AMITRIPTYLINE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Amitriptyline: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83695-7 1. Amitriptyline-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on amitriptyline. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON AMITRIPTYLINE ......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Amitriptyline ................................................................................ 4 The National Library of Medicine: PubMed ................................................................................ 17 CHAPTER 2. NUTRITION AND AMITRIPTYLINE ............................................................................. 103 Overview.................................................................................................................................... 103 Finding Nutrition Studies on Amitriptyline ............................................................................. 103 Federal Resources on Nutrition ................................................................................................. 108 Additional Web Resources ......................................................................................................... 108 CHAPTER 3. ALTERNATIVE MEDICINE AND AMITRIPTYLINE....................................................... 111 Overview.................................................................................................................................... 111 National Center for Complementary and Alternative Medicine................................................ 111 Additional Web Resources ......................................................................................................... 115 General References ..................................................................................................................... 118 CHAPTER 4. PATENTS ON AMITRIPTYLINE ................................................................................... 119 Overview.................................................................................................................................... 119 Patents on Amitriptyline ........................................................................................................... 119 Patent Applications on Amitriptyline ....................................................................................... 128 Keeping Current ........................................................................................................................ 129 CHAPTER 5. BOOKS ON AMITRIPTYLINE ....................................................................................... 131 Overview.................................................................................................................................... 131 Book Summaries: Online Booksellers......................................................................................... 131 Chapters on Amitriptyline ......................................................................................................... 131 CHAPTER 6. PERIODICALS AND NEWS ON AMITRIPTYLINE ......................................................... 135 Overview.................................................................................................................................... 135 News Services and Press Releases.............................................................................................. 135 Newsletter Articles .................................................................................................................... 137 Academic Periodicals covering Amitriptyline ........................................................................... 139 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................. 141 Overview.................................................................................................................................... 141 U.S. Pharmacopeia..................................................................................................................... 141 Commercial Databases ............................................................................................................... 142 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 147 Overview.................................................................................................................................... 147 NIH Guidelines.......................................................................................................................... 147 NIH Databases........................................................................................................................... 149 Other Commercial Databases..................................................................................................... 151 APPENDIX B. PATIENT RESOURCES ............................................................................................... 153 Overview.................................................................................................................................... 153 Patient Guideline Sources.......................................................................................................... 153 Finding Associations.................................................................................................................. 156 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 159 Overview.................................................................................................................................... 159 Preparation................................................................................................................................. 159 Finding a Local Medical Library................................................................................................ 159 Medical Libraries in the U.S. and Canada ................................................................................. 159 ONLINE GLOSSARIES................................................................................................................ 165 Online Dictionary Directories ................................................................................................... 167
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AMITRIPTYLINE DICTIONARY .............................................................................................. 169 INDEX .............................................................................................................................................. 237
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with amitriptyline is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about amitriptyline, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to amitriptyline, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on amitriptyline. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to amitriptyline, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on amitriptyline. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON AMITRIPTYLINE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on amitriptyline.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and amitriptyline, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “amitriptyline” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Effective Prophylactic Therapy for Cyclic Vomiting Syndrome in Children Using Amitriptyline or Cyproheptadine Source: Pediatrics. 100(6): 977-981. December 1997. Contact: Available from American Academy of Pediatrics. P.O. Box 927, Elk Grove Village, IL 60009-0927. Summary: This article reports on a study in which the authors evaluate their experiences using the antimigraine prophylactic drugs, amitriptyline and cyproheptadine, for the prophylactic management of cyclic vomiting syndrome (CVS) in children. Twenty-seven patients (16 males) ranging in age from 2 to 16 years at diagnosis, fulfilling the diagnostic criteria for CVS and treated prophylactically with either amytriptyline (n = 22) or cyproheptadine (n = 6; some patients received both) were identified through
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Amitriptyline
retrospective chart review. Individual patient data were corroborated by the attending physician and interviews with patients and families. Minimum followup time before entry into the study group was 5 months. Patients were stratified according to three treatment outcomes: complete response, no attacks; partial response, 50 percent or greater reduction in frequency of attacks; or no response, less than 50 percent decrease in frequency of attacks. Of the 22 patients treated with amitriptyline, 16 (73 percent) had a complete response, while 4 (18 percent) had a partial response. Of the 6 patients treated with cyproheptadine, 4 (66 percent) had a complete response and 1 (17 percent) had a partial response. Thus, 91 percent of the amitriptyline group and 83 percent of the cyproheptadine groups had at least a partial response to therapy. No patients experienced significant side effects to either medication. The authors conclude that the antimigraine prophylactic drugs, amitriptyline and cyproheptadine, represent effective prophylactic agents for the management of CVS in the vast majority of patients fulfilling the diagnostic criteria for this syndrome. 2 tables. 25 references. (AA-M). •
Treatment of Progressive Supranuclear Palsy With Amitriptyline: Therapeutic and Toxic Effects Source: Journal of the American Geriatrics Society. 44(9): 1072-1074. September 1996. Summary: This journal article describes the treatment of patients with progressive supranuclear palsy (PSP) using amitriptyline. The author presents two case reports of patients with advanced PSP to illustrate the benefits and side effects of PSP treatment. In one case, a 65-year-old man was treated with amitriptyline over an 11-week period. The patient was partially relieved of some severe symptoms at an optimal dose of 40 mg. At this dose, he could feed himself, swallow easily, and get from a wheelchair to the toilet. At a dose of 70 mg, nocturnal confusion and urinary incontinence appeared, but these symptoms resolved when the dose was reduced to 40 mg. The benefits were sustained over the next 14 months. In the second case, a 77-year-old man had substantial relief of some severe symptoms at 10 mg. He became more talkative, was able to walk independently, and started to feed himself. Increasing the dose to 40 mg over the next 4 weeks resulted in severe behavioral disturbances. The patient became irritable and demanding, threw his food, and shouted obscenities. Amitriptyline was discontinued; and these symptoms subsided within a week, but the patient returned to his untreated state. He improved when the drug was resumed at 10 mg. These cases suggest that amitriptyline may be useful and safe for the treatment of PSP if introduced at low doses. 1 table, 11 references.
Federally Funded Research on Amitriptyline The U.S. Government supports a variety of research studies relating to amitriptyline. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions.
2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
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Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to amitriptyline. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore amitriptyline. The following is typical of the type of information found when searching the CRISP database for amitriptyline: •
Project Title: AMITRIPTYLINE AND MEXILITINE FOR PAINFUL NEUROPATHY IN HIV INFECTION Principal Investigator & Institution: Kieburtz, Karl D.; Professor; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: This Project will evaluate the effectiveness of amitriptyline and mexilitene in relieving pain symptoms in patients with HIV-related painful neuropathy. The study is a three arm parallel group, placebo controlled clinical trial, with subjects randomly assigned to receive on of three treatments: amitriptyline, mexilitene or placebo. The does will be titrated upward during the initial 4 weeks of the trial, then maintained for the second four weeks of study. Benztropine will be used as an "active placebo". Response parameters will include a standardized neurological exam, a global assessment of pain response, and the requirement for additional analgesic agents. Serum levels of study drugs will be determined. It is calculated that 80 patients per arm (240 subjects total) will be required. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: AMITRYPTILINE VS MORPHINE IN THERAPY OF NEURALGIA Principal Investigator & Institution: Campbell, James N.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: The purpose of this research is to determine the effectiveness of two medications, tricyclic antidepressants (TCA) and opioids, compared to a placebo in the treatment of Post-Herpetic Neuralgia. The specific aims are to compare the effects of opioids and TCA against placebo on pain, altered skin sensitivity, and affective and cognitive function. In addition, the study will determine if the therapy with opioids or TCA affects cognitive function that may limit their usefulness in the treatment of PHN. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANALGESIA & RESPIRATION IN MONKEYS Principal Investigator & Institution: Ko, Mei-Chuan Holden.; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2001; Project Start 20-JUN-1975; Project End 30-JUN-2006 Summary: (provided by applicant) Both warm water tail-withdrawal and respiratory assays have been used to characterize the behavioral effects of various opioid compounds in monkeys. In particular, both assays serve as valid in vivo endpoints for studying the efficacy and selectivity of opioid agonists and the characteristics of opioid antagonists. We have further established an experimental model of inflammatory pain as well as intrathecal and intracisternal injection techniques in monkeys. The proposed
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Amitriptyline
research will provide a valuable opportunity to enhance the pharmacological study of pain and opioids in non-human primates. Although there are many interesting findings from rodent studies, it is not clear to what extent they can be replicated and applied to primate species. It is important to conduct monkey studies for characterizing novel, experimental compounds, which have been proposed as better analgesics with less side effects in rodents. This series of proposed studies has several aims including studying different aspects of nociceptive mechanisms, evaluating distinct or newly developed opioid agonists and antagonists, and evaluating the roles of other receptor populations in nociceptive transmission. These studies will also clarify the site(s) of action of novel analgesics, comparing the antinociceptive efficacy of exogenous and endogenous opioid ligands; they will study the non-opioid influence of certain important pain-related substances (e.g. serotonin) for their influence on opioid actions in primates. They will provide a better understanding of opioid pharmacology in general and make a substantial contribution to pain research in primates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHRONIC PROSTATITIS COLLABORATIVE RESEARCH NETWORK CPCRN Principal Investigator & Institution: Nickel, J Curtis.; Queen's University at Kingston Kingston K7l 3N6, Canada Kingston, Timing: Fiscal Year 2003; Project Start 05-SEP-2003; Project End 28-FEB-2008 Summary: (provided by applicant): The RFA specifically requests that the applicants confirm their interest and ability to take part in clinical treatment trials in chronic pelvic pain syndrome (CPPS) in men. The Queen's University Prostatitis Research Group was established under the directorship of Dr. J. Curtis Nickel in Kingston, Canada approximately 10 years ago. In the last 8 years, Dr. J.C. Nickel has been the principal investigator (or in 2 cases principal co-investigator) of 16 clinical trials enrolling 935 patients designed to evaluate 13 treatment modalities. The Queen's University site has enrolled 357 patients, specifically in clinical treatment trials (this does not include the hundreds of patients recruited for etiology and diagnostic studies during the same time period). As part of the first NIH CPCRN, the Queen's University site exceeded its enrollment quota for all studies including RCT#1. The prostatitis research group is closely affiliated with the Queen's University Interstitial Cystitis Research Group (PI Dr. J.C. Nickel) which is collaborating in the NIH ICCTG RCT#1. The IC research center is also meeting its recruitment quota in RCT#1. This application describes our aim to participate in the proposed NIH CPCRN as well as the proposed urological chronic pelvic pain syndromes collaborative group (UCPPSCG). Our group is proposing a clinically relevant definition of the urologic chronic pelvic pain syndromes encompassing both male CPPS and IC. This definition, based on chronic genito-urinary pain/discomfort with subcategories for urinary frequency/urgency and no urinary frequency/urgency will, if adopted by the UCPPSCG, facilitate decisions on treatments to be evaluated and increase the accrual rate of study participants in both CPPS and IC. We develop a rationale, hypothesis, objectives necessary to propose a 16 week randomized placebo controlled clinical trial (employing 2X2 factorial design) to evaluate the efficacy and safety of amitriptyline and gabapentin for the amelioration of symptoms in men with a clinical diagnosis of CPPS. The Queen's University site with Dr. Nickel as PI has the experience, expertise and the proven ability to design, implement and enroll patients with CPPS in clinical studies and will be a valuable partner in the proposed CPCRN and UCPPSCG. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COCAINE MECHANISMS
&
MATERNAL
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AGGRESSION--OXYTOCINERGIC
Principal Investigator & Institution: Johns, Josephine M.; Associate Professor; Psychiatry; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2006 Summary: (applicant's abstract): Cocaine abuse by human mothers is correlated with a high incidence of child neglect and abuse. Gestational cocaine (COC) treatment has been shown to increase aggression towards an intruder (maternal aggression) and reduce the levels of oxytocin (OXY) in the amygdala of rats on postpartum days (PPD) 6-10. Blocking OXY receptors in the central amygdala results in an increase in aggression parallel to that seen following COC treatment. COC likely decreases OXY in the amygdala and increases maternal aggression through its reuptake inhibition of dopamine (DA), serotonin (5-HT) and norepinephrine (NE). These studies are designed to elucidate the specific mechanisms through which COC may work to alter OXY and maternal aggression in rats. Specific Aim 1 will determine if gestational treatment with a combination treatment of selective DA and 5-HT uptake inhibitor will increase maternal aggression as does COC. To test this hypothesis, groups of rat dams will be treated gestationally (days 1-20) with COC, control vehicle buffer (VCB), selective DA, 5-HT, or NE reuptake inhibitors or combinations of selective inhibitors. Dams will be tested for maternal aggression on PPD 6. Specific Aim 2 will determine if gestational treatment with a combination of a selective DA and 5-HT uptake inhibitor will alter OXY dynamics as does COC. To test this hypothesis, groups of rat dams will be treated gestationally (days 1-20) with vehicle buffer (VCB), COC, selective DA, 5-HT, or NE reuptake inhibitors or combinations of the selective inhibitors and sacrificed on PPD 6. OXY levels and receptor binding will be measured by radioimmunoassay, in situ hybridization and autoradiography in the amygdala, medial preoptic area and paraventricular nucleus of the hypothalamus, all of which have been implicated in OXY regulation of maternal aggression. Specific Aim 3 will determine if gestational COC treatment reduces OXY synthesis in the medial preoptic area and paraventricular nucleus and oxytocin receptor (OTR) synthesis in the amygdala, medial preoptic area and paraventricular nucleus. To test this hypothesis, rat dams will be treated gestationally with VCB or COC, and these brain regions removed for in situ hybridization and autoradiography for assessment of OXY and OTR messenger ribonucleic acid on PPD 6. Specific Aim 4 will determine if prenatal exposure to COC and being raised by a COC treated mother as compared to being raised by mothers treated with control vehicle increases maternal aggression displayed by female offspring and decreases OXY in the amygdala of the offspring as adults. To test this hypothesis, female offspring of dams gestationally treated with COC or control vehicle buffer (2 groups, buffer with no pair feeding and buffer with pair feeding), will be raised by their natural dams or foster dams that are vehicle-treated (pair-fed and non-pair-fed) or COC and then bred and tested for maternal aggression in the presence of their own litters on PPD 6. OXY levels in the amygdala will be assessed following the behavioral testing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMBINING N-OF-1 TRIALS TO ASSESS FIBROMYALGIA THERAPIES Principal Investigator & Institution: Zucker, Deborah R.; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001; Project Start 09-SEP-1999; Project End 31-DEC-2003
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Amitriptyline
Summary: Fibromyalgia (FM) is a very common rheumatologic condition yet providing an effective treatment for an individual patient remains a challenge. To improve clinical treatment, better understanding of the effectiveness of new drug regimens and the factors effecting patients' responses to these treatments is needed. Anti-depressant medications have been used to treat patients with FM. However, most studies have reported that only about one third of patients show significant improvement with these treatments. A recent study reported that a combination therapy of amitriptyline and fluoxetine (AM + FL) resulted in significantly greater improvement in patients' symptoms as compared with either drug alone. As part of medical practice, physicians and patients often try new, potentially beneficial therapies to assess their effectiveness for the individual. If these studies could be carried out in a scientifically rigorous manner, the collective information could contribute greatly to our understanding of patients' responses to medical treatments. We have developed a method for effectiveness research which uses patient-focused N- of-1 trials and then combines these trials' results to obtain population estimates of treatment effectiveness and to aid in treatment decision-making for an individual patient. This proposal aims to prospectively apply this methodology to compare the effectiveness of the combination therapy AM + FL versus AM alone in the treatment of patients with FM. We propose to carry out N-of-1 trials to compare the effectiveness of AM vs. AM + FL for patients with FM using individual patient (N-of-1) trials. We will analyze the resulting data using the combined N-of-1 methodology to assess overall treatment effectiveness and compare this to results from a prior standard center-based trial. We propose to extend the use of N-of-1 trials into community practices to enable comparison of center-based and practice-based results. Through this broader patient inclusion we will attempt to identify potential patient characteristics which may affect treatment response variation. The results and feedback from both patients and physicians participating in this study will help to develop a framework that will allow transportability of this approach to effectiveness research to the study of other diagnoses and treatments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEVELOPMENT ANESTHETICS
OF
SENSORY/PAIN-SELECTIVE
LOCAL
Principal Investigator & Institution: Gerner, Peter; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant) The candidate is an Instructor in Anesthesiology at Brigham and Women's Hospital, Boston, MA. He will use the next 5 years to acquire basic molecular biology and electrophysiology skills to achieve his long-term goal of developing clinically useful pharmacological agents for the safe and specific treatment of pain. Local anesthetics (LAs) are used routinely for surgical anesthesia and for management of acute and chronic pain from all causes. In addition to blocking voltagegated Na+ channels in sensory nerves fibers, LAs also block Na+ channels in motor and sympathetic fibers, as well as in brain and heart. Therefore, complete pain relief often cannot be accomplished, or serious adverse effects occur, e.g., cardiac arrest, seizures, low blood pressure, and motor blockade causing immobility. The specific aims of this proposal are (1) To identify novel drugs with LA properties in vivo and in vitro. (2) To examine these drugs for pain-selective properties. (3) To define their affinities to both the activated and inactivated states of different Na+ channel isoforms and (4) Using site directed mutagenesis, map the LA receptor in sensory neuron-specific Na+ channels to aid in future drug design. Whole-cell voltage-clamp recordings of newly developed
Studies
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quaternary ammonium (QA) derivatives of lidocaine (tonicaine) and amitriptyline (e.g., N-methyl amitriptyline) defined a high level of additional block (use-dependent block) when neuronal cells were stimulated at a high frequency. These QA drugs will be used to study the hypothesis that they selectively treat conditions caused by high-frequency discharge, e.g., acute postoperative and neuropathic pain. To further improve design of new drugs, the candidate will use drugs with good clinical properties (best efficacy and the fewest side effects in treating postoperative and neuropathic pain in animal surgical models) to define their binding sites in sensory neuron-specific Na+ channels transiently expressed in mammalian cells. It is hypothesized that this binding site is in areas responsible for use-dependent blockade, as there is no difference of the intrinsic affinity among different Na+ channel isoforms. With the use of site-directed mutagenesis, detailed structural information about the LA binding site in sensory-specific Na+ channels will be obtained by studying the effects of specific amino acid mutations on LA action and will help to direct and further refine drug design efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: G PROTEIN COUPLING IN ANTIDEPRESSANT DRUG ACTION Principal Investigator & Institution: Rasenick, Mark M.; Professor; Physiology and Biophysics; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2002 Summary: DISCRIPTION:(from applicant's abstract) While the molecular locus of antidepressant and anti-bipolar drug action has not yet been established, it has become increasingly likely that the targets of such drugs lie distal to neuro- transmitter receptors. These targets may involve G protein-mediated signal transduction systems such as adenylyl cyclase and phospholipase C. For this study, both rats and cultured cells will be treated chronically with a varity of antidepressants (amitriptyline, iprindole, fluoxetine, phenylzine and chlorpromazine as a control). Previous studies showed an increased association between a G protein (Gs) and adenylyl cyclase. Cultured Cg glioma cells treated with antidepressant drugs also showed increased coupling between Gs and adenylyl cyclase. This allowed the conclustion that the "presynaptic" component is not required for antidepressant effects. These studies also showed a dissociation between receptor desensitization and increased Gs/adenylyl cyclase coupling. Although increased Gs-adenylyl cyclase coupling consistently results from antidepressant treatment, neither Gs nor adenylyl cyclase appears to be the actual target for antidepressant action. It is hypothesized that the effect of antidepressant treatment on increasing the coupling between Gs and adenylyl cyclase may be due to a perturbation of the membrane which alters the relationship between GTs and the cytoskeleton (specifically tubulin). This will be investigated by subjecting the membrane to differential extraction with detergents as well as to an electron microscopic examination of the effect of antidepressant treatment on the synaptic distribution of Gs and tubulin as well as their co-localization. Functional G protein will be compared to the absolute content with the photoaffinity GTP analog, azidoanilido GTP (AAGTP). Subtype specificity of adenylyl cyclase relative to antidepressant treatment will also be examined in transfected cells. A "dominant negative" chimera of Gi alpha and tranducin, which blocks normal tubulin-Gs interaction has been developed. Expression of this construct, concommitant with antidepressant treatment will help to verify the importance of tubulin-Gs interaction for the observed antidepressant response. It is hoped that successful completion of these studies will allow a greater realization of how a number of diverse drugs all exert antidepressant effects. Such knowledge should assist in the
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design of more efficient antidepressant drug therapy and may lead to a true understanding of the molecular basis of mood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERACTION AMITRIPTYLINE WITH KETOCONAZOLE AND QUINIDINE Principal Investigator & Institution: Greenblatt, David J.; Professor and Chair; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2001 Summary: In vitro studies demonstrate that N-demethylation of amitriptyline to nortriptyline is mediated mainly by cytochrome P450-3A4, while hydroxylation of amitriptyline to 10-hydroxy-amitriptyline is mediated in part by P450-2D6. These data predict the possibility of impaired clearance of amitriptyline in vivo by coadministration of ketoconazole or quinidine, highly active and relatively specific competitive inhibitors of 3A4 and 2D6, respectively. This hypothesis will be tested in two prospective double-blind controlled kinetic-dynamic studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ISOTOPE DILUTION GAS CHROMAT MASS SPECT MEASURE OF TRICYCLIC ANTIDEPRESSANT Principal Investigator & Institution: Way, Barbara; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001 Summary: Stable isotope dilution gas chromatographic-mass spectrometric (GC-MS) measurement of tricyclic antidepressants (TCA) is a useful alternative to high performance liquid chromatographic (HPLC) methods when interfering substances prevent accurate quantitation by HPLC. For satisfactory GC-MS analysis, secondary amine TCA must be derivatized. Commonly employed trifluoroacetyl and heptafluorobutyryl derivatives are relatively unstable and cause rapid deterioration of capillary gas chromatography (GC) columns. We have therefore examined 4carbethoxyhexafluorobutyryl chloride (CHFB-Cl) as an alternate derivatizing agent and have developed a stable isotope dilution GC-MS method employing ring-labeled [2H4]desipramine and [2H4]-imipramine internal standards which permits measurement of desipramine, nortriptyline, imipramine, and amitriptyline in plasma samples containing one or all of these analytes. The GC-MS assay is linear for each analyte from the lower limit of quantit ation (25 ng/mL) up to 1500 ng/mL and correlates well with HPLC measurements. The GC-MS analytic coefficient of variation was 9.7 1 1.3% for all analytes considered together. Although interferences are observed in the HPLC assay, thioridazine, perphenazine, cyclobenzaprine, or norcyclobenzaprine do not interfere with GC-MS measurements of the TCA examined here. The stability of the CHFB derivative of secondary amine TCA was found to be superior to that of the trifluoroacetyl derivatives of these compounds. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MANAGEMENT OF CHRONIC PAIN IN PTS W/ SPINAL CORD INJURY Principal Investigator & Institution: Cardenas, Diana C.; University of Washington Seattle, Wa 98195
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Timing: Fiscal Year 2001 Summary: In this prospective, double-blind, randomized controlled clinical trial we will evaluate, as compared to placebo, the effectiveness of amitriptyline in relieving chronic pain associated with spinal cord injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MARYLAND INTERSTITIAL CYSTITIS CLINICAL TRIALS GROUP Principal Investigator & Institution: Warren, John W.; Professor; Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 10-MAY-1998; Project End 28-FEB-2003 Summary: (Abstract of the application) Interstitial cystitis (IC) is a chronic disease characterized by pain, urgency and frequency and by bladder findings of ulcers, glomerulations, and diminishe capacity. The etiology(ies) is unknown and numerous treatments have been examined but only a few in well-designed trials. Patients would benefit from scrutiny of existing and novel treatments, the mission of the IC Clinical Trials Group (IC CTG). Critical to the IC CTG is our ability to recruit IC patients for well designed clinical trials. Over the last 7 years, our work with IC patients has been to explore the pathogenesis of IC. We have discovered a urine peptide, which inhibits the growth of human bladder epithelial cells in vitro in 85% of IC patients vs. 500 IC patients for these studies. The Baltimore-Washington area comprises more than 6,000,000 people. This includes many IC patients and we will energetically work with the ICA and our network o urologists/ gynecologists to recruit large numbers of patients during our clinical trials. By a dedicated and patient centered clinical research enterprise, we will be jealous (sic) of each participant's continuation in our studies. To respond to this clinical opportunity, we have developed a multi-disciplinary team comprising veteran IC investigators, urologists, and urogynecologists, skilled in bladder diseases and pain syndromes. This team ha experience in complex projects, randomized placebo-controlled double-masked trials, large data sets, and collaborative ventures. This group will bring to the IC CTG experienced, motivated, and dedicated investigators; a new cadre of IC patients; and a network of referring urologists/gynecologists to study management strategies for this distressing disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: METHOD FOR THE ANALYSIS OF PAIN CLINICAL TRIALS Principal Investigator & Institution: Farrar, John T.; Senior Scholar; Neurology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 29-SEP-2003 Summary: The application proposes to: 1) develop a computer simulation of idealized drug dose (input) data and patient response measures (output); the doses are of opiate analgesic and/or tricyclic adjunctive drugs; the output is to be assessed by questionnaire instruments, soon to be tested; 2) analyze the results of an ongoing trail, comparing amitriptyline and desipramine adjunctive analgesia in cancer pain patients treated with opiates; and 3) conduct a prospective, blinded, randomized study of veniafaxine versus placebo adjunctive treatment (to opiate analgesia) in cancer pain patients; the opioid treatment regiment will first have been stabilized for each patient. The veniafaxine (or placebo, benztropine) dose will be titrated upward, over time, unless limited by side effects. Patients will be followed for ten weeks, their condition being scored at either daily, weekly or bi-weekly intervals by the defined questionnaire battery. Over this time period, not only will adjunct does be varied upward or
