frequency declined from 5.2 episodes/year pre-treatment to 1.6 episodes/year post-treatment (p< 0.001). Average episode duration also decreased from 3.4 days to 1.7 days (p=0.002)."

Retrospective data • Review • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Migraine • Pain • Rare Diseases

Reassessing Tricyclic Antidepressants in IBS: A Review of Amitriptyline Efficacy (ACG 2025) - "Our five included studies investigated the effectiveness of amitriptyline (10mg-75mg) in treating irritable bowel syndrome (IBS), mainly focusing on its impact on pain, stress-related symptoms, and overall quality of life in 236 patients. All five of our included trials were randomized clinical trials comparing amitriptyline to placebo (Table 1). The ATLANTIS trial is the largest among all included studies."

Clinical • Review • Gastroenterology • Gastrointestinal Disorder • Xerostomia

When the Flow Stops: Functional Biliary Obstruction Secondary to Chronic Opioid Use (ACG 2025) - "Treatment included low-dose amitriptyline and lifestyle modifications. Opioids can elevate sphincter of Oddi tone via μ-opioid receptor activation, leading to functional outflow obstruction...Early recognition of opioid-induced SOD can help avoid unnecessary procedures and guide effective symptom control.Figure: Image 1: Computed Tomography (CT) of the AbdomenModerate biliary tree dilation without evidence of calcified choledocholithiasis, along with accompanying dilation of the pancreatic duct.Figure: Image 2: Magnetic resonance cholangiopancreatography (MRCP)Progressive dilation of both intrahepatic and extrahepatic bile ducts, along with prominence of the pancreatic duct, most notably in the region of the pancreatic head. No evidence of obstructing calculi or mass lesion is observed."

CNS Disorders • Diabetes • Epilepsy • Gastrointestinal Disorder • Hepatology • Metabolic Disorders • Pancreatitis • Type 2 Diabetes Mellitus