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downward, depending on the complaint of side effect, whereas the opiod dose will be varied in response to pain complaint. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROLOGIC AIDS RESEARCH CONSORTIUM Principal Investigator & Institution: Clifford, David B.; Professor and Head; Neurology; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001; Project Start 01-DEC-1993; Project End 31-JUL-2003 Summary: We will establish the "Neurologic AIDS Research Consortium" (NARC) which will be a major contributor to neurologic projects in the AIDS Clinical Trial Group (ACTG). NARC will be dedicated to clinical investigation of human immunodeficiency virus (HIV) associated neurologic disease. The consortium initially will consist of sixteen units, established at ACTG sites combining neurologic leadership in the area of clinical AIDS research, access to subjects with HIV-related neurologic disease, and leadership within the local AIDS Clinical Trial Unit supportive of neurologic projects. This grant will supplement the resources of the ACTG system to achieve maximal productivity in the area of neurologic investigation. We will provide a network of support by supplying a base grant to establish coordination of the local neurologic effort and effective communication s and travel funds to effect a collaborative relationship in this group. The base grant will be supplemented on a per capita funding basis for successful study of subjects in clinical trials. The per capita funding will supplemental local ACTU support for extraordinary costs of neurologic studies and for professional time required to manage the study. We will coordinate our efforts through the leadership of NARC which will be located at Washington University in St. Louis. Statistical and data analysis for our studies will be carried out through the ACTG system, with supplemental support to the Harvard School of Public Health through this grant. The initial projects to be undertaken in the grant include: (1) Completion of the Phase I/II study of nimodipine as an adjunction to antiretroviral therapy in the treatment of HIV motor/cognitive disorder, (2) A study of the natural history of neurologic disease in advanced HIV patients identified by CD4 counts ,<50, with particular emphasis on neuropsychometric performance as a measure of disease progression, (3) A double-blind controlled study of amitriptyline and mexiletine in the treatment of HIV associated painful peripheral neuropathy, (4) A controlled clinical trial testing the efficacy of cytosine arabinoside for treatment of progressive multifocal leukoencephalopathy, and (5) a trial of combination chemotherapy and radiation therapy for treatment of HIV associated primary central nervous system lymphoma. It is anticipated that these studies will be followed by subsequent studies to further develop therapy related to these problems. The group also anticipates participation cytomegalovirus induced neurologic disease. Plans for future study and use of resources will be guided by the ACTG Neurology Scientific Committee with review by appropriate ACTG Scientific Committees and by the ACTG Executive Committee. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Bartlett, John G.; Chief, Division of Infectious Diseases; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Delapanha, Robert; Howard University 2400 6Th St Nw Washington, Dc 20059 Timing: Fiscal Year 2001 Summary: SUBPROJECT ABSTRACT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Marigan, Thomas G.; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003 Summary: SUBPROJECT NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEUROLOGY AGENDA Principal Investigator & Institution: Krown, Susan E.; Professor; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2001 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OPIOID RESPONSIVITY/ ANALGESIC TOLERANCE IN CHRONIC PAIN Principal Investigator & Institution: Rowbotham, Michael C.; Associate Professor; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2002 Summary: (Applicant?s abstract): 1. We will test the hypothesis that underlying pain mechanism is a determinant of opioid sensitivity by simultaneously measuring in both neuropathic and non-neuropathic chronic pain patients the response of experimentally induced pain and ongoing clinical pain to I.V. remifentanyl infusion. For experimental pain, we will use a model which combine non-injurious heating and topical capsaicin to produce stable areas of cutaneous secondary hyperalgesia. In health volunteers, this model is opioid responsive. Study 1 is a two session, placebo-controlled study of the effect on experimental and clinical pain of brief infusions of the high efficacy, ultra-short acting opioid remifentanyl in 60 non-opioid using chronic pain patients. 2. In study 2 we will determine whether a prolonged I.V. remifentanyl infusion in opioid-naïve volunteers will produce acute analgesic tolerance to both noxious thermal stimulation and experimentally induced cutaneous secondary hyperalgesia. We will then test patients with ongoing chronic pain. Demonstrating the simultaneous development of acute analgesic tolerance to experimental pain and chronic pain would indicate that analgesic tolerance is possible during long term opioid therapy. If acute tolerance develops, physical dependence in the form of withdrawal symptoms, hyperalgesia to noxious stimuli, and a rebound increase in pain over pretreatment levels may follow the remifentanyl infusion. 3. Analgesic tolerance has been shown to develop during long term opioid therapy of chronic non-malignant pain. In Study 3, non-opioid using chronic pain patients will undergo a placebo-controlled study of the analgesic effect of I.V. remifentanyl on acute experimental and chronic pain before and following a 9 week,
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randomized parallel design, double-blind trial. Forty subjects will receive the opioid hydromorphone and a control group of 20 will receive the tricyclic antidepressant amitriptyline. At the end of the initial 3 week titration period and again after 6 weeks of fixed dosing, the I.V. remifentanyl infusion will be repeated to reconstruct the doseresponse curve for experimental and chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POST HERPETIC NEURALGIA/AMITRYPTILINE VS MORPHINE IN PATIENT MANAGEMENT Principal Investigator & Institution: Raja, Srinivasa N.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001 Summary: The purpose of this research is to determine the effectiveness of two medications, tricyclic antitidepressants (TCA) and opioids, compared to a placebo in the treatment of postherpetic neuralgia. The specific aims are to compare the effects of opioids and TCA against placebo on pain, altered skin sensitivity, and affective and cognitive function. In addition, the study will determine if the presence of psychiatric co- morbidity, particularly depression, predicts the outcome of treatment with opioids, TCA, and placebo. We have studied the relationships between ongoing pain, alterations in thermal sensibility, and allodynia to mechanical and thermal stimuli of patients with, PHN to determine the role of peripheral and/or central mechanisms, in PHN. Ongoing pain ratings were obtained using a verbal score (0-10). Sensory tests were performed within the affected site, and the corresponding, contralateral, normal site. The area of mechanical allodynia was mapped with a cotton swab and pain, evoked by mechanical stimuli (soft hair brush, brass probe, von Frey hairs) was rated on a verbal scale of 1-10. Thermal thresholds to warm, cold, heat pain, and cold pain were determined using a Peltier device and a modified Marstock technique. To date, fifty-nine patients (33 F, 26 M) with PHN of 3-216 months duration (median = 19 months) have been studied. The average rating of ongoing pain was 7.3 + 2 (M + SD). The majority of patients (80%) had allodynia to dynamic (hair brush), static (brass probe) or punctate (von Frey) mechanical stimuli (Z > 5.01, p<.0001). No significant correlation was observed between the intensity of ongoing pain and mechanical allodynia. As a group, the patients demonstrated hypoesthesia to cold and warm detection, and hypoalgesia to heat pain and cold pain. There were no significant correlations between ongoing pain intensity and the degree of sensory alterations (between the unaffected and affected sites) in warm, cold, heat pain, and cold pain detection thresholds. Hence, the role of primary afferent input in tlie mechanism of PHN is uncertain. The presence of allodynia/hyperalgesia to mechanical stimuli, but the relative absence of hyperalgesia to thermal stimuli in most patients in this group suggests that central sensitization in PHN is not generalized for all modalities of sensation. It has been observed that patients with chronic pain have high rates of psychiatric conditions. Controversy has existed as to whether these conditions are uniquely related to chronic pain or simply the result of ongoing suffering from a chronic physical symptom. Patients completed a structured interview (DIS-III-A) for Major Depression, Dysthymic Disorder, Generalized Anxiety Disorder and Somatization Disorder and completed the Somatization and Anxiety subscales of the SCL-90-R. Our results in PHN patients are consistent with the existing literature. PHN patients compared to patients with chronic and distressing but nonpain physical symptoms also reported higher numbers of depression symptoms as well as other medically unexplained physical symptoms. These findings suggest that
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depression and higher levels of somatic focus are more than secondary complications of experiencing chronic symptoms and are uniquely related to chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SHAM DEVICE, PILL PLACEBO OR TREATMENT FOR ARM PAIN Principal Investigator & Institution: Kaptchuk, Ted J.; Director of Complementary Specialties; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 30-JUN-2003 Summary: (adapted from investigator's abstract): This application is based on observations that the magnitude of the placebo effect produced by a device is greater than that produced by a pill. If this is generally true, there are significant implications for the design of clinical trials involving medical devices and for our understanding of the role of the placebo effect in randomized controlled trials (RCT). This is a two phase study. In the first phase, the investigators will estimate the relative magnitudes of placebo effects associated with a sham acupuncture procedure versus an inactive oral treatment in patients with persistent upper extremity pain secondary to repetitive strain injury (RSI) most notably, carpal tunnel syndrome (CTS). In the second phase, parallel RCTs of traditional Chinese acupuncture (TCA) and low-dose amitriptyline (AMI) versus their respective placebo treatments will be conducted. In Phase I, 240 patients with RSI will be randomly assigned to receive a placebo device (a recently validated sham acupuncture device) or a placebo pill (dummy AMI). The primary hypothesis in Phase I is that patients will respond better to the sham device than the placebo pill. Phase II will see patients in each arm of Phase I randomly assigned to active or inactive treatment. Patients from the sham acupuncture arm of Phase I will receive either TCA or continue to receive the sham version. Patients in the placebo pill arm of Phase I will receive either AMI or continue receiving the placebo pill. Outcomes in these studies will include assessments of the nature and severity of upper extremity pain, function, grip and pinch strength, and mood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THERAPEUTIC NA+ CHANNEL BLOCKERS: RECEPTOR & DRUG DESIGN Principal Investigator & Institution: Wang, Ging K.; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-AUG-1992; Project End 31-JUL-2004 Summary: The long term objective of this renewal application is to develop therapeutic Na+ channel blockers pertinent to pain management. Traditional local anesthetics are often unsuited for treatment of chronic or intractable cancer pain because of their insufficient duration of nerve block. There are 4 specific aims: 1. To study the structureactivity relationship of various potent Na+ channel blockers in vitro; 2. To design and synthesize their amphipathic derivatives; 3. To test selected blockers suitable for prolonged nerve block in vivo; and 4. To map their receptor site within the Na+ channel alpha subunit. The first agent to be tested is the tricyclic antidepressant amitryptyline, which is a potent sodium channel blocking agent in addition to its actions at other receptors. With bupivacaine as a standard for comparison, the binding affinities of various tricyclics and other potent sodium channel blockers will be determined in voltage clamp studies on HEK cells transiently transfected with rat skeletal muscle and human heart sodium channel clones; native neuronal sodium channels in rat pituitary GH3 cells will also be used. Elements to be characterized include use-dependence of
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block and IC50 for resting and inactivated channel block. The working hypothesis for this phase of the studies is that duration of block in vivo will correlate positively with use dependence and negatively with IC50 for inactivated channel states. The in vivo studies will employ behavioral endpoints to examine both sensory and motor nerve block of sciatic nerve following a single injection of each agent in rats; drugs effective in rats will also be tested in the cauda equina space in sheep to model spinal routes of therapy. Drug design and synthesis will initially employ amitryptiline derivatives. Studies of the receptor site in the sodium channel will probe for the locations of two hydrophobic domains using point mutations and studies of drug potency on the mutated channels in HEK cells, with a special emphasis on residues which may be responsible for high-affinity binding of the tricyclic ring. Eventually the studies will be extended to other classes of drugs including phenylacetamides, calcium channel blockers, and a potassium channel blocker that also potently blocks sodium channels. Like tricyclic antidepressants, these agents have multiple phenyl rings but they are separated into two large hydrophobic domains rather than one. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VULVODYNIA INTERVENTIONS
PREVALENCE
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Principal Investigator & Institution: Bachmann, Gloria A.; Ob, Gyn and Reproductive Scis; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2001; Project Start 29-SEP-2000; Project End 31-AUG-2005 Summary: Vulvodynia is a complex, multi-factorial chronic pain syndrome which is associated with significant distress and interpersonal. Vulvar vestibulitis and dyspareunia are two common, although not well-understood clinical components or sub-types of vulvodynia. Chronic vulvar pain is experienced by, according to recent surveys, about 10-15% of the female population between 18 and 80. Pathophysiologic findings have not been convincing for the role of any specific antibody or etiological mechanism, although several have been proposed including aberrant somatosensory processing in the peripheral or central inflammatory process. The epidemiology and predictors of vulvodynia have similarly not been well- articulated in the literature. One study suggested that the disorder may be largely limited to white, middle-aged women, although sampling and data gathering limitations cloud the assessment of these findings. Thirdly, many centers have begun emphasizing surgical treatments for vulvar vestibulitis, although these approach is rejected by about 1/3 of women at the outset. The vestibulectomy procedure also leads to definite worsening of the condition in about 10% of cases. This grant will propose to examine efficacy, outcomes and costeffectiveness associated with four non-surgical interventions for vulvodynia. In general, the women's Health Research Section of RWJMS is committed to offering minimallyinvasive services and treatments to a broad diversity of women in the central northeast region. Our previous experience and that of our Co-PI's make our site uniquely wellprepared to offer a broad range of dissemination and educational experiences, both locally and nationally, in the final years of the grant cycle. We plan to arrange and host an international consensus conference (something we have done twice recently in other areas of relevance), and to disseminate findings obtained from this and similar conferences broadly. We will also disseminate any questionnaires and treatment manuals developed in the context of this grant via website or other appropriate electronic or non-electronic form. We will develop patient education and public information materials, which will also be distributed in the most accessible and least
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costly form. Our ultimate goal is to share findings from this and related research with the broadest cross-spectrum of women that we can. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with amitriptyline, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “amitriptyline” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for amitriptyline (hyperlinks lead to article summaries): •
A comparison of characteristics of depressed patients and efficacy of sertraline and amitriptyline between Japan and the West. Author(s): Ohishi M, Kamijima K. Source: Journal of Affective Disorders. 2002 July; 70(2): 165-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12117628&dopt=Abstract
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A comparison of the antidepressant effects of a synthetic androgen (mesterolone) and amitriptyline in depressed men. Author(s): Vogel W, Klaiber EL, Broverman DM. Source: The Journal of Clinical Psychiatry. 1985 January; 46(1): 6-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3880735&dopt=Abstract
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A comparison of the effect of paroxetine and amitriptyline on the tyramine pressor response test. Author(s): Hassan SM, Wainscott G, Turner P. Source: British Journal of Clinical Pharmacology. 1985 May; 19(5): 705-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3159408&dopt=Abstract
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Author(s): Tsai YC, Chu KS. Source: Anesthesia and Analgesia. 2001 November; 93(5): 1288-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11682416&dopt=Abstract
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A controlled study of a specific MAO A reversible inhibitor (R011-1163) and amitriptyline in depressive illness. Author(s): Norman TR, Ames D, Burrows GD, Davies B. Source: Journal of Affective Disorders. 1985 January-February; 8(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3156909&dopt=Abstract
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A controlled study of amitriptyline in the treatment of chronic pain. Author(s): Pilowsky I, Hallett EC, Bassett DL, Thomas PG, Penhall RK. Source: Pain. 1982 October; 14(2): 169-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6757842&dopt=Abstract
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A controlled trial of amitriptyline and cianopramine in major depression. Author(s): Mellsop GW, Burgess CD, Vijayasenan ME. Source: Clinical Therapeutics. 1985; 7(6): 699-703. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3907842&dopt=Abstract
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A double-blind comparison of clovoxamine and amitriptyline in the treatment of depressed outpatients. Author(s): Gelenberg AJ, Wojcik JD, Newell C, Lamping DL, Spring B. Source: Journal of Clinical Psychopharmacology. 1985 February; 5(1): 30-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3882774&dopt=Abstract
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A double-blind controlled clinical trial of fluoxetine and amitriptyline in the treatment of outpatients with major depressive disorder. Author(s): Chouinard G. Source: The Journal of Clinical Psychiatry. 1985 March; 46(3 Pt 2): 32-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3882679&dopt=Abstract
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A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia. An analysis of outcome measures. Author(s): Heymann RE, Helfenstein M, Feldman D. Source: Clin Exp Rheumatol. 2001 November-December; 19(6): 697-702. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791642&dopt=Abstract
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A pilot study examining topical amitriptyline, ketamine, and a combination of both in the treatment of neuropathic pain. Author(s): Lynch ME, Clark AJ, Sawynok J. Source: The Clinical Journal of Pain. 2003 September-October; 19(5): 323-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12966259&dopt=Abstract
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A placebo-controlled, double-blind trial of amitriptyline in bulimia. Author(s): Mitchell JE, Groat R. Source: Journal of Clinical Psychopharmacology. 1984 August; 4(4): 186-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6381556&dopt=Abstract
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A randomized trial of fluoxetine versus amitriptyline in musculo-skeletal pain. Author(s): Schreiber S, Vinokur S, Shavelzon V, Pick CG, Zahavi E, Shir Y. Source: The Israel Journal of Psychiatry and Related Sciences. 2001; 38(2): 88-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11475920&dopt=Abstract
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Acute eosinophilic pneumonia associated with amitriptyline in a hemodialysis patient. Author(s): Noh H, Lee YK, Kan SW, Choi KH, Ha DS, Lee HY. Source: Yonsei Medical Journal. 2001 June; 42(3): 357-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11456405&dopt=Abstract
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Acute, subchronic and withdrawal sleep EEG changes during treatment with paroxetine and amitriptyline: a double-blind randomized trial in major depression. Author(s): Staner L, Kerkhofs M, Detroux D, Leyman S, Linkowski P, Mendlewicz J. Source: Sleep. 1995 July; 18(6): 470-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7481419&dopt=Abstract
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Adherence to treatment regimen in depressed patients treated with amitriptyline or fluoxetine. Author(s): Demyttenaere K, Mesters P, Boulanger B, Dewe W, Delsemme MH, Gregoire J, Van Ganse E. Source: Journal of Affective Disorders. 2001 August; 65(3): 243-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11511404&dopt=Abstract
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Alprazolam, amitriptyline, doxepin, and placebo in the treatment of depression. Author(s): Rickels K, Feighner JP, Smith WT. Source: Archives of General Psychiatry. 1985 February; 42(2): 134-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2858187&dopt=Abstract
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Altered amitriptyline kinetics in a depressed patient with porto-caval anastomosis. Author(s): Hrdina PD, Lapierre YD, Koranyi EK. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1985 March; 30(2): 111-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3995455&dopt=Abstract
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Amitriptyline and ciguatera. Author(s): Bowman PB. Source: The Medical Journal of Australia. 1984 June 23; 140(13): 802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6727763&dopt=Abstract
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Amitriptyline and contact lenses. Author(s): Troiano G. Source: The Journal of Clinical Psychiatry. 1985 May; 46(5): 199. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3988722&dopt=Abstract
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Amitriptyline and ephedrine in subarachnoid anaesthesia. Author(s): Serle DG. Source: Anaesthesia and Intensive Care. 1985 May; 13(2): 214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4014648&dopt=Abstract
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Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia. Author(s): Graff-Radford SB, Shaw LR, Naliboff BN. Source: The Clinical Journal of Pain. 2000 September; 16(3): 188-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11014390&dopt=Abstract
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Amitriptyline and hydroxylated metabolite plasma levels in depressed outpatients. Author(s): Robinson DS, Cooper TB, Howard D, Corcella J, Albright D. Source: Journal of Clinical Psychopharmacology. 1985 April; 5(2): 83-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3988974&dopt=Abstract
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Amitriptyline and its metabolites: blood and urine levels in overdose. Author(s): Fagarasan M, Fagarasan E, Quai I, Toma T, Florescu A. Source: Acta Med Leg Soc (Liege). 1985; 35(1): 59-63. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2979900&dopt=Abstract
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Amitriptyline and paroxetine: effects upon peripheral nervous system (PNS). Author(s): Henning O, Niedermaier N, Kniest A, Heuser I, Deuschle M. Source: Journal of Clinical Psychopharmacology. 2002 April; 22(2): 229-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11910274&dopt=Abstract
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Amitriptyline and somnambulism. Author(s): Ferrandiz-Santos JA, Mataix-Sanjuan AL. Source: The Annals of Pharmacotherapy. 2000 October; 34(10): 1208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054994&dopt=Abstract
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Amitriptyline as a prophylactic for migraine in children. Author(s): Sorge F, Barone P, Steardo L, Romano MR. Source: Acta Neurol (Napoli). 1982 October; 4(5): 362-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7158453&dopt=Abstract
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Amitriptyline enhances the central component of physiological tremor. Author(s): Raethjen J, Lemke MR, Lindemann M, Wenzelburger R, Krack P, Deuschl G. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2001 January; 70(1): 78-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11118252&dopt=Abstract
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Amitriptyline for agitation in head injury. Author(s): Jackson RD, Corrigan JD, Arnett JA. Source: Archives of Physical Medicine and Rehabilitation. 1985 March; 66(3): 180-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3977574&dopt=Abstract
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Amitriptyline in neuropathic cancer pain in patients on morphine therapy: a randomized placebo-controlled, double-blind crossover study. Author(s): Mercadante S, Arcuri E, Tirelli W, Villari P, Casuccio A. Source: Tumori. 2002 May-June; 88(3): 239-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195763&dopt=Abstract
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Amitriptyline in the prophylaxis of central poststroke pain. Preliminary results of 39 patients in a placebo-controlled, long-term study. Author(s): Lampl C, Yazdi K, Roper C. Source: Stroke; a Journal of Cerebral Circulation. 2002 December; 33(12): 3030-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468808&dopt=Abstract
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Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebocontrolled study. Author(s): Biederman J, Herzog DB, Rivinus TM, Harper GP, Ferber RA, Rosenbaum JF, Harmatz JS, Tondorf R, Orsulak PJ, Schildkraut JJ. Source: Journal of Clinical Psychopharmacology. 1985 February; 5(1): 10-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3973067&dopt=Abstract
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Amitriptyline overdose. Author(s): Cohnberg RE, Macy-Mills P, Johnson E, Stoner DD. Source: Kans Med. 1985 February; 86(2): 50-1, 62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3981852&dopt=Abstract
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Amitriptyline overdose: clinical effects on tricyclic antidepressant plasma levels. Author(s): Rudorfer MV, Robins E. Source: The Journal of Clinical Psychiatry. 1982 November; 43(11): 457-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7174623&dopt=Abstract
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Amitriptyline plus fluphenazine to prevent chemotherapy-induced emesis in cancer patients: a double-blind randomized cross-over study. Author(s): Mellink WA, Blijham GH, van Deyk WA. Source: Eur J Cancer Clin Oncol. 1984 September; 20(9): 1147-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6383839&dopt=Abstract
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Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache. Author(s): Bendtsen L, Jensen R. Source: Cephalalgia : an International Journal of Headache. 2000 July; 20(6): 603-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11075846&dopt=Abstract
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Amitriptyline treatment in chronic drug-induced headache: a double-blind comparative pilot study. Author(s): Descombes S, Brefel-Courbon C, Thalamas C, Albucher JF, Rascol O, Montastruc JL, Senard JM. Source: Headache. 2001 February; 41(2): 178-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11251703&dopt=Abstract
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Amitriptyline treatment of chronic pain in patients with temporomandibular disorders. Author(s): Plesh O, Curtis D, Levine J, McCall WD Jr. Source: Journal of Oral Rehabilitation. 2000 October; 27(10): 834-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11065017&dopt=Abstract
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Amitriptyline v. the rest: still the leading antidepressant after 40 years of randomised controlled trials. Author(s): Barbui C, Hotopf M. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2001 February; 178: 129-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11157426&dopt=Abstract
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Amitriptyline versus amitriptyline combined with fluoxetine in the preventative treatment of transformed migraine: a double-blind study. Author(s): Krymchantowski AV, Silva MT, Barbosa JS, Alves LA. Source: Headache. 2002 June; 42(6): 510-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167139&dopt=Abstract
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Amitriptyline versus other types of pharmacotherapy for depression. Author(s): Guaiana G, Barbui C, Hotopf M. Source: Cochrane Database Syst Rev. 2003; (2): Cd004186. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804503&dopt=Abstract
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Amitriptyline: still efficacious, but at what cost? Author(s): Thompson C. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2001 February; 178: 99-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11157421&dopt=Abstract
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Amitriptyline-perphenazine and doxepin in depressed outpatients: a controlled double-blind study. Author(s): Rickels K, Csanalosi I, Werblowsky J, Weise CC, Weinstock R, Brown AS, Winokur A, Von Poelnitz M. Source: The Journal of Clinical Psychiatry. 1982 October; 43(10): 419-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6749826&dopt=Abstract
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Amitriptyline-related peripheral neuropathy relieved during pyridoxine hydrochloride administration. Author(s): Meadows GG, Huff MR, Fredericks S. Source: Drug Intell Clin Pharm. 1982 November; 16(11): 876-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6293793&dopt=Abstract
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An evaluation of possible interactions between ethanol and trazodone or amitriptyline. Author(s): Warrington SJ, Ankier SI, Turner P. Source: British Journal of Clinical Pharmacology. 1984 October; 18(4): 549-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6487494&dopt=Abstract
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Anticholinergic activity in the serum of patients receiving maintenance amitriptyline or doxepin therapy. Author(s): Aaltonen L, Syvalahti E, Iisalo E, Peltomaki T. Source: Acta Pharmacol Toxicol (Copenh). 1985 January; 56(1): 75-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3976405&dopt=Abstract
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Antidepressive treatment with amitriptyline and paroxetine: comparable effects on heart rate variability. Author(s): Lederbogen F, Gernoth C, Weber B, Colla M, Kniest A, Heuser I, Deuschle M. Source: Journal of Clinical Psychopharmacology. 2001 April; 21(2): 238-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11270923&dopt=Abstract
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Antidepressive treatment with amitriptyline and paroxetine: effects on saliva cortisol concentrations. Author(s): Deuschle M, Hamann B, Meichel C, Krumm B, Lederbogen F, Kniest A, Colla M, Heuser I. Source: Journal of Clinical Psychopharmacology. 2003 April; 23(2): 201-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640223&dopt=Abstract
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Application of the relative activity factor approach in scaling from heterologously expressed cytochromes p450 to human liver microsomes: studies on amitriptyline as a model substrate. Author(s): Venkatakrishnan K, von Moltke LL, Greenblatt DJ. Source: The Journal of Pharmacology and Experimental Therapeutics. 2001 April; 297(1): 326-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11259560&dopt=Abstract
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Arterio-venous plasma concentration differences in amitriptyline overdose. Author(s): Baud FJ, Buisine A, Bismuth C, Galliot M, Vicaut E, Bourdon R, Fournier PE. Source: Journal of Toxicology. Clinical Toxicology. 1985; 23(4-6): 391-406. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4057328&dopt=Abstract
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Behavioral dyscontrol in borderline patients treated with amitriptyline. Author(s): Soloff PH, George A, Nathan RS, Schulz PM, Perel JM. Source: Psychopharmacology Bulletin. 1987; 23(1): 177-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3602316&dopt=Abstract
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Behavioral predictors of amitriptyline response in depression. Author(s): Ranelli CJ, Miller RE. Source: The American Journal of Psychiatry. 1981 January; 138(1): 30-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7446778&dopt=Abstract
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Bifunctional variations of the antidepressant amitriptyline theme. Author(s): Asscher Y, Lindley P, Rotman A, Agranat I. Source: Chemical & Pharmaceutical Bulletin. 1985 November; 33(11): 4847-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3830418&dopt=Abstract
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Biochemical correlates of antidepressant response. Results of a trazodone versus amitriptyline trial. Author(s): Healy D, Carney PA, Leonard BE. Source: Psychopathology. 1984; 17 Suppl 2: 82-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6326178&dopt=Abstract
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Biochemical measures in patients with a somatoform pain disorder, before, during, and after treatment with amitriptyline with or without flupentixol. Author(s): Van Kempen GM, Zitman FG, Linssen AC, Edelbroek PM. Source: Biological Psychiatry. 1992 April 1; 31(7): 670-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1599984&dopt=Abstract
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Biotransformation of amitriptyline in alcoholic depressive patients. Author(s): Sandoz M, Vandel S, Vandel B, Bonin B, Allers G, Volmat R. Source: European Journal of Clinical Pharmacology. 1983; 24(5): 615-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6873139&dopt=Abstract
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Biotransformation of amitriptyline in depressive patients: urinary excretion of seven metabolites. Author(s): Vandel B, Sandoz M, Vandel S, Allers G, Volmat R. Source: European Journal of Clinical Pharmacology. 1982; 22(3): 239-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7106157&dopt=Abstract
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Biotransformation of amitriptyline in man: interaction with phenothiazines. Author(s): Vandel S, Sandoz M, Vandel B, Bonin B, Allers G, Volmat R. Source: Neuropsychobiology. 1986; 15(1): 15-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2873526&dopt=Abstract
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Biphasic kinetics of quaternary ammonium glucuronide formation from amitriptyline and diphenhydramine in human liver microsomes. Author(s): Breyer-Pfaff U, Fischer D, Winne D. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1997 March; 25(3): 340-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9172952&dopt=Abstract
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Blisters of the skin in coma induced by amitriptyline and clorazepate dipotassium. Report of a case with underlying sweat gland necrosis. Author(s): Herschthal D, Robinson MJ. Source: Archives of Dermatology. 1979 April; 115(4): 499. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=35109&dopt=Abstract
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Block of human heart hH1 sodium channels by amitriptyline. Author(s): Nau C, Seaver M, Wang SY, Wang GK. Source: The Journal of Pharmacology and Experimental Therapeutics. 2000 March; 292(3): 1015-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10688618&dopt=Abstract
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Blockade of the HERG human cardiac K(+) channel by the antidepressant drug amitriptyline. Author(s): Jo SH, Youm JB, Lee CO, Earm YE, Ho WK. Source: British Journal of Pharmacology. 2000 April; 129(7): 1474-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10742304&dopt=Abstract
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Blood disorders and suicide in patients taking mianserin or amitriptyline. Author(s): Inman WH. Source: Lancet. 1988 July 9; 2(8602): 90-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2898709&dopt=Abstract
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Blood levels of mianserin and amitriptyline and clinical response in aged depressed patients. Author(s): Monteleone P, Fabrazzo M. Source: Pharmacopsychiatry. 1994 November; 27(6): 238-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7870745&dopt=Abstract
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Blood noradrenaline and 5-HT levels in depressed women during amitriptyline or lithium treatment. Author(s): Corona GL, Cucchi ML, Santagostino G, Frattini P, Zerbi F, Fenoglio L, Savoldi F. Source: Psychopharmacology. 1982; 77(3): 236-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6812145&dopt=Abstract
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Blood pressure effects of tranylcypromine when prescribed singly and in combination with amitriptyline. Author(s): O'Brien S, McKeon P, O'Regan M, O'Flaherty A, Patel R. Source: Journal of Clinical Psychopharmacology. 1992 April; 12(2): 104-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1573032&dopt=Abstract
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Bupropion and amitriptyline in the treatment of depressed patients. Author(s): Chouinard G. Source: The Journal of Clinical Psychiatry. 1983 May; 44(5 Pt 2): 121-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6406440&dopt=Abstract
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Buspirone vs amitriptyline in the treatment of chronic tension-type headache. Author(s): Mitsikostas DD, Gatzonis S, Thomas A, Ilias A. Source: Acta Neurologica Scandinavica. 1997 October; 96(4): 247-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9325477&dopt=Abstract
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Cardiovascular effects of amitriptyline in the treatment of elderly depressed patients. Author(s): Christensen P, Thomsen HY, Pedersen OL, Thayssen P, Oxhoj H, KraghSorensen P, Gram LF. Source: Psychopharmacology. 1985; 87(2): 212-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3931149&dopt=Abstract
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Cardiovascular effects of phenelzine and amitriptyline. Author(s): Adams F. Source: The Journal of Clinical Psychiatry. 1982 November; 43(11): 472. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7174627&dopt=Abstract
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Cerebrospinal fluid amine metabolites after combined amitriptyline-triiodothyronine treatment of depressed women. Author(s): Banki CM. Source: European Journal of Clinical Pharmacology. 1977 April 20; 11(4): 311-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=862653&dopt=Abstract
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Cerebrospinal fluid concentrations of corticotropin-releasing hormone, vasopressin, and somatostatin in depressed patients and healthy controls: response to amitriptyline treatment. Author(s): Heuser I, Bissette G, Dettling M, Schweiger U, Gotthardt U, Schmider J, Lammers CH, Nemeroff CB, Holsboer F. Source: Depression and Anxiety. 1998; 8(2): 71-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9784981&dopt=Abstract
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Changes in quantitatively assessed tremor during treatment of major depression with lithium augmented by paroxetine or amitriptyline. Author(s): Zaninelli R, Bauer M, Jobert M, Muller-Oerlinghausen B. Source: Journal of Clinical Psychopharmacology. 2001 April; 21(2): 190-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11270916&dopt=Abstract
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Charcoal stercolith with intestinal perforation in a patient treated for amitriptyline ingestion. Author(s): Gomez HF, Brent JA, Munoz DC 4th, Mimmack RF, Ritvo J, Phillips S, McKinney P. Source: The Journal of Emergency Medicine. 1994 January-February; 12(1): 57-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8163807&dopt=Abstract
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Chronic tension-type headache: amitriptyline reduces clinical headache-duration and experimental pain sensitivity but does not alter pericranial muscle activity readings. Author(s): Gobel H, Hamouz V, Hansen C, Heininger K, Hirsch S, Lindner V, Heuss D, Soyka D. Source: Pain. 1994 November; 59(2): 241-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7892022&dopt=Abstract
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Cianopramine and amitriptyline in the treatment of depressed patients--a placebocontrolled study. Author(s): Hormazabal L, Omer LM, Ismail S. Source: Psychopharmacology. 1985; 86(1-2): 205-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3927356&dopt=Abstract
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Cimetidine interaction with amitriptyline. Author(s): Curry SH, DeVane CL, Wolfe MM. Source: European Journal of Clinical Pharmacology. 1985; 29(4): 429-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3912187&dopt=Abstract
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Clinical course, therapy, outcome and analytical data in amitriptyline and combined amitriptyline/chlordiazepoxide overdose. Author(s): Koppel C, Wiegreffe A, Tenczer J. Source: Human & Experimental Toxicology. 1992 November; 11(6): 458-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1361133&dopt=Abstract
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Clinical evaluation of amitriptyline for the control of chronic pain caused by temporomandibular joint disorders. Author(s): Rizzatti-Barbosa CM, Nogueira MT, de Andrade ED, Ambrosano GM, de Barbosa JR. Source: Cranio. 2003 July; 21(3): 221-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12889679&dopt=Abstract
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Clinical investigations into antidepressive mechanisms. II. Dexamethasone suppression test predicts response to nomifensine or amitriptyline. Author(s): Beckmann H, Holzmuller B, Fleckenstein P. Source: Acta Psychiatrica Scandinavica. 1984 October; 70(4): 342-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6388249&dopt=Abstract
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Clinical response and plasma concentration of amitriptyline and its metabolite nortriptyline. Author(s): Vandel S, Vandel B, Sandoz M, Allers G, Bechtel P, Volmat R. Source: European Journal of Clinical Pharmacology. 1978 November 27; 14(3): 185-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=365538&dopt=Abstract
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Clinical response and plasma concentrations of amitriptyline and its metabolitenortriptyline in depressive patients. Author(s): Miljkovic B, Pokrajac M, Timotijevic I, Varagic V. Source: Eur J Drug Metab Pharmacokinet. 1996 July-September; 21(3): 251-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8980924&dopt=Abstract
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Clinical signs of amyotrophic lateral sclerosis developing after polyradiculoneuropathy associated with amitriptyline. Author(s): Leys D, Petit H. Source: Bmj (Clinical Research Ed.). 1990 March 3; 300(6724): 614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2108779&dopt=Abstract
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Clinical trial comparison of two sustained release forms of amitriptyline. Author(s): Dorman T. Source: J Int Med Res. 1977; 5(3): 191-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=330290&dopt=Abstract
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Clinical usefulness of amitriptyline in fibromyalgia: the results of 23 N-of-1 randomized controlled trials. Author(s): Jaeschke R, Adachi J, Guyatt G, Keller J, Wong B. Source: The Journal of Rheumatology. 1991 March; 18(3): 447-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1856813&dopt=Abstract
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Clovoxamine in the treatment of depressed outpatients: a double-blind, parallelgroup comparison against amitriptyline and placebo. Author(s): Gelenberg AJ, Wojcik JD, Falk WE, Spring B, Brotman AW, Galvin-Nadeau M. Source: Comprehensive Psychiatry. 1990 July-August; 31(4): 307-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2201481&dopt=Abstract
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Column switching and high-performance liquid chromatography in the analysis of amitriptyline, nortriptyline and hydroxylated metabolites in human plasma or serum. Author(s): Hartter S, Hiemke C. Source: Journal of Chromatography. 1992 July 24; 578(2): 273-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1400807&dopt=Abstract
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Coma blisters, peripheral neuropathy, and amitriptyline overdose: a brief report. Author(s): Maguiness S, Guenther L, Shum D. Source: Journal of Cutaneous Medicine and Surgery. 2002 September-October; 6(5): 43841. Epub 2002 July 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12447625&dopt=Abstract
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Comment: Serotonin syndrome associated with combined sertraline-amitriptyline treatment. Author(s): Alderman CP, Lee PC. Source: The Annals of Pharmacotherapy. 1996 December; 30(12): 1499-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8968471&dopt=Abstract
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Comments on 'A controlled study of psychotherapy and amitriptyline used individually and in combination in the treatment of chronic intractable, 'psychogenic' pain, by I. Pilowsky and C.G. Barrow, Pain, 40 (1990) 3-19. Author(s): Davis RW. Source: Pain. 1990 November; 43(2): 257-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2087337&dopt=Abstract
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Comparative bioavailability of a sustained release preparation of amitriptyline and conventional tablets. Author(s): Jorgensen A. Source: European Journal of Clinical Pharmacology. 1977 November 14; 12(3): 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=579343&dopt=Abstract
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Comparative effects of amitriptyline and amineptine in patients affected by anxious depression. Author(s): Rampello L, Nicoletti G, Raffaele R, Drago F. Source: Neuropsychobiology. 1995; 31(3): 130-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7609861&dopt=Abstract
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Comparative efficacy of lithium and amitriptyline in the maintenance treatment of recurrent unipolar depression: a randomised study. Author(s): Greil W, Ludwig-Mayerhofer W, Erazo N, Engel RR, Czernik A, Giedke H, Muller-Oerlinghausen B, Osterheider M, Rudolf GA, Sauer H, Tegeler J, Wetterling T. Source: Journal of Affective Disorders. 1996 October 14; 40(3): 179-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897118&dopt=Abstract
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Comparative N-glucuronidation kinetics of ketotifen and amitriptyline by expressed human UDP-glucuronosyltransferases and liver microsomes. Author(s): Breyer-Pfaff U, Mey U, Green MD, Tephly TR. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2000 August; 28(8): 869-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10901693&dopt=Abstract
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Comparative trial of L-tryptophan and amitriptyline in depressive illness. Author(s): Herrington RN, Bruce A, Johnstone EC, Lader MH. Source: Psychological Medicine. 1976 November; 6(4): 673-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=794897&dopt=Abstract
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Comparison of adinazolam, amitriptyline, and diazepam in endogenous depressive inpatients exhibiting DST nonsuppression or abnormal contingent negative variation. Author(s): Ansseau M, Devoitille JM, Papart P, Vanbrabant E, Mantanus H, TimsitBerthier M. Source: Journal of Clinical Psychopharmacology. 1991 June; 11(3): 160-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2066454&dopt=Abstract
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Comparison of effects of desipramine and amitriptyline on EEG sleep of depressed patients. Author(s): Shipley JE, Kupfer DJ, Griffin SJ, Dealy RS, Coble PA, McEachran AB, Grochocinski VJ, Ulrich R, Perel JM. Source: Psychopharmacology. 1985; 85(1): 14-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3920695&dopt=Abstract
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Comparison of limbitrol (chlordiazepoxide/amitriptyline) and amitriptyline alone as a single night-time dose for the treatment of depression with anxiety. Author(s): James RT, Dean BC. Source: J Int Med Res. 1985; 13(2): 84-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3888730&dopt=Abstract
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Comparison of procedures for measuring the quaternary N-glucuronides of amitriptyline and diphenhydramine in human urine with and without hydrolysis. Author(s): Fischer D, Breyer-Pfaff U. Source: The Journal of Pharmacy and Pharmacology. 1995 June; 47(6): 534-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7674140&dopt=Abstract
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Comparison of the antidepressants reboxetine, fluvoxamine and amitriptyline upon spontaneous pupillary fluctuations in healthy human volunteers. Author(s): Phillips MA, Bitsios P, Szabadi E, Bradshaw CM. Source: Psychopharmacology. 2000 March; 149(1): 72-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10789885&dopt=Abstract
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Comparison of the effects of binodaline and amitriptyline on peripheral autonomic functions in healthy volunteers. Author(s): Longmore J, Szabadi E, Bradshaw CM. Source: British Journal of Clinical Pharmacology. 1985 March; 19(3): 295-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3986084&dopt=Abstract
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Comparison of the electrocardiographic effect of dothiepin and amitriptyline. Author(s): Claghorn JL, Schroeder J, Goldstein BJ 2nd. Source: The Journal of Clinical Psychiatry. 1984 July; 45(7): 291-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6376479&dopt=Abstract
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Comparison of the tolerability and efficacy of citalopram and amitriptyline in elderly depressed patients treated in general practice. Author(s): Kyle CJ, Petersen HE, Overo KF. Source: Depression and Anxiety. 1998; 8(4): 147-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9871816&dopt=Abstract
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Comparison of three in vitro assays at evaluation of IC50 of acetylsalicylic acid, ferrous sulfate, amitriptyline, methanol, isopropanol and ethylene glycol in human cancer cells HeLa. Author(s): Ruppova K, Wsolova L, Urbancikova M, Slamenova D. Source: Neoplasma. 2000; 47(3): 172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11043841&dopt=Abstract
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Comparison of two approaches to amitriptyline dose individualisation. Author(s): Jankovic SM, Timotijevic I, Mihajlovic GS, Dukic-Dejanovic S. Source: Eur J Drug Metab Pharmacokinet. 1999 April-June; 24(2): 163-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510745&dopt=Abstract
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Compliance in depressed patients treated with fluoxetine or amitriptyline. Belgian Compliance Study Group. Author(s): Demyttenaere K, Van Ganse E, Gregoire J, Gaens E, Mesters P. Source: International Clinical Psychopharmacology. 1998 January; 13(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9988362&dopt=Abstract
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Comprehensive survey of the relationship between serum concentration and therapeutic effect of amitriptyline in depression. Author(s): Ulrich S, Lauter J. Source: Clinical Pharmacokinetics. 2002; 41(11): 853-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12190332&dopt=Abstract
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Computerised psychomotor performance testing: a comparative study of the single dose pharmacodynamics of minaprine and amitriptyline in young and elderly subjects. Author(s): Kinirons MT, Jackson SH, Kalra L, Trevit RT, Swift CG. Source: British Journal of Clinical Pharmacology. 1993 October; 36(4): 376-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959320&dopt=Abstract
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Concurrent liquid chromatographic measurement of fluoxetine, amitriptyline, imipramine, and their active metabolites norfluoxetine, nortriptyline, and desipramine in plasma. Author(s): el-Yazigi A, Raines DA. Source: Therapeutic Drug Monitoring. 1993 August; 15(4): 305-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8236366&dopt=Abstract
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Contribution to the pharmacokinetics of amitriptyline. Author(s): Ziegler VE, Biggs JT, Ardekani AB, Rosen SH. Source: Journal of Clinical Pharmacology. 1978 October; 18(10): 462-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=711927&dopt=Abstract
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Controlled comparison of bromazepam, amitriptyline, and placebo in anxietydepressive neurosis. Author(s): Shammas E. Source: Dis Nerv Syst. 1977 March; 38(3): 201-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13969&dopt=Abstract
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Controlled comparison of nefazodone and amitriptyline in major depressive inpatients. Author(s): Ansseau M, Darimont P, Lecoq A, De Nayer A, Evrard JL, Kremer P, Devoitille JM, Dierick M, Mertens C, Mesotten F, et al. Source: Psychopharmacology. 1994 June; 115(1-2): 254-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7862904&dopt=Abstract
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Controlled, double-blind, randomized trial of amitriptyline in relieving articular pain and tenderness in patients with rheumatoid arthritis. Author(s): Grace EM, Bellamy N, Kassam Y, Buchanan WW. Source: Current Medical Research and Opinion. 1985; 9(6): 426-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3886308&dopt=Abstract
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Correlation of mono and combined amitriptyline/lithium therapy with therapeutic and side effects. Author(s): Timotijevic I, Zdravkovic M, Pokrajac M, Miljkovic B, Stojkovic M, Marinkovic O. Source: Rom J Physiol. 1994 January-December; 31(1-4): 103-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8640362&dopt=Abstract
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Cost-effectiveness of mirtazapine compared to amitriptyline and fluoxetine in the treatment of moderate and severe depression in austria. Author(s): Brown MC, Nimmerrichter AA, Guest JF. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 1999 July; 14(4): 230-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10572352&dopt=Abstract
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Costs and outcomes of use of amitriptyline, citalopram and fluoxetine in major depression: exploratory study. Author(s): Hosak L, Tuma I, Hanus H, Straka L. Source: Acta Medica (Hradec Kralove). 2000; 43(4): 133-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11294131&dopt=Abstract
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Cyclobenzaprine hydrochloride is a commonly prescribed centrally acting muscle relaxant, which is structurally similar to tricyclic antidepressants (TCAs) and differs from amitriptyline by only one double bond. Author(s): Lofland JH, Szarlej D, Buttaro T, Shermock S, Jalali S. Source: The Clinical Journal of Pain. 2001 March; 17(1): 103-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11289081&dopt=Abstract
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Cytochromes P450 mediating the N-demethylation of amitriptyline. Author(s): Ghahramani P, Ellis SW, Lennard MS, Ramsay LE, Tucker GT. Source: British Journal of Clinical Pharmacology. 1997 February; 43(2): 137-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9131945&dopt=Abstract
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Death attributed to the toxic interaction of triazolam, amitriptyline and other psychotropic drugs. Author(s): Kudo K, Imamura T, Jitsufuchi N, Zhang XX, Tokunaga H, Nagata T. Source: Forensic Science International. 1997 April 18; 86(1-2): 35-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9153780&dopt=Abstract
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Decreased parameters of heart rate variation in amitriptyline treated patients: lower parameters in melancholic depression than in neurotic depression--a biological marker? Author(s): Rechlin T. Source: Biological Psychiatry. 1994 November 15; 36(10): 705-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7880941&dopt=Abstract
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Demethylation and hydroxylation of amitriptyline, nortriptyline, and 10hydroxyamitriptyline in human liver microsomes. Author(s): Mellstrom B, von Bahr C. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1981 November-December; 9(6): 565-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6120818&dopt=Abstract
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Determination of amitriptyline and cocaine by GC and GC/MS in biological fluids. Author(s): Martinez Ruiz D, Menendez Gallego M. Source: Vet Hum Toxicol. 1988 October; 30(5): 413-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3188358&dopt=Abstract
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Determination of amitriptyline and nortriptyline in human liver microsomes with reversed-phase HPLC in vitro. Author(s): Shu Y, Zhu RH, Xu ZH, Zhou HH. Source: Zhongguo Yao Li Xue Bao. 1998 July; 19(4): 343-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10375781&dopt=Abstract
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Determination of amitriptyline and some of its metabolites in blood by high-pressure liquid chromatography. Author(s): Kraak JC, Bijster P. Source: Journal of Chromatography. 1977 September 1; 143(5): 499-512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=893638&dopt=Abstract
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Determination of amitriptyline in plasma samples by high-performance liquid chromatography. Author(s): Zarghi A, Dadashzadeh S, Kiayi Z. Source: Boll Chim Farm. 2001 November-December; 140(6): 458-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11822239&dopt=Abstract
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Determination of amitriptyline in the hair of psychiatric patients. Author(s): Tracqui A, Kreissig P, Kintz P, Pouliquen A, Mangin P. Source: Human & Experimental Toxicology. 1992 September; 11(5): 363-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1358152&dopt=Abstract
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Determination of amitriptylinoxide and its major metabolites amitriptyline and nortriptyline in plasma by high-performance liquid chromatography. Author(s): Terlinden R, Borbe HO. Source: Journal of Chromatography. 1986 October 31; 382: 372-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3782407&dopt=Abstract
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Determination of citalopram, amitriptyline and clomipramine in plasma by reversedphase high-performance liquid chromatography. Author(s): Rop PP, Viala A, Durand A, Conquy T. Source: Journal of Chromatography. 1985 February 27; 338(1): 171-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3860507&dopt=Abstract
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Development of a rapid extraction and high-performance liquid chromatographic separation for amitriptyline and six biological metabolites. Author(s): Kiel JS, Abramson RK, Smith CS, Morgan SL. Source: Journal of Chromatography. 1986 November 28; 383(1): 119-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3818830&dopt=Abstract
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Dexamethasone suppression test predicts response to nomifensine or amitriptyline. Author(s): Beckmann H, Holzmuller B, Fleckenstein P. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1984 April; 144: 440-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6722407&dopt=Abstract
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Dexamethasone suppression test status does not predict differential response to nortriptyline versus amitriptyline. Author(s): Rush AJ, Weissenburger J, Vasavada N, Orsulak PJ, Fairchild CJ. Source: Journal of Clinical Psychopharmacology. 1988 December; 8(6): 421-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3069882&dopt=Abstract
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Dextromethorphan and mephenytoin phenotyping of patients treated with thioridazine or amitriptyline. Author(s): Baumann P, Meyer JW, Amey M, Baettig D, Bryois C, Jonzier-Perey M, Koeb L, Monney C, Woggon B. Source: Therapeutic Drug Monitoring. 1992 February; 14(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1546384&dopt=Abstract
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Diabetic neuropathic pain: control by amitriptyline and fluphenazine in renal insufficiency. Author(s): Mitas JA 2nd, Mosley CA Jr, Drager AM. Source: Southern Medical Journal. 1983 April; 76(4): 462-3, 467. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6836360&dopt=Abstract
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Differential effect of amitriptyline and bupropion on primary and secondary depression: a pilot study. Author(s): Othmer SC, Othmer E, Preskorn SH, Mac D. Source: The Journal of Clinical Psychiatry. 1988 August; 49(8): 310-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3137218&dopt=Abstract
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Differential effects of amitriptyline and of zimelidine on the sleep electroencephalogram of depressed patients. Author(s): Shipley JE, Kupfer DJ, Dealy RS, Griffin SJ, Coble PA, McEachran AB, Grochocinski VJ. Source: Clinical Pharmacology and Therapeutics. 1984 August; 36(2): 251-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6235082&dopt=Abstract
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Differential effects of amitriptyline on perception of somatic and visceral stimulation in healthy humans. Author(s): Gorelick AB, Koshy SS, Hooper FG, Bennett TC, Chey WD, Hasler WL. Source: The American Journal of Physiology. 1998 September; 275(3 Pt 1): G460-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9724256&dopt=Abstract
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Differential effects of amitriptyline on sudomotor, cardiovagal, and adrenergic function in human subjects. Author(s): Low PA, Opfer-Gehrking TL. Source: Muscle & Nerve. 1992 December; 15(12): 1340-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1470198&dopt=Abstract
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Differential effects of amitriptyline, nefazodone and paroxetine on performance and brain indices of visual selective attention and working memory. Author(s): van Laar MW, Volkerts ER, Verbaten MN, Trooster S, van Megen HJ, Kenemans JL. Source: Psychopharmacology. 2002 August; 162(4): 351-63. Epub 2002 June 05. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172688&dopt=Abstract
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Differential effects on suicidal ideation of mianserin, maprotiline and amitriptyline. Author(s): Montgomery S, Cronholm B, Asberg M, Montgomery DB. Source: British Journal of Clinical Pharmacology. 1978; 5 Suppl 1: 77S-80S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=341948&dopt=Abstract
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Discrepancies between pharmacokinetic studies of amitriptyline. Author(s): Schulz P, Dick P, Blaschke TF, Hollister L. Source: Clinical Pharmacokinetics. 1985 May-June; 10(3): 257-68. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3893842&dopt=Abstract
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Distigmine and amitriptyline in the treatment of chronic pain. Author(s): Hampf G, Bowsher D, Nurmikko T. Source: Anesthesia Progress. 1989 March-April; 36(2): 58-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2574958&dopt=Abstract
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Distinguishing cyclobenzaprine and amitriptyline. Author(s): Bateh RP. Source: Journal of Analytical Toxicology. 1987 September-October; 11(5): 235-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3682787&dopt=Abstract
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Distinguishing cyclobenzaprine from amitriptyline and imipramine by liquid chromatography with UV multi-wavelength or full-spectrum detection. Blood levels of cyclobenzaprine in emergency screens. Author(s): Demorest DM. Source: Journal of Analytical Toxicology. 1987 May-June; 11(3): 133-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3599920&dopt=Abstract
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Distribution of amitriptyline and nortriptyline in blood: role of alpha-1-glycoprotein. Author(s): Amitai Y, Kennedy EJ, DeSandre P, Frischer H. Source: Therapeutic Drug Monitoring. 1993 August; 15(4): 267-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8236360&dopt=Abstract
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Do urinary MHPG and plasma drug levels correlate with response to amitriptyline therapy? Author(s): Gaertner HJ, Kreuter F, Scharek G, Wiatr G, Breyer-Pfaff U. Source: Psychopharmacology. 1982; 76(3): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6808543&dopt=Abstract
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Does addition of low-dose flupentixol enhance the analgetic effects of low-dose amitriptyline in somatoform pain disorder? Author(s): Zitman FG, Linssen AC, Edelbroek PM, Van Kempen GM. Source: Pain. 1991 October; 47(1): 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1771090&dopt=Abstract
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Does amitriptyline potentiate euphorigenic effects of ethanol? Author(s): Dilsaver SC. Source: Journal of Clinical Psychopharmacology. 1988 June; 8(3): 232. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3379155&dopt=Abstract
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Does lofepramine have fewer side effects than amitriptyline? Results of a comparative trial. Author(s): Pugh R, Bell J, Cooper AJ, Dunstan S, Greedharry D, Pomeroy J, Raptopoulos P, Rowsell C, Steinert J, Priest RG. Source: Journal of Affective Disorders. 1982 December; 4(4): 355-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6219149&dopt=Abstract
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Does tolerance develop to the sedative and amnesic effects of antidepressants? A comparison of amitriptyline, trazodone and placebo. Author(s): Sakulsripong M, Curran HV, Lader M. Source: European Journal of Clinical Pharmacology. 1991; 40(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2060544&dopt=Abstract
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Dopaminergic agonist nomifensine compared with amitriptyline: a double-blind clinical trial in acute primary depressions. Author(s): Grof P, Saxena B, Daigle L, Mahutte G. Source: British Journal of Clinical Pharmacology. 1977; 4Suppl 2: 221S-225S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=334227&dopt=Abstract
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Dose-response for analgesic effect of amitriptyline in chronic pain. Author(s): McQuay HJ, Carroll D, Glynn CJ. Source: Anaesthesia. 1993 April; 48(4): 281-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8494126&dopt=Abstract
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Double blind study comparing the efficacy of zimelidine and amitriptyline in endogenous depression. Author(s): O'Connor M, Grigor J. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 1984; 8(1): 12732. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6233635&dopt=Abstract
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Double-blind comparative study of paroxetine and amitriptyline in depressed patients of a university psychiatric outpatient clinic (pilot study). Author(s): Battegay R, Hager M, Rauchfleisch U. Source: Neuropsychobiology. 1985; 13(1-2): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3162108&dopt=Abstract
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Double-blind comparative study of the antidepressant, unwanted and cardiac effects of minaprine and amitriptyline. Author(s): Edwards JG, Dinan TG, Waller DG, Greentree SG. Source: British Journal of Clinical Pharmacology. 1996 October; 42(4): 491-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8904622&dopt=Abstract
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Double-blind comparison of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia. Author(s): Benedictis E. Source: Journal of Psychopharmacology (Oxford, England). 2000 March; 14(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10757255&dopt=Abstract
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Double-blind multicenter study of paroxetine and amitriptyline in depressed inpatients. Author(s): Moller HJ, Berzewski H, Eckmann F, Gonzalves N, Kissling W, Knorr W, Ressler P, Rudolf GA, Steinmeyer EM, Magyar I, et al. Source: Pharmacopsychiatry. 1993 May; 26(3): 75-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8415897&dopt=Abstract
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Double-blind placebo-controlled trial of amitriptyline among depressed patients in general practice. Author(s): Hollyman JA, Freeling P, Paykel ES, Bhat A, Sedgwick P. Source: J R Coll Gen Pract. 1988 September; 38(314): 393-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3076905&dopt=Abstract
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Double-blind study of the therapeutic efficacy and tolerability of amitriptylinoxide in comparison with amitriptyline. Author(s): Tegeler J, Klieser E, Lehmann E, Heinrich K. Source: Pharmacopsychiatry. 1990 January; 23(1): 45-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2179974&dopt=Abstract
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Double-blind trial of sustained-release amitriptyline compared with viloxazine in moderate to severe depressive illness. Author(s): Sedman G. Source: Current Medical Research and Opinion. 1977; 5(3): 217-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=162657&dopt=Abstract
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Double-blind, multicenter comparative study of sertraline and amitriptyline in hospitalized patients with major depression. Author(s): Moller HJ, Gallinat J, Hegerl U, Arato M, Janka Z, Pflug B, Bauer H. Source: Pharmacopsychiatry. 1998 September; 31(5): 170-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9832348&dopt=Abstract
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Double-blind, multicenter comparative study of sertraline versus amitriptyline in outpatients with major depression. Author(s): Moller HJ, Glaser K, Leverkus F, Gobel C. Source: Pharmacopsychiatry. 2000 November; 33(6): 206-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11147927&dopt=Abstract
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Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients. Author(s): Cohn CK, Shrivastava R, Mendels J, Cohn JB, Fabre LF, Claghorn JL, Dessain EC, Itil TM, Lautin A. Source: The Journal of Clinical Psychiatry. 1990 December; 51 Suppl B: 28-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2258379&dopt=Abstract
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Drug induced blistering and the plastic surgeon: a case of amitriptyline induced skin necrosis. Author(s): Fogarty BJ, Khan K. Source: Burns : Journal of the International Society for Burn Injuries. 1999 December; 25(8): 768-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10630864&dopt=Abstract
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Dysesthetic (“essential”) vulvodynia. Treatment with amitriptyline. Author(s): McKay M. Source: J Reprod Med. 1993 January; 38(1): 9-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8441136&dopt=Abstract
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Dystonic reaction to amitriptyline. Author(s): Finder E, Lin KM, Ananth J. Source: The American Journal of Psychiatry. 1982 September; 139(9): 1220. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7114327&dopt=Abstract
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Dystonic reactions to amitriptyline and doxepin. Author(s): Lee HK. Source: The American Journal of Psychiatry. 1988 May; 145(5): 649. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3358469&dopt=Abstract
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Echocardiographic and psychometric effects of amitriptyline or imipramine plus alcohol. Author(s): Stromberg C, Suokas A, Seppala T, Kupari M. Source: European Journal of Clinical Pharmacology. 1991; 40(4): 349-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2050169&dopt=Abstract
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Economic impact of using mirtazapine compared to amitriptyline and fluoxetine in the treatment of moderate and severe depression in the UK. Author(s): Borghi J, Guest JF. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2000 September; 15(6): 378-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11004733&dopt=Abstract
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Effect of amitriptyline on endocrine responses to intravenous L-tryptophan. Author(s): Cowen PJ, McCance SL, Gelder MG, Grahame-Smith DG. Source: Psychiatry Research. 1990 February; 31(2): 201-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2326398&dopt=Abstract
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Effect of amitriptyline on symptoms, sleep, and visceral perception in patients with functional dyspepsia. Author(s): Mertz H, Fass R, Kodner A, Yan-Go F, Fullerton S, Mayer EA. Source: The American Journal of Gastroenterology. 1998 February; 93(2): 160-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9468233&dopt=Abstract
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Effect of amitriptyline on the thyrotropin response to thyrotropin-releasing hormone in endogenous depression. Author(s): Krog-Meyer I, Kirkegaard C, Kijne B, Lumholtz B, Smith E, Lykke-Olesen L, Bjorum N. Source: Psychiatry Research. 1985 June; 15(2): 145-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3929293&dopt=Abstract
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Effect of medications on taste: example of amitriptyline HCl. Author(s): Schiffman SS, Zervakis J, Suggs MS, Shaio E, Sattely-Miller EA. Source: Physiology & Behavior. 1999 April; 66(2): 183-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10336142&dopt=Abstract
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Effective column extraction from decomposed tissue in a suspected overdose case involving maprotiline and amitriptyline. Author(s): Fernandez GS, Witherington TL, Stafford DT. Source: Journal of Analytical Toxicology. 1985 September-October; 9(5): 230-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4057962&dopt=Abstract
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Effective prophylactic therapy for cyclic vomiting syndrome in children using amitriptyline or cyproheptadine. Author(s): Andersen JM, Sugerman KS, Lockhart JR, Weinberg WA. Source: Pediatrics. 1997 December; 100(6): 977-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9374568&dopt=Abstract
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Effectiveness of amitriptyline in the prophylactic management of childhood headaches. Author(s): Hershey AD, Powers SW, Bentti AL, Degrauw TJ. Source: Headache. 2000 July-August; 40(7): 539-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10940092&dopt=Abstract
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Effects of a controlled-release formulation of trazodone on psychomotor and autonomic functions in healthy volunteers: comparison with trazodone (conventional formulation), amitriptyline and placebo. Author(s): Longmore J, Banjar W, Bradshaw CM, Szabadi E. Source: European Journal of Clinical Pharmacology. 1988; 34(1): 97-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3360055&dopt=Abstract
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Effects of amitriptyline and imipramine on brain amine neurotransmitter metabolites in cerebrospinal fluid. Author(s): Bowden CL, Koslow SH, Hanin I, Maas JW, Davis JM, Robins E. Source: Clinical Pharmacology and Therapeutics. 1985 March; 37(3): 316-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2578912&dopt=Abstract
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Effects of amitriptyline and mianserin on psychomotor skills and memory in man. Author(s): Mattila MJ, Liljequist R, Seppala T. Source: British Journal of Clinical Pharmacology. 1978; 5 Suppl 1: 53S-55S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=341944&dopt=Abstract
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Effects of antidepressants on weight and on the plasma levels of leptin, TNF-alpha and soluble TNF receptors: A longitudinal study in patients treated with amitriptyline or paroxetine. Author(s): Hinze-Selch D, Schuld A, Kraus T, Kuhn M, Uhr M, Haack M, Pollmacher T. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2000 July; 23(1): 13-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10869882&dopt=Abstract
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Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. Author(s): Max MB, Lynch SA, Muir J, Shoaf SE, Smoller B, Dubner R. Source: The New England Journal of Medicine. 1992 May 7; 326(19): 1250-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1560801&dopt=Abstract
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Effects of divalproex sodium on amitriptyline and nortriptyline pharmacokinetics. Author(s): Wong SL, Cavanaugh J, Shi H, Awni WM, Granneman GR. Source: Clinical Pharmacology and Therapeutics. 1996 July; 60(1): 48-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8689811&dopt=Abstract
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Effects of low power laser and low dose amitriptyline therapy on clinical symptoms and quality of life in fibromyalgia: a single-blind, placebo-controlled trial. Author(s): Gur A, Karakoc M, Nas K, Cevik R, Sarac J, Ataoglu S. Source: Rheumatology International. 2002 September; 22(5): 188-93. Epub 2002 July 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215864&dopt=Abstract
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Effects of placebo washout and dose in a comparison of sertraline and amitriptyline. Author(s): Karagianis JL. Source: The Journal of Clinical Psychiatry. 1991 September; 52(9): 386. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1894591&dopt=Abstract
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Effects of zimeldine, mianserin and amitriptyline on psychomotor skills and their interaction with ethanol a placebo controlled cross-over study. Author(s): Seppala T, Stromberg C, Bergman I. Source: European Journal of Clinical Pharmacology. 1984; 27(2): 181-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6238829&dopt=Abstract
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Efficacy of amitriptyline for relief of pain in spinal cord injury: results of a randomized controlled trial. Author(s): Cardenas DD, Warms CA, Turner JA, Marshall H, Brooke MM, Loeser JD. Source: Pain. 2002 April; 96(3): 365-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11973011&dopt=Abstract
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Efficacy of amitriptyline in the treatment of subjective tinnitus. Author(s): Bayar N, Boke B, Turan E, Belgin E. Source: The Journal of Otolaryngology. 2001 October; 30(5): 300-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11771024&dopt=Abstract
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Efficacy of long duration resuscitation and magnesium sulphate treatment in amitriptyline poisoning. Author(s): Citak A, Soysal DD, Ucsel R, Karabocuoglu M, Uzel N. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 2002 March; 9(1): 63-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11989501&dopt=Abstract
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Efficacy of tianeptine in anxious-depressed patients: results of a controlled multicenter trial versus amitriptyline. Author(s): Guelfi JD, Pichot P, Dreyfus JF. Source: Neuropsychobiology. 1989; 22(1): 41-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2700774&dopt=Abstract
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Electrocardiographic effects of amitriptyline in therapeutic doses on 24-hr monitoring (Holter) with correlation to plasma levels. Author(s): Sirota P, Ori J, Schild K, Appel S, Brandis S, Zahavi I. Source: Biological Psychiatry. 1990 May 1; 27(9): 1053-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2334745&dopt=Abstract
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Electrocardiographic effects of tranylcypromine vs. amitriptyline. Author(s): White K, O'Leary J, Razani J, Rebal R, Palmer R. Source: The Journal of Clinical Psychiatry. 1983 March; 44(3): 91-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6833194&dopt=Abstract
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Electrocardiographic findings in patients undergoing amitriptyline treatment. Author(s): Ziegler VE, Biggs JT. Source: Dis Nerv Syst. 1977 September; 38(9): 697-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=902559&dopt=Abstract
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Electrophysiological and haemodynamic changes with trazodone, amitriptyline and placebo in depressed out-patients. Author(s): Van de Merwe TJ, Silverstone T, Ankier SI. Source: Current Medical Research and Opinion. 1984; 9(5): 339-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6529913&dopt=Abstract
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Enantioselective amitriptyline metabolism in patients phenotyped for two cytochrome P450 isozymes. Author(s): Breyer-Pfaff U, Pfandl B, Nill K, Nusser E, Monney C, Jonzier-Perey M, Baettig D, Baumann P. Source: Clinical Pharmacology and Therapeutics. 1992 October; 52(4): 350-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1424408&dopt=Abstract
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Encephalopathy during amitriptyline therapy: are neuroleptic malignant syndrome and serotonin syndrome spectrum disorders? Author(s): Miyaoka H, Kamijima K. Source: International Clinical Psychopharmacology. 1995 November; 10(4): 265-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8748050&dopt=Abstract
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Enhancement of cyclic AMP accumulation mediated by 5-HT after chronic amitriptyline treatment in NG 108-15 cells. Author(s): Shimizu M, Nishida A, Fukuda H, Saito H, Yamawaki S. Source: British Journal of Pharmacology. 1995 March; 114(6): 1282-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7620719&dopt=Abstract
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Enzyme kinetic modelling as a tool to analyse the behaviour of cytochrome P450 catalysed reactions: application to amitriptyline N-demethylation. Author(s): Schmider J, Greenblatt DJ, Harmatz JS, Shader RI. Source: British Journal of Clinical Pharmacology. 1996 June; 41(6): 593-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8799527&dopt=Abstract
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Enzyme-linked immunosorbent assay for amitriptyline and other antidepressants using a monoclonal antibody. Author(s): Denis H, Marullo S, Hoebeke J, Strosberg AD. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1986 September 30; 159(3): 257-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3769214&dopt=Abstract
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Epinephrine and sodium bicarbonate independently and additively increase survival in experimental amitriptyline poisoning. Author(s): Knudsen K, Abrahamsson J. Source: Critical Care Medicine. 1997 April; 25(4): 669-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9142034&dopt=Abstract
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Erythromelalgia: association with hereditary sensory neuropathy and response to amitriptyline. Author(s): Herskovitz S, Loh F, Berger AR, Kucherov M. Source: Neurology. 1993 March; 43(3 Pt 1): 621-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8451013&dopt=Abstract
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Ethological predictors of amitriptyline response in depressed outpatients. Author(s): Troisi A, Pasini A, Bersani G, Grispini A, Ciani N. Source: Journal of Affective Disorders. 1989 September-October; 17(2): 129-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2527888&dopt=Abstract
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Evaluation of amitriptyline in primary fibrositis. A double-blind, placebo-controlled study. Author(s): Carette S, McCain GA, Bell DA, Fam AG. Source: Arthritis and Rheumatism. 1986 May; 29(5): 655-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3521612&dopt=Abstract
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Evaluation of amitriptyline pharmacokinetics during peritoneal dialysis. Author(s): Tasset JJ, Singh S, Pesce AJ. Source: Therapeutic Drug Monitoring. 1985; 7(3): 255-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4049459&dopt=Abstract
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Evaluation of amitriptyline use for depression when prescribed by internists and psychiatrists. Author(s): Cano SB, Generali JA, Letendre DE, Hastings MT, Preskorn SH, Godwin HN. Source: Hospital Formulary. 1984 December; 19(12): 1131-2, 1136, 1140-1 Passim. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10269438&dopt=Abstract
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Evaluation of possible interactions between ethanol and trazodone or amitriptyline. Author(s): Warrington SJ, Ankier SI, Turner P. Source: Neuropsychobiology. 1986; 15 Suppl 1: 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3725002&dopt=Abstract
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Evaluation of the EMIT amitriptyline and nortriptyline assays for the determination of serum clomipramine and desmethylclomipramine. Author(s): Fraser AD, Bryan W, Isner AF. Source: Therapeutic Drug Monitoring. 1989; 11(3): 349-53. Erratum In: Ther Drug Monit 1989; 11(4): 492. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2658213&dopt=Abstract
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Experimental comparison between the effect of standardized trazodone-amitriptyline and placebo treatment in vitalized depressive patients. Author(s): Klieser E, Lehmann E. Source: Psychopharmacology. 1988; 95 Suppl: S3-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3133710&dopt=Abstract
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Extrapolating in vitro data on drug metabolism to in vivo pharmacokinetics: evaluation of the pharmacokinetic interaction between amitriptyline and fluoxetine. Author(s): Schmider J, von Moltke LL, Shader RI, Harmatz JS, Greenblatt DJ. Source: Drug Metabolism Reviews. 1999 May; 31(2): 545-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10335452&dopt=Abstract
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Extremely long plasma half-life of amitriptyline in a woman with the cytochrome P450IID6 29/29-kilobase wild-type allele--a slowly reversible interaction with fluoxetine. Author(s): Muller N, Brockmoller J, Roots I. Source: Therapeutic Drug Monitoring. 1991 November; 13(6): 533-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1771652&dopt=Abstract
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Extremely slow metabolism of amitriptyline but normal metabolism of imipramine and desipramine in an extensive metabolizer of sparteine, debrisoquine, and mephenytoin. Author(s): Brosen K, Gram LF, Kragh-Sorensen P. Source: Therapeutic Drug Monitoring. 1991 March; 13(2): 177-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2053127&dopt=Abstract
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Failed amitriptyline absorption. Author(s): Freed E, Atkinson K, Biggs J. Source: The Medical Journal of Australia. 1984 April 14; 140(8): 509-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6708886&dopt=Abstract
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Failure to correlate urinary MHPG with clinical response to amitriptyline. Author(s): Puzynski S, Rode A, Bidzinski A, Mrozek S, Zaluska M. Source: Acta Psychiatrica Scandinavica. 1984 February; 69(2): 117-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6702474&dopt=Abstract
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Failure to correlate urinary MHPG with clinical response to amitriptyline. Author(s): Puzynski S, Rode A, Bidzinski A, Mrozek S, Zaluska M. Source: Psychopharmacology Bulletin. 1984 Winter; 20(1): 171-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6718644&dopt=Abstract
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Fatal cholestatic jaundice associated with amitriptyline. Author(s): Randeva HS, Bangar V, Sailesh S, Hillhouse EW. Source: Int J Clin Pract. 2000 July-August; 54(6): 405-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11092117&dopt=Abstract
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Fatality associated with combined fluoxetine-amitriptyline therapy. Author(s): Preskorn SH, Baker B. Source: Jama : the Journal of the American Medical Association. 1997 June 4; 277(21): 1682. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9169893&dopt=Abstract
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Femoxetine and amitriptyline in general practice: a randomized double-blind group comparison. Author(s): Skrumsager BK, Jeppesen K. Source: Pharmacopsychiatry. 1986 September; 19(5): 368-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3774871&dopt=Abstract
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Five distinct human cytochromes mediate amitriptyline N-demethylation in vitro: dominance of CYP 2C19 and 3A4. Author(s): Venkatakrishnan K, Greenblatt DJ, von Moltke LL, Schmider J, Harmatz JS, Shader RI. Source: Journal of Clinical Pharmacology. 1998 February; 38(2): 112-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9549641&dopt=Abstract
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Fluotracen (SKF 28, 175): a new antidepressant. Double-blind study with amitriptyline. Author(s): Feldmann HS, Denber HC. Source: Prog Neuropsychopharmacol. 1980; 4(1): 51-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6996019&dopt=Abstract
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Fluoxetine and amitriptyline in the treatment of fibromyalgia. Author(s): Johnson SP. Source: The Journal of Family Practice. 1997 February; 44(2): 128-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9040508&dopt=Abstract
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Fluoxetine and amitriptyline inhibit nitric oxide, prostaglandin E2, and hyaluronic acid production in human synovial cells and synovial tissue cultures. Author(s): Yaron I, Shirazi I, Judovich R, Levartovsky D, Caspi D, Yaron M. Source: Arthritis and Rheumatism. 1999 December; 42(12): 2561-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10616001&dopt=Abstract
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Fluoxetine compared with amitriptyline in elderly depression: a controlled clinical trial. Author(s): Altamura AC, De Novellis F, Guercetti G, Invernizzi G, Percudani M, Montgomery SA. Source: Int J Clin Pharmacol Res. 1989; 9(6): 391-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2699465&dopt=Abstract
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Fluoxetine versus amitriptyline in the treatment of major depression with associated anxiety (anxious depression): a double-blind comparison. Author(s): Versiani M, Ontiveros A, Mazzotti G, Ospina J, Davila J, Mata S, Pacheco A, Plewes J, Tamura R, Palacios M. Source: International Clinical Psychopharmacology. 1999 November; 14(6): 321-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10565798&dopt=Abstract
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Fluoxetine versus amitriptyline in the treatment of major depression: a multicenter trial. Author(s): Beasley CM Jr, Sayler ME, Potvin JH. Source: International Clinical Psychopharmacology. 1993 Fall; 8(3): 143-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8263311&dopt=Abstract
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Fluoxetine vs amitriptyline in the treatment of depressed out-patients. Author(s): Laakmann G, Blaschke D, Engel R, Schwarz A. Source: The British Journal of Psychiatry. Supplement. 1988 September; (3): 64-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3074868&dopt=Abstract
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Fluoxetine, amitriptyline and the electroencephalogram. Author(s): Tarn M, Edwards JG, Sedgwick EM. Source: Journal of Affective Disorders. 1993 September; 29(1): 7-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8254147&dopt=Abstract
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Fluphenazine and amitriptyline in the anxious depressed patient. Author(s): Wallerstein E, Dykyj R, Nodine JH. Source: The American Journal of Psychiatry. 1967 September; 124(3): 397-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5342255&dopt=Abstract
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Fluvoxamine and fluoxetine: interaction studies with amitriptyline, clomipramine and neuroleptics in phenotyped patients. Author(s): Vandel S, Bertschy G, Baumann P, Bouquet S, Bonin B, Francois T, Sechter D, Bizouard P. Source: Pharmacological Research : the Official Journal of the Italian Pharmacological Society. 1995 June; 31(6): 347-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8685072&dopt=Abstract
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Food intake and the presystemic metabolism of single doses of amitriptyline and nortriptyline. Author(s): Liedholm H, Liden A. Source: Fundamental & Clinical Pharmacology. 1998; 12(6): 636-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9818297&dopt=Abstract
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Formation of a quaternary N-glucuronide of amitriptyline in human liver microsomes. Author(s): Dahl-Puustinen ML, Bertilsson L. Source: Pharmacology & Toxicology. 1987 November; 61(5): 342-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3438230&dopt=Abstract
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Formation of cytotoxic metabolites from phenytoin, imipramine, desipramine, amitriptyline and mianserin by mouse and human hepatic microsomes. Author(s): Riley RJ, Roberts P, Kitteringham NR, Park BK. Source: Biochemical Pharmacology. 1990 June 15; 39(12): 1951-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2353936&dopt=Abstract
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Four unusual reactions to amitriptyline. Author(s): Brown DD. Source: The Practitioner. 1968 February; 200(196): 288-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5636695&dopt=Abstract
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Gabapentin or amitriptyline for painful diabetic neuropathy? Author(s): Rawn T, Papoushek C, Evans MF. Source: Can Fam Physician. 2000 November; 46: 2215-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11143580&dopt=Abstract
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Gabapentin vs amitriptyline for the treatment of peripheral neuropathy. Author(s): Fudin J, Audette CM. Source: Archives of Internal Medicine. 2000 April 10; 160(7): 1040-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10761972&dopt=Abstract
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Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study. Author(s): Dallocchio C, Buffa C, Mazzarello P, Chiroli S. Source: Journal of Pain and Symptom Management. 2000 October; 20(4): 280-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11027910&dopt=Abstract
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Gas chromatographic determination of amitriptyline, nortriptyline and perphenazine in plasma of schizophrenic patients after administration of the combination of amitriptyline with perphenazine. Author(s): Cooper S, Albert JM, Dugal R, Bertrand M, Elie R. Source: Arzneimittel-Forschung. 1979; 29(1): 158-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=582110&dopt=Abstract
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Gas chromatographic--mass spectrometric determination of amitriptyline and its major metabolites in human serum. Author(s): Ishida R, Ozaki T, Uchida H, Irikura T. Source: Journal of Chromatography. 1984 January 13; 305(1): 73-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6707156&dopt=Abstract
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Gas liquid chromatographic determination of therapeutic and toxic levels of amitriptyline in human serum with a nitrogen-sensitive detector. Author(s): Vasiliades J, Bush KC. Source: Analytical Chemistry. 1976 October; 48(12): 1708-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=970631&dopt=Abstract
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Gas-chromatographic analysis for therapeutic concentrations of amitriptyline and nortriptyline in plasma, with use of a nitrogen detector. Author(s): Bailey DN, Jatlow PI. Source: Clinical Chemistry. 1976 June; 22(6): 777-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1277461&dopt=Abstract
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Gaze paresis in amitriptyline overdose. Author(s): Delaney P, Light R. Source: Annals of Neurology. 1981 May; 9(5): 513. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7271247&dopt=Abstract
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Genotoxicity evaluation of the tricyclic antidepressants amitriptyline and imipramine using human lymphocyte cultures. Author(s): Saxena R, Ahuja YR. Source: Environmental and Molecular Mutagenesis. 1988; 12(4): 421-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3191917&dopt=Abstract
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GLC method for quantitative determination of amitriptyline in human plasma. Author(s): Hucker HB, Stauffer SC. Source: Journal of Pharmaceutical Sciences. 1974 February; 63(2): 296-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4813260&dopt=Abstract
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Glucuronidation of amitriptyline in man in vivo. Author(s): Dahl-Puustinen ML, Aberg-Wistedt A, Bertilsson L. Source: Pharmacology & Toxicology. 1989 July; 65(1): 37-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2780506&dopt=Abstract
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Glutamic pyruvic acid transaminases during treatment with amitriptyline and imipramine. Author(s): Kramp JL. Source: Acta Psychiatrica Scandinavica. 1967; 43(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6059707&dopt=Abstract
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Growth hormone release after acute amitriptyline administration to normal human subjects. Author(s): Schulz P, Reaven GM, Blaschke TF. Source: Psychopharmacology. 1982; 76(3): 299-301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6808555&dopt=Abstract
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Heart rate analysis in 24 patients treated with 150 mg amitriptyline per day. Author(s): Rechlin T, Claus D, Weis M. Source: Psychopharmacology. 1994 September; 116(1): 110-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7862922&dopt=Abstract
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Heart rate variability in depressed patients and differential effects of paroxetine and amitriptyline on cardiovascular autonomic functions. Author(s): Rechlin T, Weis M, Claus D. Source: Pharmacopsychiatry. 1994 May; 27(3): 124-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8078953&dopt=Abstract
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Hemoperfusion in the treatment of amitriptyline intoxication. Author(s): Diaz-Buxo JA, Farmer CD, Chandler JT. Source: Trans Am Soc Artif Intern Organs. 1978; 24: 699-703. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=716083&dopt=Abstract
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Hepatitis caused by amitriptyline therapy. Author(s): Yon J, Anuras S. Source: Jama : the Journal of the American Medical Association. 1975 May 26; 232(8): 833-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1173187&dopt=Abstract
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High platelet-serotonin uptake activity is associated with a rapid response in depressed patients treated with amitriptyline. Author(s): Franke L, Schewe HJ, Uebelhack R, Muller-Oerlinghausen B. Source: Neuroscience Letters. 2003 July 17; 345(2): 105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821182&dopt=Abstract
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High-performance liquid chromatographic quantitation of amitriptyline and nortriptyline in dialysate from plasma or serum using on-line solid-phase extraction. Author(s): Svensson C, Nyberg G, Martensson E. Source: Journal of Chromatography. 1988 November 18; 432: 363-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3220906&dopt=Abstract
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High-pressure liquid chromatographic determination of amitriptyline and its major metabolites in human whole blood. Author(s): Smith GA, Schulz P, Giacomini KM, Blaschke TF. Source: Journal of Pharmaceutical Sciences. 1982 May; 71(5): 581-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7097507&dopt=Abstract
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Hydroxyzine, amitriptyline and their combination in the treatment of psychoneurotic patients. Author(s): Silver D, Beaubien J, Ban TA, Saxena BM, Bennett J. Source: Curr Ther Res Clin Exp. 1969 November; 11(11): 663-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4982300&dopt=Abstract
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Hypersensitivity syndrome caused by amitriptyline administration. Author(s): Milionis HJ, Skopelitou A, Elisaf MS. Source: Postgraduate Medical Journal. 2000 June; 76(896): 361-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10824052&dopt=Abstract
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Hypertension during coprescription of mirtazapine and low-dose amitriptyline. Author(s): Zedkova L, Coupland NJ. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1998 October; 43(8): 858-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9806099&dopt=Abstract
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Hypertensive crisis in a patient given sinemet, metoclopramide, and amitriptyline. Author(s): Rampton DS. Source: British Medical Journal. 1977 September 3; 2(6087): 607-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=901999&dopt=Abstract
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Hypnagogic and hypnopompic hallucinations during amitriptyline treatment. Author(s): Hemmingsen R, Rafaelsen OJ. Source: Acta Psychiatrica Scandinavica. 1980 October; 62(4): 364-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7468295&dopt=Abstract
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Hypnotic properties of amitriptyline: comparison with secobarbital. Author(s): Urbach KF. Source: Anesthesia and Analgesia. 1967 November-December; 46(6): 835-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6070176&dopt=Abstract
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Hypochondriacal fears and beliefs in DSM-III melancholia. Changes with amitriptyline. Author(s): Kellner R, Fava GA, Lisansky J, Perini GI, Zielezny M. Source: Journal of Affective Disorders. 1986 January-February; 10(1): 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2939120&dopt=Abstract
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Hypomania in an AIDS patient receiving amitriptyline for neuropathic pain. Author(s): Holmes VF, Fricchione GL. Source: Neurology. 1989 February; 39(2 Pt 1): 305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2464776&dopt=Abstract
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Hypomanic reaction to amitriptyline in a depressed child. Author(s): Kashani JH, Hodges KK, Shekim WO. Source: Psychosomatics. 1980 October; 21(10): 867, 872. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7443959&dopt=Abstract
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Identifying delirious states and autonomic cardiovascular dysfunction associated with amitriptyline treatment by standardized analysis of heart rate. Author(s): Rechlin T, Weis M, Claus D, Kaschka WP. Source: Psychiatry Research. 1995 April 28; 56(3): 279-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7568550&dopt=Abstract
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Identifying the specific clinical actions of amitriptyline: interrelationships of behaviour, affect and plasma levels in depression. Author(s): Katz MM, Koslow SH, Maas JW, Frazer A, Kocsis J, Secunda S, Bowden CL, Casper RC. Source: Psychological Medicine. 1991 August; 21(3): 599-611. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1946849&dopt=Abstract
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Imipramine and amitriptyline in hyperactive children. Author(s): Mills IH. Source: Qjm : Monthly Journal of the Association of Physicians. 1996 April; 89(4): 321-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8733521&dopt=Abstract
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Imipramine and amitriptyline plasma concentrations and clinical response in major depression. Author(s): Kocsis JH, Hanin I, Bowden C, Brunswick D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1986 January; 148: 52-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3513884&dopt=Abstract
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Immunoassay reagents for psychoactive drugs. Part 4. Quantitative determination of amitriptyline and nortriptyline by fluorescence polarization immunoassay. Author(s): Adamczyk M, Fishpaugh JR, Harrington CA, Hartter DE, Vanderbilt AS, Orsulak P, Akers L. Source: Therapeutic Drug Monitoring. 1994 June; 16(3): 298-311. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8085284&dopt=Abstract
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Importance of evaporation conditions and two internal standards for quantitation of amitriptyline and nortriptyline. Author(s): Sonsalla PK, Jennison TA, Finkle BS. Source: Clinical Chemistry. 1982 June; 28(6): 1401-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7074956&dopt=Abstract
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Improvements in pain responsiveness in patients with fibrositis after successful treatment with amitriptyline. Author(s): Scudds RA, McCain GA, Rollman GB, Harth M. Source: J Rheumatol Suppl. 1989 November; 19: 98-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2481743&dopt=Abstract
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Inappropriate antidiuresis during amitriptyline therapy. Author(s): Solammadevi SV. Source: Southern Medical Journal. 1981 June; 74(6): 775-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7244770&dopt=Abstract
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Increase of alpha 1-acid glycoprotein after treatment with amitriptyline. Author(s): Baumann P, Tinguely D, Schopf J. Source: British Journal of Clinical Pharmacology. 1982 July; 14(1): 102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7104160&dopt=Abstract
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Individual variations in response of human REM sleep to amitriptyline and haloperidol. Author(s): Nakazawa Y, Kotorii M, Kotorii T, Ohshima M, Hasuzawa H. Source: Electroencephalography and Clinical Neurophysiology. 1977 June; 42(6): 769-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=67928&dopt=Abstract
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Influence of imipramine and amitriptyline on the hypothalamic function in affective disorders. Author(s): Horodnicki JM, Szakowski A, Wdowiak J. Source: Act Nerv Super (Praha). 1989 April; 31(1): 27-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2781995&dopt=Abstract
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Influence of single doses of dothiepin and amitriptyline on physiological measures and psychomotor performance in normal young and elderly volunteers. Author(s): Ogura C, Kishimoto A, Mizukawa R, Kunimoto N, Hazama H, Ryoke K, Takeda A, Honma H, Kawahara K. Source: Neuropsychobiology. 1983; 10(2-3): 103-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6674817&dopt=Abstract
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Inhibition of ejaculation by amitriptyline. Author(s): Nininger JE. Source: The American Journal of Psychiatry. 1978 June; 135(6): 750-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=655290&dopt=Abstract
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Inhibition of platelet uptake of serotonin in plasma from patients treated with clomipramine and amitriptyline. Author(s): Lingjaerde O. Source: European Journal of Clinical Pharmacology. 1979 June 12; 15(5): 335-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=456405&dopt=Abstract
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Inhibition of the current of heterologously expressed HERG potassium channels by imipramine and amitriptyline. Author(s): Teschemacher AG, Seward EP, Hancox JC, Witchel HJ. Source: British Journal of Pharmacology. 1999 September; 128(2): 479-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510461&dopt=Abstract
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Inotropic effect of prenalterol in amitriptyline poisoning. Author(s): Heath A, Marin P, Sjostrand I. Source: Intensive Care Medicine. 1984; 10(4): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6147367&dopt=Abstract
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In-patient major depression: is rolipram as effective as amitriptyline? Author(s): Scott AI, Perini AF, Shering PA, Whalley LJ. Source: European Journal of Clinical Pharmacology. 1991; 40(2): 127-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2065693&dopt=Abstract
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Insidious and prolonged antagonism of guanethidine by amitriptyline. Author(s): Meyer JF, McAllister CK, Goldberg LI. Source: Jama : the Journal of the American Medical Association. 1970 August 31; 213(9): 1487-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5468457&dopt=Abstract
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Interaction between amitriptyline and phenothiazine in man: effect on plasma concentration of amitriptyline and its metabolite nortriptyline and the correlation with clinical response. Author(s): Vandel B, Vandel S, Allers G, Bechtel P, Volmat R. Source: Psychopharmacology. 1979 October; 65(2): 187-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=42101&dopt=Abstract
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Interaction between the beta-adrenoceptor blockers metoprolol and atenolol with amitriptyline and their effects on oxidative liver metabolism. Author(s): Kirch W, Spahn H, Kitteringham NR, Hutt HJ, Mutschler E, Ohnhaus EE. Source: British Journal of Clinical Pharmacology. 1984; 17 Suppl 1: 65S-68S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6743476&dopt=Abstract
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Interaction of desipramine and amitriptyline with adrenergic mechanisms in the human iris in vivo. Author(s): Szabadi E, Gaszner P, Bradshaw CM. Source: European Journal of Clinical Pharmacology. 1981; 19(6): 403-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6265223&dopt=Abstract
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Interactions of alcohol with amitriptyline, fluoxetine and placebo in normal subjects. Author(s): Allen D, Lader M. Source: International Clinical Psychopharmacology. 1989 January; 4 Suppl 1: 7-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2783702&dopt=Abstract
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Interindividual differences in amitriptyline demethylation. Author(s): Rollins DE, Alvan G, Bertilsson L, Gillette JR, Mellstrom B, Sjoqvist F, Traskman L. Source: Clinical Pharmacology and Therapeutics. 1980 July; 28(1): 121-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7389249&dopt=Abstract
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Interindividual variations of desmethylation and hydroxylation of amitriptyline in a Japanese psychiatric population. Author(s): Shimoda K, Noguchi T, Morita S, Ozeki Y, Shibasaki M, Someya T, Takahashi S. Source: Journal of Clinical Psychopharmacology. 1995 June; 15(3): 175-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7635994&dopt=Abstract
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Interpretation of blood and tissue concentrations in fatal self-ingested overdose involving amitriptyline: an update (1978-1979). Author(s): Bailey DN, Shaw RF. Source: Journal of Analytical Toxicology. 1980 September-October; 4(5): 232-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7442135&dopt=Abstract
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Intractable hiccups treated with amitriptyline. Author(s): Peabody CA, Dewitt J, Herrin S, Woodward-Smith MA, Warren MD. Source: The American Journal of Psychiatry. 1988 August; 145(8): 1036-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3394859&dopt=Abstract
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Intrahepatic obstructive jaundice from amitriptyline. Author(s): Biagi RW, Bapat BN. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1967 October; 113(503): 1113-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6057380&dopt=Abstract
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Intraindividual similarity in the metabolism of amitriptyline and chlorimipramine in depressed patients. Author(s): Mellstrom B, Bertilsson L, Traskman L, Rollins D, Asberg M, Sjoqvist F. Source: Pharmacology. 1979; 19(5): 282-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=538083&dopt=Abstract
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Intravenous amitriptyline in pediatrics. Author(s): Collins JJ, Kerner J, Sentivany S, Berde CB. Source: Journal of Pain and Symptom Management. 1995 August; 10(6): 471-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7561230&dopt=Abstract
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Intravenous versus oral administration of amitriptyline in patients with major depression. Author(s): Deisenhammer EA, Whitworth AB, Geretsegger C, Kurzthaler I, Gritsch S, Miller CH, Fleischhacker WW, Stuppack CH. Source: Journal of Clinical Psychopharmacology. 2000 August; 20(4): 417-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10917402&dopt=Abstract
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Ion-pair liquid chromatography of amitriptyline and metabolites in plasma. Author(s): Mellstrom B, Braithwaite R. Source: Journal of Chromatography. 1978 September 21; 157: 379-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=701446&dopt=Abstract
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Is amitriptyline + perphenazine superior to doxepin? Author(s): Dilsaver SC, Domino L. Source: The Journal of Clinical Psychiatry. 1983 May; 44(5): 195. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6853455&dopt=Abstract
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Is anxious-agitated major depression responsive to fluoxetine? A double-blind comparison with amitriptyline. Author(s): Marchesi C, Ceccherininelli A, Rossi A, Maggini C. Source: Pharmacopsychiatry. 1998 November; 31(6): 216-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9930635&dopt=Abstract
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Jaundice and eosinophilia associated with amitriptyline. Author(s): Anderson BN, Henrikson IR. Source: The Journal of Clinical Psychiatry. 1978 September; 39(9): 730-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=690091&dopt=Abstract
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Jaundice associated with amitriptyline. Author(s): Morgan DH. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1969 January; 115(518): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5781951&dopt=Abstract
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Jejunal ulceration and stricture due to wax-matrix potassium chloride tablets and amitriptyline. Author(s): Bronson DL, Gamelli RL. Source: Journal of Clinical Pharmacology. 1987 October; 27(10): 788-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3429685&dopt=Abstract
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Kleptomanic behavior response to perphenazine-amitriptyline HCL combination. Author(s): Fishbain DA. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1988 April; 33(3): 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3383099&dopt=Abstract
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Lack of correlation between plasma levels of amitriptyline (and nortriptyline) and clinical improvement of chronic pain of peripheral neurologic origin. Author(s): Rascol O, Tran MA, Bonnevialle P, Belin J, Cotonat J, Guiraud-Chaumeil B, Montastruc JL. Source: Clinical Neuropharmacology. 1987 December; 10(6): 560-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3427563&dopt=Abstract
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Lack of effect of amitriptyline on risperidone pharmacokinetics in schizophrenic patients. Author(s): Sommers DK, Snyman JR, van Wyk M, Blom MW, Huang ML, Levron JC. Source: International Clinical Psychopharmacology. 1997 May; 12(3): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9248870&dopt=Abstract
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Lack of interaction of ranitidine with amitriptyline. Author(s): Curry SH, DeVane CL, Wolfe MM. Source: European Journal of Clinical Pharmacology. 1987; 32(3): 317-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3595705&dopt=Abstract
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Lactation and ovarian cyst formation following treatment with amitriptyline. Author(s): Rees WD. Source: The Practitioner. 1967 June; 198(188): 835-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6068952&dopt=Abstract
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Letter: Amitriptyline and imipramine poisoning in children. Author(s): Carpenter DC, Beaubien AR, Mathieu LF, Hrdina PD. Source: British Medical Journal. 1975 March 1; 1(5956): 516-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1125614&dopt=Abstract
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Letter: Amitriptyline and imipramine poisoning in children. Author(s): Asbach HW, Schuler HW. Source: British Medical Journal. 1974 August 24; 3(5929): 524. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4414110&dopt=Abstract
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Letter: Amitriptyline and imipramine poisoning in children. Author(s): Matthew H. Source: British Medical Journal. 1974 June 29; 2(921): 726. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852686&dopt=Abstract
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Letter: Amitriptyline and imipramine poisoning in children. Author(s): Postlethwaite RJ, Price DA. Source: British Medical Journal. 1974 June 1; 2(917): 504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4834118&dopt=Abstract
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Letter: Amitriptyline and imipramine poisoning in children. Author(s): Asbach HW, Schuler HW. Source: British Medical Journal. 1974 May 18; 2(915): 386-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4835854&dopt=Abstract
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Letter: Amitriptyline and isoproterenol: fatal drug combination. Author(s): Kadar D. Source: Can Med Assoc J. 1975 March 8; 112(5): 556-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1116081&dopt=Abstract
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Letter: Amitriptyline in enuresis. Author(s): Healy JB. Source: Ir Med J. 1974 August 31; 67(16): 449-50. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4419822&dopt=Abstract
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Letter: Amitriptyline poisoning in childhood. Author(s): Chambers T, Kindley AD. Source: British Medical Journal. 1974 September 14; 3(5932): 687. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4425804&dopt=Abstract
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Letter: Amitriptyline therapy in anorexia nervosa. Author(s): Mills IH. Source: Lancet. 1976 September 25; 02(7987): 687. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=60543&dopt=Abstract
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Letter: Amitriptyline therapy in patients with anorexia nervosa. Author(s): Needleman HL, Waber D. Source: Lancet. 1976 September 11; 2(7985): 580. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=60661&dopt=Abstract
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Letter: Antiasthmatic effect of amitriptyline. Author(s): Wilson RC. Source: Can Med Assoc J. 1974 August 3; 111(3): 212. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4852695&dopt=Abstract
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Letter: Antiasthmatic effect of amitriptyline. Author(s): Ananth J. Source: Can Med Assoc J. 1974 May 18; 110(10): 1131 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4829836&dopt=Abstract
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Letter: Neostigmine methysulfate in the treatment of cardiac arryhthmia induced by perphenazine-amitriptyline. Author(s): Raymond CW. Source: Can Med Assoc J. 1976 January 24; 114(2): 102-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1253038&dopt=Abstract
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Letter: Psychosis in Down's syndrome treated with amitriptyline. Author(s): Keegan DL, Pettigrew A, Parker Z. Source: Can Med Assoc J. 1974 May 18; 110(10): 1128 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4275305&dopt=Abstract
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Letter: Reaction to amitriptyline. Author(s): Ferguson KR. Source: Can Med Assoc J. 1974 November 16; 111(10): 1054. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4429931&dopt=Abstract
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Limbitrol (amitriptyline plus chlordiazepoxide) revisited. Author(s): Rickels K. Source: Psychopharmacology. 1981; 75(1): 31-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6795655&dopt=Abstract
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Liquid chromatography of amitriptyline and related tricyclic compounds. Author(s): Preskorn SH, Leonard K, Hignite C. Source: Journal of Chromatography. 1980 September 19; 197(2): 246-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7451597&dopt=Abstract
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Lithium + L-tryptophan compared with amitriptyline in endogenous depression. Author(s): Honore P, Moller SE, Jorgensen A. Source: Journal of Affective Disorders. 1982 March; 4(1): 79-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6461690&dopt=Abstract
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Longitudinal effect of amitriptyline and fluoxetine treatment on plasma phenylacetic acid concentrations in depression. Author(s): Davis BA, Boulton AA, Yu PH, Durden DA, Keegan DL, Bowen RC, Blackshaw S, D'Arcy C, Remillard AJ, Dayal N, et al. Source: Biological Psychiatry. 1991 September 15; 30(6): 600-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1932407&dopt=Abstract
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Long-term amitriptyline in chronic depression. Author(s): Giller E Jr, Bialos D, Harkness L, Jatlow P, Waldo M. Source: Hillside J Clin Psychiatry. 1985; 7(1): 16-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3894196&dopt=Abstract
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Long-term treatment of alcoholism with amitriptyline and emylcamate. A doubleblind evaluation. Author(s): Charnoff SM. Source: Q J Stud Alcohol. 1967 June; 28(2): 289-94. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4860508&dopt=Abstract
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Long-term versus short-term amitriptyline side effects as measured by a postmarketing surveillance system. Author(s): Bryant SG, Fisher S, Kluge RM. Source: Journal of Clinical Psychopharmacology. 1987 April; 7(2): 78-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3584525&dopt=Abstract
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Lorazepam, amitriptyline, and sulpiride: withdrawal effects. Author(s): Benazzi F. Source: Biological Psychiatry. 1991 September 1; 30(5): 528-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1932402&dopt=Abstract
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Low dose amitriptyline in ankylosing spondylitis: a short term, double blind, placebo controlled study. Author(s): Koh WH, Pande I, Samuels A, Jones SD, Calin A. Source: The Journal of Rheumatology. 1997 November; 24(11): 2158-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9375877&dopt=Abstract
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Low dose amitriptyline in chronic pain: the gain is modest. Author(s): Zitman FG, Linssen AC, Edelbroek PM, Stijnen T. Source: Pain. 1990 July; 42(1): 35-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2234996&dopt=Abstract
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Low dose amitriptyline in the treatment of chronic pain. Author(s): McQuay HJ, Carroll D, Glynn CJ. Source: Anaesthesia. 1992 August; 47(8): 646-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1519713&dopt=Abstract
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Low serum levels of tricyclic antidepressants in amitriptyline- and doxepin-treated inpatients with depressive syndromes are associated with nonresponse. Author(s): Rao ML, Deister A, Laux G, Staberock U, Hoflich G, Moller HJ. Source: Pharmacopsychiatry. 1996 May; 29(3): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8738313&dopt=Abstract
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Low-dose amitriptyline as an adjunct to opioids for postoperative orthopedic pain: a placebo-controlled trial. Author(s): Kerrick JM, Fine PG, Lipman AG, Love G. Source: Pain. 1993 March; 52(3): 325-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8460050&dopt=Abstract
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Magnesium sulphate in the treatment of ventricular fibrillation in amitriptyline poisoning. Author(s): Knudsen K, Abrahamsson J. Source: European Heart Journal. 1997 May; 18(5): 881-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152662&dopt=Abstract
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Maintenance therapy with amitriptyline: a controlled trial. Author(s): Stein MK, Rickels K, Weise CC. Source: The American Journal of Psychiatry. 1980 March; 137(3): 370-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6986799&dopt=Abstract
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Malignant hypertension associated with use of amitriptyline hydrochloride. Author(s): Dunn FG. Source: Southern Medical Journal. 1982 September; 75(9): 1124-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7123337&dopt=Abstract
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MAO inhibition and control of anxiety following amitriptyline therapy. A pilot study. Author(s): Davidson J, Linnoila M, Raft D, Turnbull CD. Source: Acta Psychiatrica Scandinavica. 1981 February; 63(2): 147-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7234472&dopt=Abstract
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Maprotiline and amitriptyline in the treatment of depressive illness. A double-blind comparison. Author(s): Levin A. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1974 January 12; 48(2): 47-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4595136&dopt=Abstract
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Medicines evaluation and monitoring group. A follow-up study of cardiac patients receiving amitriptyline. Author(s): Moir DC, Dingwall-Fordyce I, Weir RD. Source: European Journal of Clinical Pharmacology. 1973 August; 6(2): 98-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4588855&dopt=Abstract
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Meta-analysis of randomized, double-blind, placebo-controlled, efficacy and safety studies of mirtazapine versus amitriptyline in major depression. Author(s): Stahl S, Zivkov M, Reimitz PE, Panagides J, Hoff W. Source: Acta Psychiatrica Scandinavica. Supplementum. 1997; 391: 22-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9265948&dopt=Abstract
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Metabolic interaction between amitriptyline and perphenazine in psychiatric patients. Author(s): Cooper SF, Dugal R, Elie R, Albert JM. Source: Prog Neuropsychopharmacol. 1979; 3(4): 369-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=400992&dopt=Abstract
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Metabolism of amitriptyline in patients with chronic renal failure. Author(s): Sandoz M, Vandel S, Vandel B, Bonin B, Hory B, St Hillier Y, Volmat R. Source: European Journal of Clinical Pharmacology. 1984; 26(2): 227-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6723762&dopt=Abstract
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Metabolism of amitriptyline with CYP2D6 expressed in a human cell line. Author(s): Coutts RT, Bach MV, Baker GB. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 1997 January; 27(1): 33-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9041677&dopt=Abstract
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Metabolism of the tricyclic antidepressant amitriptyline by cDNA-expressed human cytochrome P450 enzymes. Author(s): Olesen OV, Linnet K. Source: Pharmacology. 1997 November; 55(5): 235-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9399333&dopt=Abstract
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Methadone maintenance and amitriptyline. Author(s): Cantor R. Source: Jama : the Journal of the American Medical Association. 1979 June 1; 241(22): 2378. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=439310&dopt=Abstract
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MHPG, amitriptyline and affective disorders. A longitudinal study. Author(s): Sacchetti E, Smeraldi E, Cagnasso M, Biondi PA, Bellodi L. Source: Int Pharmacopsychiatry. 1976; 11(3): 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=992956&dopt=Abstract
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Mianserin and maprotiline as compared to amitriptyline in severe endogenous depression. A new methodological approach to the clinical evaluation of the efficacy of antidepressants. Author(s): Cording-Tommel C, von Zerssen D. Source: Pharmacopsychiatria. 1982 November; 15(6): 197-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7156183&dopt=Abstract
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Mianserin in the treatment of depressive illness: a comparison with amitriptyline. Author(s): Daly RJ, Browne PJ, Morgan E. Source: Ir J Med Sci. 1979 April; 148(4): 145-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=393652&dopt=Abstract
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Mianserin versus amitriptyline for depression: a double-blind 6-week trial. Author(s): Rabkin JG, McGrath PJ, Quitkin FM, Fyer A, Stewart JW, Liebowitz MR, Markowitz J. Source: Neuropsychobiology. 1984; 12(4): 224-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6398862&dopt=Abstract
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Mianserin versus amitriptyline. A double-blind-trial evaluated by the AMP system. Author(s): Vogel HP, Bente D, Feder J, Helmchen H, Muller-Oerlinghausen B, Bohacek N, Mihovilovic M, Brandli A, Fleischhauer J, Walcher W. Source: Int Pharmacopsychiatry. 1976; 11(1): 25-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=770364&dopt=Abstract
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Mianserin, danitracen and amitriptyline withdrawal increases the behavioural responses of rats to L-5-HTP. Author(s): Mogilnicka E, Klimek V. Source: The Journal of Pharmacy and Pharmacology. 1979 October; 31(10): 704-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=41046&dopt=Abstract
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Microsomal binding of amitriptyline: effect on estimation of enzyme kinetic parameters in vitro. Author(s): Venkatakrishnan K, von Moltke LL, Obach RS, Greenblatt DJ. Source: The Journal of Pharmacology and Experimental Therapeutics. 2000 May; 293(2): 343-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10773001&dopt=Abstract
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Migraine and depression: effect of amitriptyline prophylaxis. Author(s): Couch JR, Hassanein RS. Source: Trans Am Neurol Assoc. 1976; 101: 234-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=800690&dopt=Abstract
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Migraine prophylaxis. A comparison of propranolol and amitriptyline. Author(s): Ziegler DK, Hurwitz A, Hassanein RS, Kodanaz HA, Preskorn SH, Mason J. Source: Archives of Neurology. 1987 May; 44(5): 486-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3579659&dopt=Abstract
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Minaprine in depression. A controlled trial with amitriptyline. Author(s): Wheatley D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 July; 161: 113-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1638306&dopt=Abstract
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Minor and clinically non-significant interaction between toloxatone and amitriptyline. Author(s): Vandel S, Bertschy G, Perault MC, Sandoz M, Bouquet S, Chakroun R, Guibert S, Vandel B. Source: European Journal of Clinical Pharmacology. 1993; 44(1): 97-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8436164&dopt=Abstract
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Mirtazapine in combination with amitriptyline: a drug-drug interaction study in healthy subjects. Author(s): Sennef C, Timmer CJ, Sitsen JM. Source: Human Psychopharmacology. 2003 March; 18(2): 91-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590402&dopt=Abstract
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Mirtazapine versus amitriptyline in the long-term treatment of depression: a doubleblind placebo-controlled study. Author(s): Montgomery SA, Reimitz PE, Zivkov M. Source: International Clinical Psychopharmacology. 1998 March; 13(2): 63-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9669186&dopt=Abstract
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Mirtazapine vs. amitriptyline vs. placebo in the treatment of major depressive disorder. Author(s): Smith WT, Glaudin V, Panagides J, Gilvary E. Source: Psychopharmacology Bulletin. 1990; 26(2): 191-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2236455&dopt=Abstract
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Mirtazepine: heir apparent to amitriptyline? Author(s): Davis MP, Dickerson ED, Pappagallo M, Benedetti C, Grauer PA, Lycan J. Source: Am J Hosp Palliat Care. 2001 January-February; 18(1): 42-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11406877&dopt=Abstract
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Moclobemide versus amitriptyline in the treatment of depression: two small doubleblind multicentre studies in Belgium. Author(s): Beckers G, Vereecken A, de Bleeker E, Jaunes C, Sieben G, Faidherbe J, Wolfrum C, Berger M, Hellstern K, Ward J. Source: Acta Psychiatrica Scandinavica. Supplementum. 1990; 360: 52-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2248072&dopt=Abstract
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Modified oral anticoagulant potency in an amitriptyline-treated patient? Author(s): Hampel H, Berger C, Muller-Spahn F. Source: Acta Haematologica. 1996; 96(3): 178-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876616&dopt=Abstract
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Monoamine metabolites in cerebrospinal fluid of depressed patients during treatment with mianserin or amitriptyline. Author(s): Mendlewicz J, Pinder RM, Stulemeijer SM, Van Dorth R. Source: Journal of Affective Disorders. 1982 September; 4(3): 219-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6182175&dopt=Abstract
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Multicenter double blind study of paroxetine and amitriptyline in elderly depressed inpatients. Author(s): Geretsegger C, Stuppaeck CH, Mair M, Platz T, Fartacek R, Heim M. Source: Psychopharmacology. 1995 June; 119(3): 277-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7675961&dopt=Abstract
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Multifocal neurological impairment caused by infection-induced rise in blood lithium and amitriptyline. Author(s): Pheterson AD, Miller L, Fox CF, Estroff TW, Sweeney DR. Source: International Journal of Psychiatry in Medicine. 1986-87; 16(3): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3542870&dopt=Abstract
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Multiple-dose pharmacokinetics and pharmacodynamics of OROS and immediaterelease amitriptyline hydrochloride formulations. Author(s): Gupta SK, Shah J, Guinta D, Hwang S. Source: Journal of Clinical Pharmacology. 1998 January; 38(1): 60-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9597561&dopt=Abstract
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Muscle contraction headache: dexamethasone suppression test and response to amitriptyline. Author(s): Tuchman AJ, Daras M. Source: European Neurology. 1989; 29(5): 291-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2792151&dopt=Abstract
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Myocardial damage in amitriptyline and nortriptyline poisoning. Author(s): Brackenridge RG, Peters TJ, Watson JM. Source: Scott Med J. 1968 June; 13(6): 208-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5655277&dopt=Abstract
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Myocardial infarction: a complication of amitriptyline overdose. Author(s): Chamsi-Pasha H, Barnes PC. Source: Postgraduate Medical Journal. 1988 December; 64(758): 968-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3256820&dopt=Abstract
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Myotonic dystrophy: quantification of muscle weakness and myotonia and the effect of amitriptyline and exercise. Author(s): Milner-Brown HS, Miller RG. Source: Archives of Physical Medicine and Rehabilitation. 1990 November; 71(12): 983-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2241546&dopt=Abstract
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Naturalistic study of the weight effects of amitriptyline, fluoxetine, and sertraline in an outpatient medical setting. Author(s): Sansone RA, Wiederman MW, Shrader JA. Source: Journal of Clinical Psychopharmacology. 2000 April; 20(2): 272-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770474&dopt=Abstract
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N-demethylation of amitriptyline in vitro: role of cytochrome P-450 3A (CYP3A) isoforms and effect of metabolic inhibitors. Author(s): Schmider J, Greenblatt DJ, von Moltke LL, Harmatz JS, Shader RI. Source: The Journal of Pharmacology and Experimental Therapeutics. 1995 November; 275(2): 592-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7473143&dopt=Abstract
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Near fatal case of atrio-ventricular block induced by amitriptyline at therapeutic dose. Author(s): Lappa A, Castagna A, Imperiale C, Fenga M. Source: Intensive Care Medicine. 2000 September; 26(9): 1399. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11089775&dopt=Abstract
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Nefazodone in psychotic unipolar and bipolar depression: a retrospective chart analysis and open prospective study on its efficacy and safety versus combined treatment with amitriptyline and haloperidol. Author(s): Grunze H, Marcuse A, Scharer LO, Born C, Walden J. Source: Neuropsychobiology. 2002; 46 Suppl 1: 31-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571431&dopt=Abstract
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Neuroleptic malignant syndrome, amitriptyline, and thioridazine. Author(s): Corrigan FM, Coulter F. Source: Biological Psychiatry. 1988 February 1; 23(3): 320-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3337866&dopt=Abstract
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Neuropathy associated with amitriptyline. Bilateral footdrop. Author(s): Casarino JP. Source: N Y State J Med. 1977 November; 77(13): 2124-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=270634&dopt=Abstract
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No interaction of diazepam on amitriptyline disposition in depressed patients. Author(s): Otani K, Nordin C, Bertilsson L. Source: Therapeutic Drug Monitoring. 1987; 9(1): 120-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3576658&dopt=Abstract
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Nomifensine and amitriptyline in the treatment of depression. A multi-centre doubleblind comparison. Author(s): Wistedt B, Agren H, Bjaring B, Kallstrom B, Lund M, Mansby J, Peterson LE, Roos BE. Source: Acta Psychiatrica Scandinavica. 1983 September; 68(3): 212-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6356793&dopt=Abstract
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Noradrenaline, depressive illness, and the action of amitriptyline. Author(s): Ghose K, Coppen A. Source: Psychopharmacology. 1977 August 31; 54(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=410061&dopt=Abstract
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Noradrenergic output and clinical response in depressed women during amitriptyline therapy. Author(s): Corona GL, Cucchi ML, Frattini P, Santagostino G, Schinelli S, Comincioli V, Zerbi F, Fenoglio L, Savoldi F. Source: Pharmacopsychiatry. 1989 July; 22(4): 144-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2762377&dopt=Abstract
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Nortriptyline formation after single oral and intramuscular doses of amitriptyline. Author(s): Mellstrom B, Alvan G, Bertilsson L, Potter WZ, Sawe J, Sjoqvist F. Source: Clinical Pharmacology and Therapeutics. 1982 November; 32(5): 664-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7128008&dopt=Abstract
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Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial. Author(s): Watson CP, Vernich L, Chipman M, Reed K. Source: Neurology. 1998 October; 51(4): 1166-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9781549&dopt=Abstract
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Noxiptilin (Agedal)--a new tricyclic antidepressant with a faster onset of action? A double-blind, multicentre comparison with amitriptyline. Author(s): Lingjaerde O, Asker T, Bugge A, Engstrand E, Eide A, Grinaker H, Herlofsen H, Ose E, Ofsti E. Source: Pharmakopsychiatr Neuropsychopharmakol. 1975 January; 8(1): 26-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=788000&dopt=Abstract
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Oculomotor signs in amitriptyline induced coma. Author(s): Sandyk R. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1983 April 23; 63(17): 636-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6845065&dopt=Abstract
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Olfactory facial hyperhydrosis responding to amitriptyline. Author(s): Eedy DJ, Corbett JR. Source: Clinical and Experimental Dermatology. 1987 July; 12(4): 298-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3427819&dopt=Abstract
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On the clinical response/serum level relationship for antidepressants I: Amitriptyline. Author(s): Dutt JE. Source: Psychopharmacology Bulletin. 1981 April; 17(2): 42-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7244061&dopt=Abstract
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On the relationship between free plasma and saliva amitriptyline and nortriptyline. Author(s): Baumann P, Tinguely D, Koeb L, Schopf J, Le PK. Source: Int Pharmacopsychiatry. 1982; 17(3): 136-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7141811&dopt=Abstract
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On the relationship of nortriptyline: amitriptyline ratio to clinical improvement of amitriptyline treated depressive patients. Author(s): Jungkunz G, Kuss HJ. Source: Pharmakopsychiatr Neuropsychopharmakol. 1980 May; 13(3): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7393997&dopt=Abstract
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Once-daily treatment for mixed anxiety/depressive states: a comparison of slow release amitriptyline and fluphenazine with nortriptyline. Author(s): Magnus RV, Schiff AA. Source: J Int Med Res. 1977; 5(2): 109-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=873028&dopt=Abstract
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On-line solid-phase extraction and high-performance liquid chromatographic determination of nortriptyline and amitriptyline in serum. Author(s): Dolezalova M. Source: Journal of Chromatography. 1992 September 2; 579(2): 291-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1429976&dopt=Abstract
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Open comparative randomised study of moclobemide versus amitriptyline in major depressive illness (DSM IIIR) in Nigeria. Author(s): Ononye F, Sijuola OA, Chukwuani CM, Mume OC, Makanjuola RO. Source: West Afr J Med. 2000 April-June; 19(2): 148-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11070752&dopt=Abstract
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Open study of low-dose amitriptyline in the treatment of patients with idiopathic fecal incontinence. Author(s): Santoro GA, Eitan BZ, Pryde A, Bartolo DC. Source: Diseases of the Colon and Rectum. 2000 December; 43(12): 1676-81; Discussion 1681-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156450&dopt=Abstract
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Opsoclonus with amitriptyline overdose. Author(s): Au WJ, Keltner JL. Source: Annals of Neurology. 1979 July; 6(1): 87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=507769&dopt=Abstract
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Organ levels of amitriptyline and nortriptyline in fatal amitriptyline poisoning. Author(s): Kristinsson J, Johannesson T, Bjarnason O, Geirsson G. Source: Acta Pharmacol Toxicol (Copenh). 1983 February; 52(2): 150-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6846023&dopt=Abstract
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Orthotopic liver transplantation resulting in amitriptyline toxicity in the recipient. Author(s): Brems JJ, Merenda GO, Hayek ME, Kane RE, Flynn MF, Kaminski DL. Source: Transplantation. 1989 July; 48(1): 159-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2665225&dopt=Abstract
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Out-patient cognitive-behavioural therapy with amitriptyline for chronic nonmalignant pain: a comparative study with 6-month follow-up. Author(s): Pilowsky I, Spence N, Rounsefell B, Forsten C, Soda J. Source: Pain. 1995 January; 60(1): 49-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7715941&dopt=Abstract
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Paradoxical effects of amitriptyline on borderline patients. Author(s): Soloff PH, George A, Nathan RS, Schulz PM, Perel JM. Source: The American Journal of Psychiatry. 1986 December; 143(12): 1603-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3538914&dopt=Abstract
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Parenteral pentazocine: effects on psychomotor skills and respiration, and interactions with amitriptyline. Author(s): Saarialho-Kere U, Mattila MJ, Seppala T. Source: European Journal of Clinical Pharmacology. 1988; 35(5): 483-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3069477&dopt=Abstract
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Paroxetine and amitriptyline augmentation of lithium in the treatment of major depression: a double-blind study. Author(s): Bauer M, Zaninelli R, Muller-Oerlinghausen B, Meister W. Source: Journal of Clinical Psychopharmacology. 1999 April; 19(2): 164-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10211918&dopt=Abstract
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Paroxetine and amitriptyline in the treatment of depression in general practice. Author(s): Christiansen PE, Behnke K, Black CH, Ohrstrom JK, Bork-Rasmussen H, Nilsson J. Source: Acta Psychiatrica Scandinavica. 1996 March; 93(3): 158-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8739658&dopt=Abstract
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Paroxetine in the treatment of depression--a randomized comparison with amitriptyline. Author(s): Laursen AL, Mikkelsen PL, Rasmussen S, le Fevre Honore P. Source: Acta Psychiatrica Scandinavica. 1985 March; 71(3): 249-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3157296&dopt=Abstract
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Paroxetine in the treatment of elderly depressed patients in general practice: a double-blind comparison with amitriptyline. Author(s): Hutchinson DR, Tong S, Moon CA, Vince M, Clarke A. Source: International Clinical Psychopharmacology. 1992 June; 6 Suppl 4: 43-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1431010&dopt=Abstract
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Paroxetine versus amitriptyline for treatment of depression associated with rheumatoid arthritis: a randomized, double blind, parallel group study. Author(s): Bird H, Broggini M. Source: The Journal of Rheumatology. 2000 December; 27(12): 2791-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11128665&dopt=Abstract
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Patterns of response to amitriptyline and haloperidol among borderline patients. Author(s): Soloff PH, George A, Nathan RS, Schulz P, Cornelius J. Source: Psychopharmacology Bulletin. 1988; 24(2): 264-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3212160&dopt=Abstract
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Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine. Author(s): Davis JL, Lewis SB, Gerich JE, Kaplan RA, Schultz TA, Wallin JD. Source: Jama : the Journal of the American Medical Association. 1977 November 21; 238(21): 2291-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=199754&dopt=Abstract
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Peripheral neuropathy in scleroderma successfully treated with amitriptyline. Author(s): Bondavalli P, Parodi A, Rebora A. Source: International Journal of Dermatology. 1997 March; 36(3): 234-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9159014&dopt=Abstract
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Perspectives in clinical psychopharmacology of amitriptyline and fluvoxamine. A double-blind study in depressed inpatients. Author(s): Gasperini M, Gatti F, Bellini L, Anniverno R, Smeraldi E. Source: Neuropsychobiology. 1992; 26(4): 186-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1299793&dopt=Abstract
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Pharmacokinetic and pharmacodynamic characterization of OROS and immediaterelease amitriptyline. Author(s): Gupta SK, Shah JC, Hwang SS. Source: British Journal of Clinical Pharmacology. 1999 July; 48(1): 71-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10383563&dopt=Abstract
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Pharmacokinetics and pharmacodynamics of amitriptyline in depression. Author(s): Coppen A, Ghose K, Jorgensen A. Source: Prog Neuropsychopharmacol. 1979; 3(1-3): 191-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=400982&dopt=Abstract
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Pharmacokinetics of amitriptyline and amitriptylinoxide after intravenous or oral administration in humans. Author(s): Filser JG, Kaumeier S, Brand T, Schanz H, Terlinden R, Muller WE. Source: Pharmacopsychiatry. 1988 November; 21(6): 381-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3244775&dopt=Abstract
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Pharmacokinetics of lofepramine and amitriptyline in elderly healthy subjects. Author(s): Ghose K, Spragg BP. Source: International Clinical Psychopharmacology. 1989 July; 4(3): 201-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2677125&dopt=Abstract
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Pharmacological treatment of severely depressed patients: a meta-analysis comparing efficacy of mirtazapine and amitriptyline. Author(s): Kasper S, Zivkov M, Roes KC, Pols AG. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 1997 May; 7(2): 115-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9169299&dopt=Abstract
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Phenytoin hypersensitivity syndrome with positive patch test. A possible crossreactivity with amitriptyline. Author(s): Galindo Bonilla PA, Romero Aguilera G, Feo Brito F, Gomez Torrijos E, Garcia Rodriguez R, Cortina de la Calle P, Encinas Barrios C. Source: J Investig Allergol Clin Immunol. 1998 May-June; 8(3): 186-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9684195&dopt=Abstract
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Photopatch test reaction to amitriptyline. Author(s): Sandra A, Srinivas CR, Deshpande SC. Source: Contact Dermatitis. 1998 October; 39(4): 208-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9817240&dopt=Abstract
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Photosensitivity and thrombocytopenia due to amitriptyline. Author(s): Taniguchi S, Hamada T. Source: American Journal of Hematology. 1996 September; 53(1): 49-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8813100&dopt=Abstract
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Pituitary-adrenal-system regulation and psychopathology during amitriptyline treatment in elderly depressed patients and normal comparison subjects. Author(s): Heuser IJ, Schweiger U, Gotthardt U, Schmider J, Lammers CH, Dettling M, Yassouridis A, Holsboer F. Source: The American Journal of Psychiatry. 1996 January; 153(1): 93-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8540599&dopt=Abstract
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Platelet 5-HT transport in depressed patients under double-blind treatment with paroxetine versus amitriptyline. Author(s): Schlake HP, Kuhs H, Rolf LH, Bosse T, Schuhknecht E, Rudolf GA, Brune GG. Source: Acta Psychiatrica Scandinavica. Supplementum. 1989; 350: 149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2530775&dopt=Abstract
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Platelet counts in depressed patients treated with amitriptyline or paroxetine. Author(s): Lederbogen F, Horer E, Hellweg R, Heuser I, Deuschle M. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2003 March; 18(2): 89-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711406&dopt=Abstract
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Platelet met-enkephalin immunoreactivity and 5-hydroxytryptamine concentrations in migraine patients: effects of 5-hydroxytryptophan, amitriptyline and chlorimipramine treatment. Author(s): Boiardi A, Picotti GB, Di Giulio AM, Bussone G, Galva MD, La Mantia L, Mantegazza P. Source: Cephalalgia : an International Journal of Headache. 1984 June; 4(2): 81-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6610476&dopt=Abstract
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Pooling two controlled comparisons of milnacipran (F2207) and amitriptyline in endogenous inpatients. A new approach in dose ranging studies. Author(s): von Frenckell R, Ansseau M, Serre C, Sutet P. Source: International Clinical Psychopharmacology. 1990 January; 5(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2185303&dopt=Abstract
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Postherpetic neuralgia. Treatment with amitriptyline is cheaper than with aciclovir. Author(s): Marshall T. Source: Bmj (Clinical Research Ed.). 2001 April 7; 322(7290): 860-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11290647&dopt=Abstract
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Postmortem amitriptyline pharmacokinetics in pigs after oral and intravenous routes of administration. Author(s): Hilberg T, Ripel A, Smith AJ, Slordal L, Morland J, Bjorneboe A. Source: J Forensic Sci. 1998 March; 43(2): 380-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9544547&dopt=Abstract
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Postmortem changes in blood amitriptyline concentration. Author(s): Pounder DJ, Owen V, Quigley C. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1994 September; 15(3): 224-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7825553&dopt=Abstract
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Predicting response to amitriptyline in posttraumatic stress disorder. Author(s): Davidson JR, Kudler HS, Saunders WB, Erickson L, Smith RD, Stein RM, Lipper S, Hammett EB, Mahorney SL, Cavenar JO Jr. Source: The American Journal of Psychiatry. 1993 July; 150(7): 1024-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8317571&dopt=Abstract
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Prediction of relapse with the TRH test and prophylactic amitriptyline in 39 patients with endogenous depression. Author(s): Krog-Meyer I, Kirkegaard C, Kijne B, Lumholtz B, Smith E, Lykke-Olesen L, Bjorum N. Source: The American Journal of Psychiatry. 1984 August; 141(8): 945-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6431834&dopt=Abstract
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Predictors of outcome in the treatment of chronic “psychogenic” pain with amitriptyline and brief psychotherapy. Author(s): Pilowsky I, Barrow G. Source: The Clinical Journal of Pain. 1992 December; 8(4): 358-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1493347&dopt=Abstract
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Predictors of therapeutic benefit from amitriptyline in mild depression: a general practice placebo-controlled trial. Author(s): Paykel ES, Hollyman JA, Freeling P, Sedgwick P. Source: Journal of Affective Disorders. 1988 January-February; 14(1): 83-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2963054&dopt=Abstract
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Pretreatment ECGs and the prescription of amitriptyline in an internal medicine clinic. Author(s): Sansone RA, Todd T, Meier BP. Source: Psychosomatics. 2002 May-June; 43(3): 250-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075047&dopt=Abstract
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Primary care treatment of depression in the elderly: a double-blind, multi-centre study of flupenthixol ('Fluanxol') and sustained-release amitriptyline. Author(s): Hostmaelingen HJ, Asskilt O, Austad SG, Fjellheim J, Hostmaelingen EA, Kristiansen PH, Olsen TI, Skotte T, Ofsti E. Source: Current Medical Research and Opinion. 1989; 11(9): 593-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2692973&dopt=Abstract
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Prolonged coma and loss of brainstem reflexes following amitriptyline overdose. Author(s): Roberge RJ, Krenzelok EP. Source: Vet Hum Toxicol. 2001 February; 43(1): 42-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11205078&dopt=Abstract
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Prolonged QT interval and torsades de pointes caused by the combination of fluconazole and amitriptyline. Author(s): Dorsey ST, Biblo LA. Source: The American Journal of Emergency Medicine. 2000 March; 18(2): 227-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10750939&dopt=Abstract
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Propranolol and amitriptyline in prophylaxis of migraine. Pharmacokinetic and therapeutic effects. Author(s): Ziegler DK, Hurwitz A, Preskorn S, Hassanein R, Seim J. Source: Archives of Neurology. 1993 August; 50(8): 825-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8352668&dopt=Abstract
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Psychiatric presentation of hyponatremia associated with the use of amitriptyline--a report of two cases. Author(s): Henkin Y, Kaplan Z, Alkan M. Source: Isr J Med Sci. 1989 October; 25(10): 587-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2807860&dopt=Abstract
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Psychomotor performance of patients with rheumatoid arthritis: cross-over comparison of dextropropoxyphene, dextropropoxyphene plus amitriptyline, indomethacin, and placebo. Author(s): Saarialho-Kere U, Julkunen H, Mattila MJ, Seppala T. Source: Pharmacology & Toxicology. 1988 October; 63(4): 286-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3057482&dopt=Abstract
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Psychomotor skills during acute and two-week treatment with mianserin (ORG GB 94) and amitriptyline, and their combined effects with alcohol. Author(s): Seppala T. Source: Ann Clin Res. 1977 April; 9(2): 66-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=329743&dopt=Abstract
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Psychomotor, respiratory and neuroendocrinological effects of buprenorphine and amitriptyline in healthy volunteers. Author(s): Saarialho-Kere U, Mattila MJ, Paloheimo M, Seppala T. Source: European Journal of Clinical Pharmacology. 1987; 33(2): 139-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3691607&dopt=Abstract
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Qualitative and quantitative studies on the disposition of amitriptyline and other tricyclic antidepressant drugs in man as it relates to the management of the overdosed patient. Author(s): Gard H, Knapp D, Walle T, Gaffney T, Hanenson I. Source: Clin Toxicol. 1973; 6(4): 571-84. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4790681&dopt=Abstract
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Quality control of amitriptyline and nortriptyline plasma level assessments: a multicenter study. Author(s): Baumann P, Breyer-Pfaff U, Kuss HJ, Muller-Oerlinghausen B, Sandoz M. Source: Pharmacopsychiatria. 1982 September; 15(5): 156-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7178230&dopt=Abstract
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Quantification of amitriptyline, nortriptyline, and 10-hydroxy metabolite isomers in plasma by capillary gas chromatography with nitrogen-sensitive detection. Author(s): Jones DR, Lukey BJ, Hurst HE. Source: Journal of Chromatography. 1983 December 9; 278(2): 291-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6668310&dopt=Abstract
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Quantitation of amitriptyline and nortriptyline in human serum. Author(s): Connor JN, Johnson GF, Solomon HM. Source: Journal of Chromatography. 1977 July 1; 143(4): 415-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=885981&dopt=Abstract
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Quantitative analysis of amitriptyline and nortriptyline in human plasma and liver microsomal preparations by high-performance liquid chromatography. Author(s): Ghahramani P, Lennard MS. Source: Journal of Chromatography. B, Biomedical Applications. 1996 October 25; 685(2): 307-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8953172&dopt=Abstract
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Quantitative determination of amitriptyline and its principal metabolite, nortriptyline, by GLC-chemical ionization mass spectrometry. Author(s): Garland WA. Source: Journal of Pharmaceutical Sciences. 1977 January; 66(1): 77-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=833746&dopt=Abstract
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Quantitative determination of amitriptyline and nortriptyline in plasma by highperformance liquid chromatography. Author(s): Watson ID, Stewart MJ. Source: Journal of Chromatography. 1977 February 1; 132(1): 155-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=833225&dopt=Abstract
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Quantitative determination of amitriptyline in blood. Author(s): Kaul PN, Whitfield LR, Clark ML. Source: Journal of Pharmaceutical Sciences. 1978 January; 67(1): 60-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=619116&dopt=Abstract
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Quantitative homogeneous enzyme immunoassays for amitriptyline, nortriptyline, imipramine, and desipramine. Author(s): Pankey S, Collins C, Jaklitsch A, Izutsu A, Hu M, Pirio M, Singh P. Source: Clinical Chemistry. 1986 May; 32(5): 768-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3516450&dopt=Abstract
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Quaternary ammonium-linked glucuronides of amitriptyline, imipramine, and chlorpromazine. Author(s): Lehman JP, Fenselau C, Depaulo JR. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1983 MayJune; 11(3): 221-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6135580&dopt=Abstract
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Quaternary N-glucuronides of 10-hydroxylated amitriptyline metabolites in human urine. Author(s): Breyer-Pfaff U, Becher B, Nusser E, Nill K, Baier-Weber B, Zaunbrecher D, Wachsmuth H, Prox A. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 1990 July; 20(7): 727-38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2238706&dopt=Abstract
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Radioimmunoassay for nortriptyline and amitriptyline. Author(s): Aherne GW, Marks V, Mould G, Stout G. Source: Lancet. 1977 June 4; 1(8023): 1214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=68320&dopt=Abstract
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Radioimmunoassay of amitriptyline and nortriptyline in body fluids. Author(s): Mould GP, Stout G, Aherne GW, Marks V. Source: Annals of Clinical Biochemistry. 1978 July; 15(4): 221-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=567954&dopt=Abstract
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Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care. Author(s): Mynors-Wallis LM, Gath DH, Lloyd-Thomas AR, Tomlinson D. Source: Bmj (Clinical Research Ed.). 1995 February 18; 310(6977): 441-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7873952&dopt=Abstract
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Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Author(s): Morello CM, Leckband SG, Stoner CP, Moorhouse DF, Sahagian GA. Source: Archives of Internal Medicine. 1999 September 13; 159(16): 1931-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10493324&dopt=Abstract
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Randomized, controlled trial of amitriptyline versus placebo for adolescents with “treatment-resistant” major depression. Author(s): Birmaher B, Waterman GS, Ryan ND, Perel J, McNabb J, Balach L, Beaudry MB, Nasr FN, Karambelkar J, Elterich G, Quintana H, Williamson DE, Rao U. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1998 May; 37(5): 527-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9585655&dopt=Abstract
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Rapidity of symptom reduction in depressions treated with amitriptyline. Author(s): Haskell DS, DiMascio A, Prusoff B. Source: The Journal of Nervous and Mental Disease. 1975 January; 160(1): 24-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1113090&dopt=Abstract
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Recognition of rapid-eye-movement sleep from single-channel EEG data by artificial neural networks: a study in depressive patients with and without amitriptyline treatment. Author(s): Grozinger M, Roschke J. Source: Neuropsychobiology. 1996; 33(3): 155-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8776745&dopt=Abstract
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Recovery from massive amitriptyline overdosage. Author(s): Oreopoulos DG, Lal S. Source: Lancet. 1968 July 27; 2(7561): 221. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4173437&dopt=Abstract
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Recovery from massive amitriptyline overdosage. Author(s): Borden EC, Rostand SG. Source: Lancet. 1968 June 8; 1(7554): 1256. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4172817&dopt=Abstract
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Recurrence of depression after discontinuation of long-term amitriptyline treatment. Author(s): Bialos D, Giller E, Jatlow P, Docherty J, Harkness L. Source: The American Journal of Psychiatry. 1982 March; 139(3): 325-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6800270&dopt=Abstract
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Recurrent gastroesophageal symptoms and precordial pain in a gastrectomized man improved by amitriptyline. Physiologic, metabolic, endocrine, neurochemical and psychiatric findings. Author(s): Lechin F, van der Dijs B, Rada I, Jara H, Lechin M, Cabrera A, Lechin A, Gomez F, Jimenez V, Arocha L, et al. Source: J Med. 1989; 20(5-6): 407-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2576435&dopt=Abstract
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Reflexes of the cutaneous microcirculation in amitriptyline and in fluoxetine treated patients. Author(s): Muck-Weymann M, Rechlin T. Source: Psychopharmacology. 1996 April; 124(3): 241-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8740045&dopt=Abstract
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Regioselectivity and substrate concentration-dependency of involvement of the CYP2D subfamily in oxidative metabolism of amitriptyline and nortriptyline in rat liver microsomes. Author(s): Masubuchi Y, Iwasa T, Fujita S, Suzuki T, Horie T, Narimatsu S. Source: The Journal of Pharmacy and Pharmacology. 1996 September; 48(9): 925-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9036183&dopt=Abstract
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Regulation of glucocorticoid receptor-mRNA in human blood cells by amitriptyline and dexamethasone. Author(s): Vedder H, Bening-Abu-Shach U, Lanquillon S, Krieg JC. Source: Journal of Psychiatric Research. 1999 July-August; 33(4): 303-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10404468&dopt=Abstract
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Relationship between parameters of serotonin transport and antidepressant plasma levels or therapeutic response in depressive patients treated with paroxetine and amitriptyline. Author(s): Kuhs H, Schlake HP, Rolf LH, Rudolf GA. Source: Acta Psychiatrica Scandinavica. 1992 May; 85(5): 364-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1534961&dopt=Abstract
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Relationship between plasma and salivary concentrations of amitriptyline. Author(s): Jeffrey AA, Turner P. Source: British Journal of Clinical Pharmacology. 1978 March; 5(3): 268-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=656273&dopt=Abstract
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Relationship between response to phenelzine and MAO inhibition in a clinical trial of phenelzine, amitriptyline and placebo. Author(s): Raft D, Davidson J, Wasik J, Mattox A. Source: Neuropsychobiology. 1981; 7(3): 122-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7231652&dopt=Abstract
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Relative contribution of CYP3A to amitriptyline clearance in humans: in vitro and in vivo studies. Author(s): Venkatakrishnan K, Schmider J, Harmatz JS, Ehrenberg BL, von Moltke LL, Graf JA, Mertzanis P, Corbett KE, Rodriguez MC, Shader RI, Greenblatt DJ. Source: Journal of Clinical Pharmacology. 2001 October; 41(10): 1043-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11583471&dopt=Abstract
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Relative safety of amitriptyline in maintenance treatment of depression. Author(s): DiMascio A, Klerman GL, Prusoff B. Source: The Journal of Nervous and Mental Disease. 1975 January; 160(1): 34-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1113092&dopt=Abstract
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Reliability of amitriptyline dose prediction based on single-dose plasma levels. Author(s): Madakasira S, Khazanie PG. Source: Clinical Pharmacology and Therapeutics. 1985 February; 37(2): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3967457&dopt=Abstract
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Reliable routine method for the determination of plasma amitriptyline and nortriptyline by gas chromatography. Author(s): Burch JE, Raddats MA, Thompson SG. Source: Journal of Chromatography. 1979 March 1; 162(3): 351-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=528600&dopt=Abstract
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REMEDi drug profiling system readily distinguishes between cyclobenzaprine and amitriptyline in emergency toxicology urine specimens. Author(s): Poklis A, Edinboro LE. Source: Clinical Chemistry. 1992 November; 38(11): 2349-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1424145&dopt=Abstract
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REM-suppressing effects of amitriptyline and amitriptyline-N-oxide after acute medication in healthy volunteers: results of two uncontrolled pilot trials. Author(s): Riemann D, Velthaus S, Laubenthal S, Muller WE, Berger M. Source: Pharmacopsychiatry. 1990 November; 23(6): 253-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2284326&dopt=Abstract
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Repeated sleep deprivation once versus twice a week in combination with amitriptyline. Author(s): Kuhs H, Kemper B, Lippe-Neubauer U, Meyer-Dunker J, Tolle R. Source: Journal of Affective Disorders. 1998 January; 47(1-3): 97-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9476749&dopt=Abstract
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Respiratory distress syndrome and thrombotic, non-bacterial endocarditis after amitriptyline overdose. Author(s): Lindstrom FD, Flodmark O, Gustafsson B. Source: Acta Med Scand. 1977; 202(3): 203-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=910638&dopt=Abstract
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Response of postpsychotic depression to adjunctive imipramine or amitriptyline. Author(s): Siris SG, Rifkin AE, Reardon GT. Source: The Journal of Clinical Psychiatry. 1982 December; 43(12): 485-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6131064&dopt=Abstract
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Response to amitriptyline and urinary MHPG in bipolar depressive patients. Author(s): Modai I, Apter A, Golomb M, Wijsenbeek H. Source: Neuropsychobiology. 1979; 5(4): 181-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=440555&dopt=Abstract
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Response to phenelzine and amitriptyline in subtypes of outpatient depression. Author(s): Paykel ES, Rowan PR, Parker RR, Bhat AV. Source: Archives of General Psychiatry. 1982 September; 39(9): 1041-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7052009&dopt=Abstract
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Responses of isolated canine basilar artery and human platelet to chlorpromazine and amitriptyline. Author(s): Sukenaga A, Tani E, Fukumori T, Maeda Y. Source: Stroke; a Journal of Cerebral Circulation. 1984 March-April; 15(2): 295-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6583879&dopt=Abstract
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Responses to phenelzine and amitriptyline absence of differential predictors by multiple regression analysis. Author(s): Bhat AV, Rowan PR, Paykel ES. Source: Journal of Affective Disorders. 1984 April; 6(2): 209-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6233353&dopt=Abstract
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Reversal of amitriptyline intoxication by physostigmine. Author(s): Snyder BD, Blonde L, McWhirter WR. Source: Jama : the Journal of the American Medical Association. 1974 December 4; 230(10): 1433-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4547804&dopt=Abstract
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Reversal of multidrug resistance by amitriptyline in vitro. Author(s): Varga A, Nugel H, Baehr R, Marx U, Hever A, Nacsa J, Ocsovszky I, Molnar J. Source: Anticancer Res. 1996 January-February; 16(1): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8615610&dopt=Abstract
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Reversible brain death. A manifestation of amitriptyline overdose. Author(s): Yang KL, Dantzker DR. Source: Chest. 1991 April; 99(4): 1037-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2009762&dopt=Abstract
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Risperidone versus haloperidol and amitriptyline in the treatment of patients with a combined psychotic and depressive syndrome. Author(s): Muller-Siecheneder F, Muller MJ, Hillert A, Szegedi A, Wetzel H, Benkert O. Source: Journal of Clinical Psychopharmacology. 1998 April; 18(2): 111-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9555596&dopt=Abstract
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Role of oxidation polymorphism on blood and urine concentrations of amitriptyline and its metabolites in man. Author(s): Balant-Gorgia AE, Schulz P, Dayer P, Balant L, Kubli A, Gertsch C, Garrone G. Source: Arch Psychiatr Nervenkr. 1982; 232(3): 215-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7159207&dopt=Abstract
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Secretion of amitriptyline and metabolites into breast milk. Author(s): Breyer-Pfaff U, Nill K, Entenmann KN, Gaertner HJ. Source: The American Journal of Psychiatry. 1995 May; 152(5): 812-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7726331&dopt=Abstract
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Sedative effects of maprotiline and amitriptyline. Author(s): Holmberg G. Source: Acta Psychiatrica Scandinavica. 1988 May; 77(5): 584-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3044007&dopt=Abstract
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Selective determination of amitriptyline and nortriptyline in human plasma by HPLC with ultraviolet and particle beam mass spectrometry. Author(s): Kudo K, Jitsufuchi N, Imamura T. Source: Journal of Analytical Toxicology. 1997 May-June; 21(3): 185-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9171200&dopt=Abstract
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Separation and identification of the antidepressants Imipramine, amitriptyline and Nomifensine by thin layer chromatography. Author(s): Baltova EJ, Shishkov A. Source: Folia Med (Plovdiv). 1983; 25(3): 36-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6143713&dopt=Abstract
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Serotonin function and mechanism of action of antidepressant treatment. Effects of amitriptyline and desipramine. Author(s): Charney DS, Heninger GR, Sternberg DE. Source: Archives of General Psychiatry. 1984 April; 41(4): 359-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6703855&dopt=Abstract
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Serotonin syndrome induced by amitriptyline, meperidine, and venlafaxine. Author(s): Dougherty JA, Young H, Shafi T. Source: The Annals of Pharmacotherapy. 2002 October; 36(10): 1647-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243617&dopt=Abstract
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Serum levels and response to amitriptyline in depressed out-patients. Author(s): Rowan PR, Paykel ES, Marks V, Mould G, Bhat A. Source: Neuropsychobiology. 1984; 12(1): 9-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6514181&dopt=Abstract
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Serum levels of amitriptyline and therapeutic effect in non-delusional moderately to severely depressed in-patients: a therapeutic window relationship. Author(s): Ulrich S, Northoff G, Wurthmann C, Partscht G, Pester U, Herscu H, Meyer FP. Source: Pharmacopsychiatry. 2001 January; 34(1): 33-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11229620&dopt=Abstract
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Severe amitriptyline overdose: relationship between toxicokinetics and toxicodynamics. Author(s): Hulten BA, Heath A, Knudsen K, Nyberg G, Starmark JE, Martensson E. Source: Journal of Toxicology. Clinical Toxicology. 1992; 30(2): 171-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1588667&dopt=Abstract
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Significance of lipoproteins in serum binding variations of amitriptyline, nortriptyline, and quinidine. Author(s): Pike E, Skuterud B, Kierulf P, Lunde PK. Source: Clinical Pharmacology and Therapeutics. 1982 November; 32(5): 599-606. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7128000&dopt=Abstract
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Significance of monitoring plasma levels of amitriptyline, and its hydroxylated and desmethylated metabolites in prediction of the clinical outcome of depressive state. Author(s): Shimoda K, Yasuda S, Morita S, Shibasaki M, Someya T, Bertilsson L, Takahashi S. Source: Psychiatry and Clinical Neurosciences. 1997 February; 51(1): 35-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9076859&dopt=Abstract
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Simultaneous determination of amitriptyline, nortriptyline and four hydroxylated metabolites in serum by capillary gas-liquid chromatography with nitrogenphosphorus-selective detection. Author(s): Ulrich S, Isensee T, Pester U. Source: Journal of Chromatography. B, Biomedical Applications. 1996 October 11; 685(1): 81-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8930756&dopt=Abstract
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Simultaneous determination of amitriptyline, nortriptyline and their respective isomeric 10-hydroxy metabolites in plasma by liquid chromatography. Author(s): Suckow RF, Cooper TB. Source: Journal of Chromatography. 1982 July 9; 230(2): 391-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7107784&dopt=Abstract
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Simultaneous liquid chromatographic analysis of amitriptyline, nortriptyline, imipramine, desipramine, doxepin, and nordoxepin. Author(s): Kabra PM, Mar NA, Marton LJ. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1981 April 9; 111(2-3): 123-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7226545&dopt=Abstract
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Single dose prediction of steady state plasma levels of amitriptyline. Author(s): Madakasira S, Preskorn SH, Weller R, Pardo M. Source: Journal of Clinical Psychopharmacology. 1982 April; 2(2): 136-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7076879&dopt=Abstract
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Single oral dose pharmacokinetics of amitriptylinoxide and amitriptyline in humans. Author(s): Kuss HJ, Jungkunz G, Johannes KJ. Source: Pharmacopsychiatry. 1985 July; 18(4): 259-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4023050&dopt=Abstract
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Single-dose single-point method in amitriptyline therapy. Author(s): Madakasira S, Khazanie PG, Sato TL. Source: Psychopharmacology. 1984; 84(4): 574-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6441960&dopt=Abstract
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Sleep apnea following withdrawal of amitriptyline. Author(s): Musa MN. Source: Journal of Clinical Pharmacology. 1988 November; 28(11): 1038-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3243916&dopt=Abstract
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Sleep electroencephalography and the clinical response to amitriptyline in patients with fibromyalgia. Author(s): Carette S, Oakson G, Guimont C, Steriade M. Source: Arthritis and Rheumatism. 1995 September; 38(9): 1211-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7575714&dopt=Abstract
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Social adjustment in depressed patients treated with venlafaxine and amitriptyline. Author(s): Gorenstein C, Andrade L, Moreno RA, Artes R. Source: International Clinical Psychopharmacology. 2002 July; 17(4): 171-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131600&dopt=Abstract
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Speech blockage, memory impairment, and age: a prospective comparison of amitriptyline and maprotiline. Author(s): Branconnier RJ, Harto NE, Dessain EC, Spera KF, McNiff ME. Source: Psychopharmacology Bulletin. 1987; 23(1): 230-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3602325&dopt=Abstract
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Sperm immobilizing potency of amitriptyline and imipramine: measured with transmembrane migration. Author(s): Hong CY, Chiang BN, Ku J. Source: Archives of Andrology. 1984; 12(1): 25-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6476965&dopt=Abstract
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Spinal cord mechanisms in amitriptyline responsive restless legs syndrome in Parkinson's disease. Author(s): Sandyk R, Iacono RP, Bamford CR. Source: The International Journal of Neuroscience. 1988 January; 38(1-2): 121-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3356496&dopt=Abstract
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Steady state plasma concentration profiles and therapeutic response in anxiousdepressed outpatients after administration of a chlordiazepoxide-amitriptyline combination. Author(s): Dixon R, Cohen J. Source: Journal of Clinical Psychopharmacology. 1983 April; 3(2): 107-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6404953&dopt=Abstract
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Steady-state concentrations of amitriptyline and its metabolite nortriptyline in Saudi patients. Author(s): el-Yazigi A, Chaleby K. Source: Therapeutic Drug Monitoring. 1987; 9(1): 6-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3576661&dopt=Abstract
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Steady-state kinetics of fluoxetine and amitriptyline in patients treated with a combination of these drugs as compared with those treated with amitriptyline alone. Author(s): el-Yazigi A, Chaleby K, Gad A, Raines DA. Source: Journal of Clinical Pharmacology. 1995 January; 35(1): 17-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7751409&dopt=Abstract
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Steady-state plasma concentrations of cis- and trans-10-OH amitriptyline metabolites. Author(s): Bock JL, Giller E, Gray S, Jatlow P. Source: Clinical Pharmacology and Therapeutics. 1982 May; 31(5): 609-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6122526&dopt=Abstract
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Steady-state plasma levels during antidepressant therapy with amitriptyline and amitriptylinoxide. Author(s): Koch H. Source: The Israel Journal of Psychiatry and Related Sciences. 1990; 27(1): 48-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2194992&dopt=Abstract
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Stimulus intensity control in depression: a study of the comparative effect of doxepin and amitriptyline on cortical evoked potentials. Author(s): Friedman J, McCallum P, Meares R. Source: The Australian and New Zealand Journal of Psychiatry. 1980 June; 14(2): 115-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6932866&dopt=Abstract
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Subjective side-effects of amitriptyline and lithium in affective disorders. Author(s): Abou-Saleh MT, Coppen A. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1983 April; 142: 391-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6405833&dopt=Abstract
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Symptom reduction in depressed outpatients treated with amitriptyline or maprotiline: repeated measurement analysis. Author(s): Prusoff BA, Weissman MM, Tanner J, Lieb J. Source: Comprehensive Psychiatry. 1976 November-December; 17(6): 749-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=791572&dopt=Abstract
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Symptom relief with amitriptyline in the irritable bowel syndrome. Author(s): Rajagopalan M, Kurian G, John J. Source: Journal of Gastroenterology and Hepatology. 1998 July; 13(7): 738-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715427&dopt=Abstract
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Symptomatic improvement with amitriptyline in ciguatera fish poisoning. Author(s): Davis RT, Villar LA. Source: The New England Journal of Medicine. 1986 July 3; 315(1): 65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3713788&dopt=Abstract
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Symptoms as predictors of response to amitriptyline and nortriptyline -- the plasma level variable. Author(s): Coryell W, Ziegler VE, Biggs JT. Source: Journal of Affective Disorders. 1980 March; 2(1): 27-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6448878&dopt=Abstract
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Syncope associated with concurrent amitriptyline and fluconazole therapy. Author(s): Robinson RF, Nahata MC, Olshefski RS. Source: The Annals of Pharmacotherapy. 2000 December; 34(12): 1406-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11144697&dopt=Abstract
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Synergism of minocycline and amitriptyline in cutaneous hyperpigmentation. Author(s): Basler RS, Goetz CS. Source: Journal of the American Academy of Dermatology. 1985 March; 12(3): 577. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3989016&dopt=Abstract
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Synergistic effect of benzodiazepines in fatal amitriptyline poisonings. Author(s): King LA. Source: Lancet. 1982 October 30; 2(8305): 982-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6127477&dopt=Abstract
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The absorption rate and bioavailability of amitriptyline in the form of Lentizol. Author(s): Burch J, Hullin RP. Source: Neuropharmacology. 1978 December; 17(12): 1069-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=745696&dopt=Abstract
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The effect of amitriptyline on pain intensity and perception of stress in bruxers. Author(s): Raigrodski AJ, Mohamed SE, Gardiner DM. Source: Journal of Prosthodontics : Official Journal of the American College of Prosthodontists. 2001 June; 10(2): 73-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11512111&dopt=Abstract
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The effect of amitriptyline, doxepin, fluvoxamine, and paroxetine treatment on heart rate variability. Author(s): Rechlin T. Source: Journal of Clinical Psychopharmacology. 1994 December; 14(6): 392-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7884019&dopt=Abstract
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The effect of four-week administration of amitriptyline on sleep bruxism. A doubleblind crossover clinical study. Author(s): Raigrodski AJ, Christensen LV, Mohamed SE, Gardiner DM. Source: Cranio. 2001 January; 19(1): 21-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11842836&dopt=Abstract
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The effects of amitriptyline, citalopram and reboxetine on autonomic nervous system. A randomised placebo-controlled study on healthy volunteers. Author(s): Penttila J, Syvalahti E, Hinkka S, Kuusela T, Scheinin H. Source: Psychopharmacology. 2001 April; 154(4): 343-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11349386&dopt=Abstract
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The effects of imipramine, amitriptyline and clonidine administered by iontophoresis on the pain threshold. Author(s): Taniguchi K, Yoshitake S, Iwasaka H, Honda N, Oyama T. Source: Acta Anaesthesiol Belg. 1995; 46(3-4): 121-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8669217&dopt=Abstract
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The effects of pre-emptive treatment of postherpetic neuralgia with amitriptyline: a randomized, double-blind, placebo-controlled trial. Author(s): Bowsher D. Source: Journal of Pain and Symptom Management. 1997 June; 13(6): 327-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9204652&dopt=Abstract
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The effects of reboxetine and amitriptyline, with and without alcohol on cognitive function and psychomotor performance. Author(s): Kerr JS, Powell J, Hindmarch I. Source: British Journal of Clinical Pharmacology. 1996 August; 42(2): 239-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8864325&dopt=Abstract
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The efficacy and safety of tianeptine in the treatment of depressive disorder: results of a controlled double-blind multicentre study vs. amitriptyline. Author(s): Invernizzi G, Aguglia E, Bertolino A, Casacchia M, Ciani N, Marchesi GF, Nardini M, Rapisarda V. Source: Neuropsychobiology. 1994; 30(2-3): 85-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7800169&dopt=Abstract
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The efficacy of amitriptyline and acetaminophen in the management of acute low back pain. Author(s): Stein D, Peri T, Edelstein E, Elizur A, Floman Y. Source: Psychosomatics. 1996 January-February; 37(1): 63-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8600497&dopt=Abstract
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The impact of CYP2C19 and CYP2D6 genotypes on metabolism of amitriptyline in Japanese psychiatric patients. Author(s): Shimoda K, Someya T, Yokono A, Morita S, Hirokane G, Takahashi S, Okawa M. Source: Journal of Clinical Psychopharmacology. 2002 August; 22(4): 371-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172336&dopt=Abstract
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The influence of amitriptyline and flunarizine on catecholamine response to light in patients with migraine. Author(s): Stoica E, Enulescu O. Source: Rom J Neurol Psychiatry. 1993 January-March; 31(1): 11-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8363973&dopt=Abstract
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The kinetics of amitriptyline following single oral dose administration to man. Author(s): Garland WA, Min BH, Birkett DJ. Source: Res Commun Chem Pathol Pharmacol. 1978 December; 22(3): 475-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=734227&dopt=Abstract
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The opposite effects of amitriptyline on noradrenaline- and methoxamine-evoked venoconstriction in man. Author(s): Abdelmawla AH, Langley RW, Szabadi E, Bradshaw CM. Source: Naunyn-Schmiedeberg's Archives of Pharmacology. 1996 June; 354(1): 25-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8832584&dopt=Abstract
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The pattern of physical symptom changes in major depressive disorder following treatment with amitriptyline or imipramine. Author(s): Casper RC, Katz MM, Bowden CL, Davis JM, Koslow SH, Hanin I. Source: Journal of Affective Disorders. 1994 July; 31(3): 151-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7963067&dopt=Abstract
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The relationship between changes in REM sleep and clinical improvement in depressed patients treated with amitriptyline. Author(s): Gillin JC, Wyatt RJ, Fram D, Snyder F. Source: Psychopharmacology. 1978 December 8; 59(3): 267-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=216045&dopt=Abstract
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The role of CYP2C19 in amitriptyline N-demethylation in Chinese subjects. Author(s): Jiang ZP, Shu Y, Chen XP, Huang SL, Zhu RH, Wang W, He N, Zhou HH. Source: European Journal of Clinical Pharmacology. 2002 May; 58(2): 109-13. Epub 2002 April 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12012142&dopt=Abstract
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The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline, and a combination of L-tryptophan and amitriptyline with placebo. Author(s): Thomson J, Rankin H, Ashcroft GW, Yates CM, McQueen JK, Cummings SW. Source: Psychological Medicine. 1982 November; 12(4): 741-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7156248&dopt=Abstract
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The use of amitriptyline in mycosis fungoides. Author(s): Coe P. Source: Palliative Medicine. 1999 May; 13(3): 264. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10474718&dopt=Abstract
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The use of amitriptyline in patients with urinary frequency and pain. Author(s): Pranikoff K, Constantino G. Source: Urology. 1998 May; 51(5A Suppl): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9610578&dopt=Abstract
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The use of therapeutic drug monitoring data to document kinetic drug interactions: an example with amitriptyline and nortriptyline. Author(s): Jerling M, Bertilsson L, Sjoqvist F. Source: Therapeutic Drug Monitoring. 1994 February; 16(1): 1-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7909176&dopt=Abstract
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Three double-blind comparative trials of mianserine (ORG GB 94) and amitriptyline in the treatment of depressive illness. Author(s): Jaskari MO, Ahfors UG, Ginman L, Lydekcne K, Tienari P. Source: Pharmakopsychiatr Neuropsychopharmakol. 1977 March; 10(2): 101-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=360231&dopt=Abstract
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Three novel spinal analgesics: clonidine, neostigmine, amitriptyline. Author(s): Eisenach JC. Source: Reg Anesth. 1996 November-December; 21(6 Suppl): 81-3. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8956428&dopt=Abstract
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Thyroid function and growth hormone secretion in amitriptyline-treated depression. Author(s): Leichter SB, Kirstein L, Martin ND. Source: The American Journal of Psychiatry. 1977 November; 134(11): 1270-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=910982&dopt=Abstract
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Tinnitus associated with amitriptyline. Author(s): Feder R. Source: The Journal of Clinical Psychiatry. 1990 February; 51(2): 85-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2298710&dopt=Abstract
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Tone discrimination secondary to amitriptyline. Author(s): Malone DA Jr. Source: Journal of Clinical Psychopharmacology. 1991 June; 11(3): 221-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2066463&dopt=Abstract
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Total gaze paresis in amitriptyline overdose. Author(s): Miadinich EK, Carlow TJ. Source: Neurology. 1977 July; 27(7): 695. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=559979&dopt=Abstract
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Toxicokinetics of nortriptyline and amitriptyline: two case reports. Author(s): Franssen EJ, Kunst PW, Bet PM, Strack van Schijndel RJ, van Loenen AC, Wilhelm AJ. Source: Therapeutic Drug Monitoring. 2003 April; 25(2): 248-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12657923&dopt=Abstract
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Toxicological findings after fatal amitriptyline self-poisoning. Author(s): Tracqui A, Kintz P, Ritter-Lohner S, Mangin P, Lugnier A, Chaumont A. Source: Human & Experimental Toxicology. 1990 July; 9(4): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2390323&dopt=Abstract
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Transplacental transfer of amitriptyline and nortriptyline in isolated perfused human placenta. Author(s): Heikkinen T, Ekblad U, Laine K. Source: Psychopharmacology. 2001 February; 153(4): 450-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11243492&dopt=Abstract
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Treatment of amitriptyline poisoning with ovine antibody to tricyclic antidepressants. Author(s): Heard K, O'Malley GF, Dart RC. Source: Lancet. 1999 November 6; 354(9190): 1614-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10560683&dopt=Abstract
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Treatment of depression in patients with breast cancer: a comparison between paroxetine and amitriptyline. Author(s): Pezzella G, Moslinger-Gehmayr R, Contu A. Source: Breast Cancer Research and Treatment. 2001 November; 70(1): 1-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11766999&dopt=Abstract
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Treatment of depression with cognitive therapy and amitriptyline. Author(s): Beck AT, Hollon SD, Young JE, Bedrosian RC, Budenz D. Source: Archives of General Psychiatry. 1985 February; 42(2): 142-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3883938&dopt=Abstract
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Treatment of endogenous depression with oral thyrotropin-releasing hormone and amitriptyline. Author(s): Karlberg BE, Kjellman BF, Kagedal B. Source: Acta Psychiatrica Scandinavica. 1978 November; 58(5): 389-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=102114&dopt=Abstract
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Treatment of progressive supranuclear palsy with amitriptyline: therapeutic and toxic effects. Author(s): Engel PA. Source: Journal of the American Geriatrics Society. 1996 September; 44(9): 1072-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8790233&dopt=Abstract
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Treatment resistance of depression after head injury: a preliminary study of amitriptyline response. Author(s): Dinan TG, Mobayed M. Source: Acta Psychiatrica Scandinavica. 1992 April; 85(4): 292-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1595364&dopt=Abstract
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Typological prediction of response to amitriptyline: a replication study. Author(s): Prusoff BA, Paykel ES. Source: Int Pharmacopsychiatry. 1977; 12(3): 153-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=334687&dopt=Abstract
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Unmasking of cerebellar tumours by amitriptyline in depressive patients. Author(s): Rabey JM, Avrahami E. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1985 March; 48(3): 291. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4038996&dopt=Abstract
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Unstable anticoagulation in the course of amitriptyline treatment. Author(s): Hampel H, Berger C, Kuss HJ, Muller-Spahn F. Source: Pharmacopsychiatry. 1996 January; 29(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8852533&dopt=Abstract
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Unusual 'spike-wave stupor' in a patient with manic-depressive psychosis treated with amitriptyline. Author(s): Rumpl E, Hinterhuber H. Source: Journal of Neurology. 1981; 226(2): 131-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6186783&dopt=Abstract
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Unusual therapeutic effect of amitriptyline. Author(s): Waring EM. Source: Can Med Assoc J. 1977 July 9; 117(1): 21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=861905&dopt=Abstract
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Uptake of 5-hydroxytryptamine by blood platelets incubated in plasma from rats and humans treated with amitriptyline and imipramine. Author(s): Tukiainen E. Source: Med Biol. 1981 April; 59(2): 121-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7311628&dopt=Abstract
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Urinary 4-hydroxy-3-methoxyphenylglycol is not a predictor for clinical response to amitriptyline in depressive illness. Author(s): Coppen A, Rama Rao VA, Ruthven CR, Goodwin BL, Sandler M. Source: Psychopharmacology. 1979 June 28; 64(1): 95-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=113840&dopt=Abstract
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Urinary excretion of amitriptyline N-oxide in humans. Author(s): Santagostino G, Facino RM, Pirillo D. Source: Journal of Pharmaceutical Sciences. 1974 November; 63(11): 1690-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4610117&dopt=Abstract
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Urinary metabolites of amitriptylinoxide and amitriptyline in single-dose experiments and during continuous therapy. Author(s): Becher B, Fischer W, Taneri Z, Scholz E, Muller WE, Breyer-Pfaff U. Source: Psychopharmacology. 1992; 106(3): 303-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1570375&dopt=Abstract
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Urinary MHPG and clinical response to amitriptyline in depressed patients. Author(s): Spiker DG, Edwards D, Hanin I, Neil JF, Kupfer DJ. Source: The American Journal of Psychiatry. 1980 October; 137(10): 1183-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7416262&dopt=Abstract
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Urinary MHPG and response to amitriptyline. Author(s): Modai I, Apter A, Golomb M, Wijsenbeek H. Source: Archives of General Psychiatry. 1983 April; 40(4): 467. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6838327&dopt=Abstract
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Urinary MHPG excretion and treatment with desipramine or amitriptyline: prediction of response, effect of treatment, and methodological hazards. Author(s): Veith RC, Bielski RJ, Bloom V, Fawcett JA, Narasimhachari N, Friedel RO. Source: Journal of Clinical Psychopharmacology. 1983 February; 3(1): 18-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6833519&dopt=Abstract
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Use of amitriptyline (Elavil) for phantom limb pain in younger children. Author(s): Rogers AG. Source: Journal of Pain and Symptom Management. 1989 June; 4(2): 96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2732528&dopt=Abstract
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Use of amitriptyline and fluoxetine in prophylaxis of migraine and tension-type headaches. Author(s): Oguzhanoglu A, Sahiner T, Kurt T, Akalin O. Source: Cephalalgia : an International Journal of Headache. 1999 June; 19(5): 531-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10403070&dopt=Abstract
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Use of amitriptyline in a patient with tinnitus. Author(s): Koshes RJ. Source: Psychosomatics. 1992 Summer; 33(3): 341-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1410210&dopt=Abstract
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Use of amitriptyline in the treatment of interstitial cystitis. Author(s): Hanno PM, Buehler J, Wein AJ. Source: The Journal of Urology. 1989 April; 141(4): 846-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2926877&dopt=Abstract
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Use of plasma levels to avoid amitriptyline toxicity. Author(s): Preskorn SH. Source: The Journal of Clinical Psychiatry. 1983 November; 44(11): 430. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6643409&dopt=Abstract
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Use of transdermal amitriptyline gel in a patient with chronic pain and depression. Author(s): Scott MA, Letrent KJ, Hager KL, Burch JL. Source: Pharmacotherapy. 1999 February; 19(2): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10030776&dopt=Abstract
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Validation of a therapeutic plasma level range in amitriptyline treatment of depression. Author(s): Breyer-Pfaff U, Giedke H, Gaertner HJ, Nill K. Source: Journal of Clinical Psychopharmacology. 1989 April; 9(2): 116-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2723128&dopt=Abstract
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Validity and sensitivity of the french version of the Zerssen BfS/BfS' self-rating mood scale during treatment with trazodone and amitriptyline. Author(s): Bobon DP, Lapierre YD, Lottin T. Source: Prog Neuropsychopharmacol. 1981; 5(5-6): 519-22. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7339644&dopt=Abstract
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Valproic acid-amitriptyline interaction in man. Author(s): Pisani F, Primerano G, Amendola D'Agostino A, Spina E, Fazio A. Source: Therapeutic Drug Monitoring. 1986; 8(3): 382-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3092410&dopt=Abstract
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Valpromide increases the plasma concentrations of amitriptyline and its metabolite nortriptyline in depressive patients. Author(s): Vandel S, Bertschy G, Jounet JM, Allers G. Source: Therapeutic Drug Monitoring. 1988; 10(4): 386-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3144066&dopt=Abstract
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Venlafaxine-induced serotonin syndrome with relapse following amitriptyline. Author(s): Perry NK. Source: Postgraduate Medical Journal. 2000 April; 76(894): 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10727586&dopt=Abstract
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Ventricular arrhythmias induced by doxepin and amitriptyline: case report. Author(s): Todd RD, Faber R. Source: The Journal of Clinical Psychiatry. 1983 November; 44(11): 423-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6643406&dopt=Abstract
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Verbal learning by major depressive disorder patients during treatment with fluoxetine or amitriptyline. Author(s): Richardson JS, Keegan DL, Bowen RC, Blackshaw SL, Cebrian-Perez S, Dayal N, Saleh S, Shrikhande S. Source: International Clinical Psychopharmacology. 1994 Spring; 9(1): 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8195581&dopt=Abstract
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Viloxazine and amitriptyline in depressive illness. A double blind controlled trial in general practice. Author(s): Lennox IG, Asbury JF, Couldrick WG, Beswick KB. Source: The Practitioner. 1978 January; 220(1315): 153-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=343090&dopt=Abstract
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Viloxazine in the treatment of endogenous depression. A standard (amitriptyline) controlled clinical study. Author(s): Petrie WM, Ban TA, Wilson WH, Jamieson RC, Guy W. Source: Int Pharmacopsychiatry. 1982; 17(4): 280-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7185772&dopt=Abstract
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Visual hallucinations on low dose amitriptyline. Author(s): Rundell JR, Murray GB. Source: Journal of Clinical Psychopharmacology. 1988 February; 8(1): 75-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3351009&dopt=Abstract
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WA 335 (danitracen): a preliminary evaluation of a potential antidepressant compound. A comparative double-blind study with WA 335 and amitriptyline in the treatment of depressive patients. Author(s): Kaumeier S, Dohren J, Flach D. Source: Curr Ther Res Clin Exp. 1977 January; 21(1): 108-13. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=401705&dopt=Abstract
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Weight changes in antidepressants: a comparison of amitriptyline and trazodone. Author(s): Hecht Orzack M, Cole JO, Friedman L, Bird M, McEachern J. Source: Neuropsychobiology. 1986; 15 Suppl 1: 28-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3725001&dopt=Abstract
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Which tricyclic for depressed outpatients, imipramine pamoate or amitriptyline? Author(s): Goldberg HL, Finnerty RJ. Source: Dis Nerv Syst. 1977 October; 38(10): 785-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=332472&dopt=Abstract
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Who responds to amitriptyline? Author(s): Milln P, Coppen A. Source: Lancet. 1980 April 5; 1(8171): 763-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6103174&dopt=Abstract
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Why do amitriptyline and dothiepin appear to be so dangerous in overdose? Author(s): Montgomery SA, Baldwin D, Green M. Source: Acta Psychiatrica Scandinavica. Supplementum. 1989; 354: 47-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2589103&dopt=Abstract
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Will amitriptyline prevent the “cheese” reaction of monoamine-oxidase inhibitors? Author(s): Pare CM, Kline N, Hallstrom C, Cooper TB. Source: Lancet. 1982 July 24; 2(8291): 183-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6123888&dopt=Abstract
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Withdrawal from chronic treatment with metergoline, dl-propranolol and amitriptyline enhances serotonin receptor mediated behaviour in the rat. Author(s): Stolz JF, Marsden CA. Source: European Journal of Pharmacology. 1982 April 8; 79(1-2): 17-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7200899&dopt=Abstract
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Withdrawal symptoms after abrupt cessation of amitriptyline in an eight-year-old boy. Author(s): Gualtieri CT, Staye J. Source: The American Journal of Psychiatry. 1979 April; 136(4A): 457-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=426117&dopt=Abstract
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Zimeldine tolerability in comparison to amitriptyline and placebo: findings from a multicentre trial. Author(s): Claghorn J, Gershon S, Goldstein BJ. Source: Acta Psychiatrica Scandinavica. Supplementum. 1983; 308: 104-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6230883&dopt=Abstract
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Zimeldine versus amitriptyline in endogenous depression. A double-blind study with special reference to effects on liver function. Author(s): Larsen FW, Hansen CE. Source: Acta Psychiatrica Scandinavica. 1984 April; 69(4): 343-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6232828&dopt=Abstract
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Zimelidine and amitriptyline in the treatment of depressive illness in general practice. Author(s): Loudon JB, Tiplady B, Ashcroft GW, Waddell JL. Source: Acta Psychiatrica Scandinavica. Supplementum. 1981; 290: 454-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6452805&dopt=Abstract
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CHAPTER 2. NUTRITION AND AMITRIPTYLINE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and amitriptyline.
Finding Nutrition Studies on Amitriptyline The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “amitriptyline” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “amitriptyline” (or a synonym): •
A comparison of amitriptyline, vasopressin and amitriptyline with vasopressin in nocturnal enuresis. Author(s): Mater Misericordiae Children's Hospital, South Brisbane, Queensland, Australia. Source: Burke, J R Mizusawa, Y Chan, A Webb, K L Pediatr-Nephrol. 1995 August; 9(4): 438-40 0931-041X
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A double blind trial of moclobemide versus amitriptyline in the treatment of depressive disorders. Author(s): Department of Psychiatry, Rotorua Hospital. Source: Newburn, G M Fraser, A R Menkes, D B Mullen, P E Aust-N-Z-J-Psychiatry. 1990 December; 24(4): 475-9 0004-8674
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A study of mechanisms underlying amitriptyline-induced acute lung function impairment. Author(s): Division of Inhalation Toxicology, Karolinska Institutet, Stockholm, S-171 77, Sweden. Source: Svens, K Ryrfeldt, A Toxicol-Appl-Pharmacol. 2001 December 15; 177(3): 179-87 0041-008X
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Amitriptyline and clomipramine increase the concentration of administered Ltryptophan in the rat brain. Author(s): Department of Pharmacology, Goteborg University, Sweden. Source: Eriksson, T Walinder, J J-Pharm-Pharmacol. 1998 October; 50(10): 1133-7 00223573
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Amitriptyline and dexamethasone combined treatment in drug-induced headache. Author(s): Institute of Clinical Neurology, University of Pisa, Italy. Source: Bonuccelli, U Nuti, A Lucetti, C Pavese, N Dell'Agnello, G Muratorio, A Cephalalgia. 1996 May; 16(3): 198-200 0333-1024
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Amitriptyline and procainamide inhibition of cocaine and cocaethylene degradation in human serum in vitro. Author(s): Department of Pathology, University of California Medical Center, San Diego 92103-8320, USA. Source: Bailey, D N J-Anal-Toxicol. 1999 Mar-April; 23(2): 99-102 0146-4760
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Amitriptyline in neuropathic cancer pain in patients on morphine therapy: a randomized placebo-controlled, double-blind crossover study. Author(s): Anesthesia and Intensive Care Unit, Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Home Palliative Care Program, Societa Assistenza Malato Oncologico Terminale, Palermo, Italy.
[email protected] Source: Mercadante, S Arcuri, E Tirelli, W Villari, P Casuccio, A Tumori. 2002 May-June; 88(3): 239-42 0300-8916
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Amitriptyline-induced constipation in cynomolgus monkeys is beneficial for the evaluation of laxative efficacy. Author(s): Research and Development, Otsuka Pharmaceutical Factory, Inc., Naruto, Tokushima, Japan.
[email protected] Source: Tsusumi, K Kishimoto, S Koshitani, O Kohri, H Biol-Pharm-Bull. 2000 May; 23(5): 657-9 0918-6158
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Antimalarial properties of imipramine and amitriptyline. Author(s): Memorial Sloan-Kettering Cancer Center, New York, New York.
Nutrition 105
Source: Dutta, P Pinto, J Rivlin, R J-Protozool. 1990 Jan-February; 37(1): 54-8 0022-3921 •
Blockade of the HERG human cardiac K(+) channel by the antidepressant drug amitriptyline. Author(s): Department of Life Science, Pohang University of Science and Technology, Pohang 790 - 784, South Korea. Source: Jo, S H Youm, J B Lee, C O Earm, Y E Ho, W K Br-J-Pharmacol. 2000 April; 129(7): 1474-80 0007-1188
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Chronic administration of amitriptyline and caffeine in a rat model of neuropathic pain: multiple interactions. Author(s): Departments of Pharmacology and Anatomy and Neurobiology, Dalhousie University, Nova Scotia, B3H 4H7, Halifax, Canada Source: Esser, M J Chase, T Allen, G V Sawynok, J Eur-J-Pharmacol. 2001 November 2; 430(2-3): 211-8 0014-2999
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Comparison of three in vitro assays at evaluation of IC50 of acetylsalicylic acid, ferrous sulfate, amitriptyline, methanol, isopropanol and ethylene glycol in human cancer cells HeLa. Author(s): Institute of Preventive and Clinical Medicine, Bratislava, Slovak Republic. Source: Ruppova, K Wsolova, L Urbancikova, M Slamenova, D Neoplasma. 2000; 47(3): 172-6 0028-2685
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Correlation of mono and combined amitriptyline/lithium therapy with therapeutic and side effects. Author(s): Institute for Mental Health, Beograd, Yugoslavija. Source: Timotijevic, I Zdravkovic, M Pokrajac, M Miljkovic, B Stojkovic, M Marinkovic, O Rom-J-Physiol. 1994 Jan-December; 31(1-4): 103-11
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Decreased plasma levels of amitriptyline and its metabolites on comedication with an extract from St. John's wort ( Hypericum perforatum ). Author(s): Institute of Clinical Pharmacology, University Medical Center Charite, Humboldt University of Berlin, Berlin, Germany. Source: Johne, Andreas Schmider, Jurgen Brockmoller, Jurgen Stadelmann, Andreas M Stormer, Elke Bauer, Steffen Scholler, Gudrun Langheinrich, Matthias Roots, Ivar J-ClinPsychopharmacol. 2002 February; 22(1): 46-54 0271-0749
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Determination of amitriptyline and nortriptyline in human liver microsomes with reversed-phase HPLC in vitro. Author(s): Pharmacogenetics Research Institute, Hunan Medical University, Changsha, China. Source: Shu, Y Zhu, R H Xu, Z H Zhou, H H Zhongguo-Yao-Li-Xue-Bao. 1998 July; 19(4): 343-6 0253-9756
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Differential inhibition of catecholamine secretion by amitriptyline through blockage of nicotinic receptors, sodium channels, and calcium channels in bovine adrenal chromaffin cells. Author(s): Department of Life Science, Pohang University of Science and Technology, Korea. Source: Park, T J Shin, S Y Suh, B C Suh, E K Lee, I S Kim, Y S Kim, K T Synapse. 1998 July; 29(3): 248-56 0887-4476
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Extrapolating in vitro data on drug metabolism to in vivo pharmacokinetics: evaluation of the pharmacokinetic interaction between amitriptyline and fluoxetine. Author(s): Department of Clinical Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, Boston, Massachusetts, USA.
[email protected]
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Source: Schmider, J von Moltke, L L Shader, R I Harmatz, J S Greenblatt, D J DrugMetab-Revolume 1999 May; 31(2): 545-60 0360-2532 •
Extremely slow metabolism of amitriptyline but normal metabolism of imipramine and desipramine in an extensive metabolizer of sparteine, debrisoquine, and mephenytoin. Author(s): Department of Clinical Pharmacology, Odense University, Denmark. Source: Brosen, K Gram, L F Kragh Sorensen, P Ther-Drug-Monit. 1991 March; 13(2): 177-82 0163-4356
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Food intake and the presystemic metabolism of single doses of amitriptyline and nortriptyline. Author(s): Department of Community Medicine, Malmo University Hospital, Sweden. Source: Liedholm, H Liden, A Fundam-Clin-Pharmacol. 1998; 12(6): 636-42 0767-3981
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Involvement of adenosine in the anti-allodynic effect of amitriptyline in streptozotocin-induced diabetic rats. Author(s): Department of Pharmacology, Faculty of Medicine, Trakya University, 22030, Edirne, Turkey.
[email protected] Source: Ulugol, A Karadag, H C Tamer, M Firat, Z Aslantas, A Dokmeci, I NeurosciLett. 2002 August 9; 328(2): 129-32 0304-3940
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LI 160, an extract of St. John's wort, versus amitriptyline in mildly to moderately depressed outpatients--a controlled 6-week clinical trial. Author(s): Department of Psychological Medicine, Royal Masonic Hospital, London, UK. Source: Wheatley, D Pharmacopsychiatry. 1997 September; 30 Suppl 277-80 0176-3679
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N-demethylation of amitriptyline in vitro: role of cytochrome P-450 3A (CYP3A) isoforms and effect of metabolic inhibitors. Author(s): Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, Boston Massachusetts, USA. Source: Schmider, J Greenblatt, D J von Moltke, L L Harmatz, J S Shader, R I JPharmacol-Exp-Ther. 1995 November; 275(2): 592-7 0022-3565
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Parenteral pentazocine: effects on psychomotor skills and respiration, and interactions with amitriptyline. Author(s): Department of Pharmacology and Toxicology, University of Helsinki, Finland. Source: Saarialho Kere, U Mattila, M J Seppala, T Eur-J-Clin-Pharmacol. 1988; 35(5): 4839 0031-6970
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Paroxetine and amitriptyline augmentation of lithium in the treatment of major depression: a double-blind study. Author(s): Department of Psychiatry, Berlin Lithium Clinic, Freie Universitat Berlin, Germany. Source: Bauer, M Zaninelli, R Muller Oerlinghausen, B Meister, W J-ClinPsychopharmacol. 1999 April; 19(2): 164-71 0271-0749
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Psychomotor, respiratory and neuroendocrinological effects of buprenorphine and amitriptyline in healthy volunteers. Author(s): Department of Pharmacology, University of Helsinki, Finland. Source: Saarialho Kere, U Mattila, M J Paloheimo, M Seppala, T Eur-J-Clin-Pharmacol. 1987; 33(2): 139-46 0031-6970
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Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Author(s): Veterans Affairs San Diego Healthcare System, Calif 92161, USA. Source: Morello, C M Leckband, S G Stoner, C P Moorhouse, D F Sahagian, G A ArchIntern-Med. 1999 September 13; 159(16): 1931-7 0003-9926
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Regioselectivity and substrate concentration-dependency of involvement of the CYP2D subfamily in oxidative metabolism of amitriptyline and nortriptyline in rat liver microsomes. Author(s): Laboratory of Biopharmaceutics, Faculty of Pharmaceutical Sciences, Chiba University, Japan. Source: Masubuchi, Y Iwasa, T Fujita, S Suzuki, T Horie, T Narimatsu, S J-PharmPharmacol. 1996 September; 48(9): 925-9 0022-3573
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The anti-allodynic effects of amitriptyline, gabapentin, and lidocaine in a rat model of neuropathic pain. Author(s): Department of Anesthesiology and Critical Care, The Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
[email protected] Source: Abdi, S Lee, D H Chung, J M Anesth-Analg. 1998 December; 87(6): 1360-6 00032999
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The antidotal effect of alpha(1)-acid glycoprotein on amitriptyline toxicity in cardiac myocytes. Author(s): Academic Department of Accident and Emergency Medicine, Imperial College School of Medicine, St. Mary's Hospital, W2 1NY, London, UK.
[email protected] Source: Ma, Y Henry, J A Toxicology. 2001 December 14; 169(2): 133-44 0300-483X
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The effect of a lipid suspension on amitriptyline disposition. Author(s): Poisons Unit, Guy's Hospital, London, UK. Source: Minton, N A Goode, A G Henry, J A Arch-Toxicol. 1987 August; 60(6): 467-9 0340-5761
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The effect of the nitric oxide synthesis inhibitor L-NAME on amitriptyline-induced hypotension in rats. Author(s): Department of Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
[email protected] Source: Tuncok, Yesim Kalkan, Sule Murat, Nergis Arkan, Filiz Guven, Hulya Aygoren, Oguz Kurt, Serdar J-Toxicol-Clin-Toxicol. 2002; 40(2): 121-7 0731-3810
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The effects of St John's wort extract on heart rate variability, cognitive function and quantitative EEG: a comparison with amitriptyline and placebo in healthy men. Author(s): Institute of Clinical Pharmacology, Medical Faculty, Technical University, Dresden, Germany.
[email protected] Source: Siepmann, M Krause, S Joraschky, P Muck Weymann, M Kirch, W Br-J-ClinPharmacol. 2002 September; 54(3): 277-82 0306-5251
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The interaction between gabapentin and amitriptyline in the rat formalin test after systemic administration. Author(s): Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada. Source: Heughan, Caroline E Sawynok, Jana Anesth-Analg. 2002 April; 94(4): 975-80, table of contents 0003-2999
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Valpromide increases the plasma concentrations of amitriptyline and its metabolite nortriptyline in depressive patients. Author(s): Departement de Pharmacologie Clinique, Centre Hospitalier Universitaire, Besancon, France. Source: Vandel, S Bertschy, G Jounet, J M Allers, G Ther-Drug-Monit. 1988; 10(4): 386-9 0163-4356
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to amitriptyline; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Riboflavin Alternative names: Vitamin B2 (Riboflavin) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B2 (riboflavin) Alternative names: Riboflavin Source: Integrative Medicine Communications; www.drkoop.com
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CHAPTER 3. AMITRIPTYLINE
ALTERNATIVE
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to amitriptyline. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to amitriptyline and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “amitriptyline” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to amitriptyline: •
A comparison of bupropion hydrochloride with dexamphetamine and amitriptyline in healthy subjects. Author(s): Peck AW, Bye CE, Clubley M, Henson T, Riddington C. Source: British Journal of Clinical Pharmacology. 1979 May; 7(5): 469-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=475943&dopt=Abstract
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A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches. Author(s): Holroyd KA, Nash JM, Pingel JD, Cordingley GE, Jerome A. Source: Journal of Consulting and Clinical Psychology. 1991 June; 59(3): 387-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2071723&dopt=Abstract
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Acupuncture and amitriptyline for HIV-related peripheral neuropathic pain. Author(s): King SA. Source: Jama : the Journal of the American Medical Association. 1999 April 14; 281(14): 1271-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208138&dopt=Abstract
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Acupuncture and amitriptyline for HIV-related peripheral neuropathic pain. Author(s): Ulett GA. Source: Jama : the Journal of the American Medical Association. 1999 April 14; 281(14): 1270-1; Author Reply 1271-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208137&dopt=Abstract
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Acupuncture and amitriptyline for HIV-related peripheral neuropathic pain. Author(s): Kaptchuk TJ. Source: Jama : the Journal of the American Medical Association. 1999 April 14; 281(14): 1270; Author Reply 1271-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208136&dopt=Abstract
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Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS. Author(s): Shlay JC, Chaloner K, Max MB, Flaws B, Reichelderfer P, Wentworth D, Hillman S, Brizz B, Cohn DL. Source: Jama : the Journal of the American Medical Association. 1998 November 11; 280(18): 1590-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9820261&dopt=Abstract
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Amitriptyline, clovoxamine and cognitive function: a placebo-controlled comparison in depressed outpatients. Author(s): Spring B, Gelenberg AJ, Garvin R, Thompson S. Source: Psychopharmacology. 1992; 108(3): 327-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1523282&dopt=Abstract
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Amitriptyline-induced constipation in cynomolgus monkeys is beneficial for the evaluation of laxative efficacy. Author(s): Tsusumi K, Kishimoto S, Koshitani O, Kohri H. Source: Biological & Pharmaceutical Bulletin. 2000 May; 23(5): 657-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10823684&dopt=Abstract
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Decreased plasma levels of amitriptyline and its metabolites on comedication with an extract from St. John's wort ( Hypericum perforatum ). Author(s): Johne A, Schmider J, Brockmoller J, Stadelmann AM, Stormer E, Bauer S, Scholler G, Langheinrich M, Roots I.
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Source: Journal of Clinical Psychopharmacology. 2002 February; 22(1): 46-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799342&dopt=Abstract •
Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief. Author(s): Kumar D, Alvaro MS, Julka IS, Marshall HJ. Source: Diabetes Care. 1998 August; 21(8): 1322-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9702441&dopt=Abstract
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Effect of certain drugs upon amitriptyline induced electrocardiographic changes. Author(s): Nymark M, Rasmussen J. Source: Acta Pharmacol Toxicol (Copenh). 1966; 24(2): 148-56. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6013087&dopt=Abstract
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Effects of chlorpromazine and the antidepressant drugs amitriptyline, clomipramine and mianserin on the Ca-depleted rat uterus. Author(s): Villar A, Sevilla E, Anselmi E. Source: Arch Int Pharmacodyn Ther. 1985 October; 277(2): 264-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3933445&dopt=Abstract
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Electro-acupuncture vs. amitriptyline in the treatment of depressive states. Author(s): Luo HC, Jia YK, Li Z. Source: J Tradit Chin Med. 1985 March; 5(1): 3-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3849629&dopt=Abstract
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Experimental amitriptyline poisoning: treatment of severe cardiovascular toxicity with cardiopulmonary bypass. Author(s): Larkin GL, Graeber GM, Hollingsed MJ. Source: Annals of Emergency Medicine. 1994 March; 23(3): 480-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8135422&dopt=Abstract
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Factors influencing decomposition rate of amitriptyline hydrochloride in aqueous solution. Author(s): Enever RP, Li Wan Po A, Shotton E. Source: Journal of Pharmaceutical Sciences. 1977 August; 66(8): 1087-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=408476&dopt=Abstract
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Idiopathic Subjective Tinnitus Treated by Amitriptyline Hydrochloride/Biofeedback. Author(s): Podoshin L, Ben-David Y, Fradis M, Malatskey S, Hafner H. Source: Int Tinnitus J. 1995; 1(1): 54-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10753321&dopt=Abstract
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Influence of heparin on the assay of amitriptyline, clomipramine, and their metabolites. Author(s): Levering SC, Oostelbos MC, Toll PJ, Loonen AJ. Source: Therapeutic Drug Monitoring. 1996 June; 18(3): 304-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8738773&dopt=Abstract
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Inhibition of human platelet-collagen adhesion reaction by amitriptyline and imipramine. Author(s): Mohammad SF, Mason RG. Source: Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N. Y.). 1974 March; 145(3): 1106-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4206514&dopt=Abstract
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LI 160, an extract of St. John's wort, versus amitriptyline in mildly to moderately depressed outpatients--a controlled 6-week clinical trial. Author(s): Wheatley D. Source: Pharmacopsychiatry. 1997 September; 30 Suppl 2: 77-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9342764&dopt=Abstract
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Severe amitriptyline intoxication and the use of charcoal hemoperfusion. Author(s): Comstock TJ, Watson WA, Jennison TA. Source: Clin Pharm. 1983 January-February; 2(1): 85-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6883936&dopt=Abstract
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Spinal manipulation vs. amitriptyline for the treatment of chronic tension headache: a randomized clinical trial. Author(s): Hobson WH, Shiraki R, Steiner D, Van Horn M. Source: Journal of Manipulative and Physiological Therapeutics. 1996 May; 19(4): 278-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8926482&dopt=Abstract
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Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. Author(s): Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Source: Journal of Manipulative and Physiological Therapeutics. 1995 March-April; 18(3): 148-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7790794&dopt=Abstract
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The effect of forewarning on the occurrence of side-effects and discontinuance of medication in patients on amitriptyline. Author(s): Myers ED, Calvert EJ.
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Source: The British Journal of Psychiatry; the Journal of Mental Science. 1973 April; 122(569): 461-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4718283&dopt=Abstract •
The effect of guided imagery and amitriptyline on daily fibromyalgia pain: a prospective, randomized, controlled trial. Author(s): Fors EA, Sexton H, Gotestam KG. Source: Journal of Psychiatric Research. 2002 May-June; 36(3): 179-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886696&dopt=Abstract
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The effects of propranolol and amitriptyline on vascular and EMG biofeedback training. Author(s): Jay GW, Renelli D, Mead T. Source: Headache. 1984 March; 24(2): 59-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6715161&dopt=Abstract
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The effects of St John's wort extract on heart rate variability, cognitive function and quantitative EEG: a comparison with amitriptyline and placebo in healthy men. Author(s): Siepmann M, Krause S, Joraschky P, Muck-Weymann M, Kirch W. Source: British Journal of Clinical Pharmacology. 2002 September; 54(3): 277-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236848&dopt=Abstract
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The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Author(s): Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. Source: Journal of Manipulative and Physiological Therapeutics. 1998 October; 21(8): 511-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9798179&dopt=Abstract
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Treatment of disease without the use of drugs. V. Phasing out of benzodiazepine and amitriptyline medication with thought control. Author(s): Sim MK, Ratnam KV. Source: Singapore Med J. 1980 August; 21(4): 655-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7221578&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to amitriptyline; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Chickenpox and Shingles Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Depression Source: Integrative Medicine Communications; www.drkoop.com Fibromyalgia Source: Healthnotes, Inc.; www.healthnotes.com Fibromyalgia Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Herpes Zoster and Varicella Viruses Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com
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Shingles and Chickenpox Source: Integrative Medicine Communications; www.drkoop.com Tension Headache Source: Healthnotes, Inc.; www.healthnotes.com Varicella and Herpes Zoster Viruses Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Chiropractic Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements 5-htp Source: Integrative Medicine Communications; www.drkoop.com 5-hydroxytryptophan (5-htp) Source: Integrative Medicine Communications; www.drkoop.com Antidepressants Source: Healthnotes, Inc.; www.healthnotes.com Fiber Source: Integrative Medicine Communications; www.drkoop.com Ginkgo Alternative names: Ginkgo biloba Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Phenothiazine Derivatives Source: Integrative Medicine Communications; www.drkoop.com Same (s-adenosylmethionine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,818,00.html St. John's Wort Source: Prima Communications, Inc.www.personalhealthzone.com Thioxanthene Derivatives Source: Integrative Medicine Communications; www.drkoop.com Tricyclic Antidepressants Source: Healthnotes, Inc.; www.healthnotes.com Tricyclic Antidepressants (tcas) Source: Integrative Medicine Communications; www.drkoop.com
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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. PATENTS ON AMITRIPTYLINE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “amitriptyline” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on amitriptyline, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Amitriptyline By performing a patent search focusing on amitriptyline, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 5Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on amitriptyline: •
5H Dibenzo (a,d) cycloheptene, 10,11 dihydro, 5(1-halo-3-dimethylaminoprop-1ylidene) derivatives Inventor(s): Hesse; Robert Henry (Cambridge, MA), Barton; Derek Harold Richard (London, EN) Assignee(s): Research Institute for Medicine and Chemistry Inc. (Cambridge, MA) Patent Number: 3,991,103 Date filed: October 21, 1974 Abstract: 11-Halo derivatives of amitriptyline and its analogues, i.e. 5-(1'-halo-3'aminoprop-1'-yl-idene)-5H-dibenzo[a,d]-10,11-dihydrocyclohep tenes and corresponding 11-oxa analogues as well as the acid addition salts thereof, have notable anti-depressant and tranquillising activity. They are prepared by reacting a 5-(3'aminoprop-1'-ylidene)-5H-dibenz[a,d]-10,11-dihydrocycloheptene or an 11-oxa analogue thereof, or an acid addition salt thereof, with an electrophilic halogenating agent. Excerpt(s): This invention relates to novel dibenzocycloheptenes related to amitriptyline which have notable anti-depressant and tranquillising activity. The new compounds may be generally characterised as 11-halo derivatives of amitriptyline and its analogues and are thus generally 5-(1'-halo-3'-aminoprop-1'-yl-idene)-5H-dibenzo [a,d]-10,11dihydrocycloheptenes and corresponding 11-oxa analogues as well as the acid addition salts thereof. Where R is a halogen atom, e.g. a fluorine, chlorine or bromine atom; X is -CH.sub.2 -- or --O--; R.sup.1 and R.sup.2 which may be the same or different are hydrogen atoms or alkyl groups; R.sup.3 and R.sup.4 which may be the same or different represent alkyl groups which may carry substituents such as aryl groups, e.g. phenyl groups, or alkylamino groups, e.g. diethylamino or dimethylamino groups, R.sup.4 alternatively representing a hydrogen atom; or R.sup.3 and R.sup.4 together with the intervening N represent a heterocyclic group; and where the nucleus may optionally carry further substituents such as alkyl, alkoxy, or alkylthio groups or halogen atoms. Web site: http://www.delphion.com/details?pn=US03991103__
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Amitriptyline conjugates to antigenic proteins and enzymes Inventor(s): Singh; Prithipal (Santa Clara, CA), Hu; Mae W. (Sunnyvale, CA) Assignee(s): Syva Company (Palo Alto, CA) Patent Number: 4,307,245 Date filed: April 7, 1980 Abstract: Amitriptyline functionalized compounds are provided for conjugation to antigenic compositions, particularly poly(amino acids), and enzymes. The antigenic conjugates are employed for the production of antibodies, which find particular use in immunoassays for the determination of amitriptyline, while the enzyme conjugate finds use in a homogeneous enzyme immunoassay for the determination of amitriptyline.
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Excerpt(s): Amitriptyline is a tricyclic antidepressant which finds extensive use. The therapeutic range for the drug is from about 50 to 175 ng/ml. Lower dosages do not have significant effect and overdosages have substantial side effects which can be lifethreatening. Overdoses can be characterized by convulsions, coma, cardiac arrhythmias, and anticholinergic signs, such as mydriasis and tachycardia. It is found that the rate of metabolism of the drug can vary widely with individuals, as well as the sensitivity of the individual to the drug. It is therefore necessary to insure proper dosage levels to monitor the plasma level, so that a therapeutic dosage level may be maintained. In monitoring the dosage level, it is desirable that there be a simple accurate rapid technique for measuring the amitriptyline level, which can distinguish amitriptyline from other drugs and metabolites of amitriptyline, which might otherwise give an erroneous value of the amitriptyline level. Web site: http://www.delphion.com/details?pn=US04307245__ •
Diffusion-osmotic controlled drug-release pharmaceutical composition and process for preparing same Inventor(s): Mandi; Attila (Budapest, HU), Sipos; Gabor (Budapest, HU), Kiraly nee Ignacz; Maria (Budapest, HU), Fekete; Pal (Budapest, HU), Ujfalussy; Gyorgy (Budapest, HU), Barczay; Erzsebet (Budapest, HU), Krisztian; Maria (Budapest, HU), Drabant; Sandor (Budapest, HU), Gora nee Hernyes; Magdolna (Budapest, HU), Klebovich; Imre (Budapest, HU), Kiss nee Szabo; Gizella (Budapest, HU), Jambor nee Hoffmann; Zsuzsanna (Budapest, HU) Assignee(s): Egis Gyogyszergyar Rt. (Budapest, HU) Patent Number: 5,543,155 Date filed: December 5, 1994 Abstract: The invention relates to a novel diffusion-osmotic controlled drug-release pharmaceutical composition containing a one-layer tablet core including a polymeric film-coat, a therapeutically active agent and a hydrophilic polymer; if desired, a twolayer tablet core including active agent and hydrophilic polymer in the first layer thereof and a hydrophilic polymer in the second layer thereof; at least one bore on the part of film-coat in contact with the core or core layer containing the active agent; and, if desired, containing one or more bore(s) in the part thereof in contact with the second layer containing the hydrophilic polymer, which comprises an ammonium methacrylate copolymer as coating material and hydroxypropyl-methylcellulose as hydrophilic polymer. The composition according to the invention is useful for preparing controlled drug-release tablets containing as active agents e.g.beta.-adrenergic inhibitors (e.g. propranolol) calcium-antagonists (e.g. nifedipine), angiotensin convertase enzyme (ACE) inhibitors (e.g. captopril); prazosin; or nitroglycerol, all used in heart and circulation diseases; vasodilatory active agents (e.g. pentoxyfylline), nonsteroidal antiinflammatory agents (e.g. naproxene), analgetic drugs (e.g. morphine) and drugs acting on the central nervous system (e.g. amitriptyline, buspiron). The invention furthermore relates to a process for the preparation of the above compositions. Excerpt(s): The invention relates to novel diffusion-osmotic controlled drug-release pharmaceutical compositions. More particularly, the subject of the invention is an onelayer or two-layer tablet superficially coated with ammonium methacrylate copolymer film and containing polymer(s) dissolving in aqueous media, from which the active agent is released partly by molecular diffusion through the ammonium methacrylate copolymer wall, partly by pressing out through the hole(s) bored on the coat together
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with the aqueous dispersion or solution of the polymer(s). The invention furthermore relates to a process for the preparation of the above compositions. Compositions known in the art are osmotic drug-release systems which became known in the pharmaceutical technology in the past decades. Osmotic compositions prepared according to the first patent specifications (U.S. Pat. Nos. 3,845,770 and 3,916,899) consisted of the active agent and a semipermeable coat surrounding it. Being permeable to water, the coat makes possible the penetration of water from the environment into the interior of the composition; however, the coat is impermeable to the active agent and therefore it impedes the molecules of the active agent to get out through the coat into the environment. Thus, the getting-out of the active agent of the composition is provided by one or more hole(s) formed on the coat. During the release of the active agent the composition takes up water from the environment through the coat, then the solution or suspension of the active agent is pressed out into the environment through the opening(s) being present on the coat under effect of the osmotic pressure developing in the system. The rate of water uptake and consequently the rate of active agent release is determined by the permeability to water of the wall; or the potential difference between the osmotic pressure, more precisely the difference between the chemical potential of the solution formed within the composition and that of the environment (the decrease of osmotic pressure through the coat or the extent of difference of chemical potentials), respectively. However, a composition of this type is useful only for water-soluble active agents or for substances slightly soluble in water when those are employed in a mixture with water-soluble, so-called osmotic additives (auxiliaries). An additional drawback of these compositions lies in that, after cessation of the saturation concentration, the osmotic pressure within the composition decreases and therefore the zero-order, i.e. time-constant rate of active agent release, a great advantage of the composition, is changed. Web site: http://www.delphion.com/details?pn=US05543155__ •
Method and composition for transdermal administration of pharmacologic agents Inventor(s): Williams; C. Donald (Yakima, WA), Murdock; Robert W. (Selah, WA) Assignee(s): Pharmaceutical Applications Associates, LLC (Yakima, WA) Patent Number: 6,290,986 Date filed: June 29, 1998 Abstract: A method and composition for transdermal delivery of pharmaceuticals or combinations of pharmaceuticals is provided. The pharmaceuticals are delivered using a matrix of a lecithin gel such as a lecithin organogel. A number of psychopharmaceuticals can be used including fluoxetine, sertraline, carbamazepine, paroxetine, amitriptyline, trazadone, venlafaxine, propranolol, buproprion, valproic acid, nefazodone, ketoprofen, gabapentin, piroxican, doxepin, guaifenesin, pemoline and doxepin and combinations. Excerpt(s): The present invention is directed to transdermal administration of pharmacologic agents, and in particular to transdermal administration of drugs including antidepressant serotonin specific reuptake inhibitors (as SSRIs) such as fluoxetine, antidepressants such as buproprion and reboxetine, tricyclic antidepressant medications that have neuropathic pain treatment efficacy such as amitriptyline and doxepin, mood stabilizers such as carbamazepine, or valproic acid, Attention Deficit Hyperactivity Disorder (ADHD) medications such as pemoline anti-inflammatory or analgesic medications such as ketoprofen or piroxicam, treatments for impotence such as sildenafil and or anti-convulsants believed to possess neuropathic pain treatment
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efficacy such as gabapentin, carbamazepine, or combinations thereof such as using a gel matrix, preferably a lecithin organogel and/or a polymer gel. In the past, patients suffering from a wide variety of conditions have been successfully treated by administration of pharmacologic agents. A vast majority of such patients receive doses of these agents orally. Unfortunately, in some situations, oral administration of such agents has been infeasible or ineffective. In some cases, oral administration is associated with side effects, particularly gastrointestinal side effects, sedation, or weight gain which cannot be tolerated well by the patient. In other cases, malabsorption of oral preparation have resulted in subtherapeutic plasma levels. In other cases, the agents have relatively short plasma half-lives, necessitating inconveniently frequent dosing. In general, oral delivery involves a time delay as the pharmaceutical is absorbed via the digestive system before entering the bloodstream. A number of agents which have traditionally been administered orally or by injection have been inappropriate or suboptimal for some patients when so-administered. There are a number of medications which in at least some patients are not tolerated well when orally administered (e.g. which cause undesirable gastrointestinal or other side effects) and/or which provide undesirably high or low concentrations or delayed concentrations in a target tissue. In some cases, dosages which are appropriate for oral administration, upon being distributed more or less uniformly throughout the body, are undesirably low in a particular tissue to achieve desired results. Oral or injection administration may result in to slow or too rapid increase in blood plasma levels, e.g. may involve an undesirably long time delay as the pharmaceutical is absorbed by the digestive system before entering the bloodstream, or may result in a "spike" in blood plasmal levels followed by an undesirably low level, where a more constant level would be preferable. Some pharmaceuticals are particularly prone to cause or contribute to liver damage when administered orally. Web site: http://www.delphion.com/details?pn=US06290986__ •
Stabilized solutions of psychotropic agents Inventor(s): Mentink; Maria M. F. (Oss, NL), Van Den Oetelaar; Petrus J. M. (Heesch, NL) Assignee(s): Akzo N.V. (Arnhem, NL) Patent Number: 5,208,261 Date filed: October 1, 1991 Abstract: Disclosed are stabilized aqueous preparations containing an antidepressant in admixture with a stabilizing compound such as L-methionine, D-methionine, DLmethionine, or mixtures thereof. The stabilized preparations display better stability when exposed to light, relatively high temperatures, time, and peroxides resulting in longer shelf-lives. Antidepressants which are stabilized include mirtazapine, mianserin, septiline, and amitriptyline. Excerpt(s): This invention relates to pharmaceutical compositions generally, and to stabilized aqueous solutions of certain antidepressant drugs specifically. Solutions of certain antidepressants (e.g., amitriptyline) are not very stable. They discolor, form particles, and/or suffer a decrease in concentration under certain conditions. For example, they may discolor or show a decrease in concentration upon exposure to light; upon the formation of peroxides in, or addition of peroxides to, the solutions; or when such solutions are stored at elevated temperatures. Particles may also form in such solutions under these conditions. Discoloration, development of opalescence, a decrease
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in concentration, and particle formation are all tokens of instability. These tokens of instability may occur rather rapidly, sometimes within days, forcing the dispensing pharmacist to mix new solutions frequently. An attempt to stabilize dry pharmaceutical preparations containing amitriptyline oxide dihydrate is described in German Patent Application DE 3247676 A1, published on Jun. 28, 1984 (corresponding to U.S. Pat. No. 4,567,202). That patent application describes a composition containing amitriptyline oxide dihydrate and an organic acid including certain listed amino acids. The organic acid, especially citric acid, is used to stabilize the amitriptyline. Web site: http://www.delphion.com/details?pn=US05208261__ •
Topical pain relief composition and carrier Inventor(s): Ford; Peter R. (544 St. George Blvd., Moncton, NB, CA) Assignee(s): none reported Patent Number: 6,461,600 Date filed: July 12, 2001 Abstract: A cream carrier is provided which has use as a cream-type carrier for topical delivery of medicaments including analgesics. The carrier comprises a mixture of: squalane NF, an emulsifier such as Tween 80, glycerin, cetyl alcohol NF, glyceryl monostearate, lecithin organogel preserved, BHT, urea USP, EDTA, water, stearic acid, simethicone USP, and ethoxy diglycol reagent. The invention also comprises a combination of the carrier, with either or both of ketamine hydrochloride and amitriptyline hydrochloride, which has use as a topically applied analgesic. Excerpt(s): The invention relates to topical pain relief compositions for applying to the skin of a patient, and to cream-type carrier compositions or bases for use with topical pain relief medicaments. It has been proposed to use compounds for topical pain relief which have not had widespread use as such, such as ketamine and amitriptyline. These compounds may provide pain relief in some circumstances when applied topically. However, it has been found that their use as topical pain relief medicaments is highly dependent on the selection of a suitable carrier. Previous proposals have related to mixing such medicaments with a cream-type base, for applying on the skin of a patient. However, suitable topical pain relief properties of these compounds require admixture with a carrier which achieves a suitable delivery to the skin of a patient. Improved delivery of such medicaments may be achieved with a suitable carrier having enhanced properties for delivering the medicinal compounds to the skin of a patient in a manner which enhances absorption by the patient's skin over a suitable period of time. The invention further relates to an improved method for preparing a cream-based carrier for use with a topical pain relief medication such as ketamine or amitriptyline. Web site: http://www.delphion.com/details?pn=US06461600__
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Treatment for insomnia Inventor(s): Kavey; Neil B. (26 West Orchard Rd., Chappaqua, NY 10514) Assignee(s): none reported Patent Number: 5,643,897 Date filed: March 25, 1996
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Abstract: A method for the treatment of chronic insomnia is disclosed which involves the administration of low dosages of a compound selected from the pharmaceutically acceptable forms of doxepin, trimipramine, amitriptyline, trazodone and mixtures hereof. Excerpt(s): This invention relates to a method for the treatment of individuals suffering from chronic insomnia. In a preferred embodiment, the present invention relates to a method for the treatment of chronic insomnia in individuals other than those suffering from depression. A large percentage of the adult population suffers from insomnia in some form at some time in their lives. This may vary from an occasional episode to chronic conditions and may involve onset and/or maintenance insomnia. Chronic insomnia is typically accepted to involve episodes greater than three (3) weeks in duration. The effects of sleep deprivation resulting from such insomnia are well known and need not be described herein other than to say that they are to be avoided. Currently, there exist treatments only for acute insomnia. These treatments involve the administration of medication, either of the non-barbiturate or barbiturate type, shortly before bedtime. While both types of sedatives may be used to effectively treat insomnia, neither is without its undesirable side effects. For instance, barbiturate type sedatives, such as secobarbital sodium (sold by Eli Lilly and Company under the tradename of Seconal.RTM.) are general depressants. While effective, these medications are well known to lose their effectiveness after a few days. They are further highly addictive and commonly abused. They are therefore no longer widely prescribed. Web site: http://www.delphion.com/details?pn=US05643897__ •
Treatment of transient and short term insomnia Inventor(s): Kavey; Neil B. (26 W. Orchard Rd., Chappaqua, NY 10514) Assignee(s): none reported Patent Number: 6,211,229 Date filed: February 17, 2000 Abstract: The invention is directed to a method for the treatment of a patient suffering from transient or short term insomnia. The claimed method comprises the administration of a compound selected from the group consisting of the pharmaceutically acceptable forms of doxepin, amitriptyline, trimipramine, trazodone and mixtures thereof in dosages ranging from about 0.5 to about 20.0 milligrams. Excerpt(s): This invention relates to a method for the treatment of individuals suffering from transient or short term insomnia. A large percentage of the adult population suffers from insomnia in some form at some time in their lives. This may vary from a single episode of one night's duration to chronic conditions. Transient insomnia is an insomnia that is present for one to several days, and is less than one week in duration. Short term insomnia is an insomnia of one to three weeks in duration. Chronic insomnia is typically accepted to involve episodes greater than three (3) weeks in duration. The insomnia may further involve onset insomnia (difficulty in falling asleep) and/or maintenance insomnia (difficulty in maintaining uninterrupted sleep). It is well known that the sleep deprivation resulting from such insomnia adversely affects cognition, safety and quality of life. Known treatments for insomnia include the administration of medication, either of the non-barbiturate or barbiturate type, shortly before bedtime. While both types of sedatives may be used to effectively treat insomnia, neither is without its undesirable side effects. Barbiturate type sedatives, such as secobarbital (sold
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by Eli Lilly and Company under the tradename of Seconal.RTM.) are general depressants. While effective, these medications are well known to lose their effectiveness after a few days. Furthermore, they are highly addictive and commonly abused. They are therefore no longer widely prescribed. Web site: http://www.delphion.com/details?pn=US06211229__ •
Tricyclic antidepressant drug immunogens, antibodies, labeled conjugates, and related derivatives Inventor(s): Buckler; Robert T. (Edwardsburg, MI), Ward; Frederick E. (Elkhart, IN) Assignee(s): Miles Laboratories, Inc. (Elkhart, IN) Patent Number: 4,495,281 Date filed: October 21, 1982 Abstract: Tricyclic antidepressant drug (e.g., imipramine, desipramine, amitriptyline, or nortriptyline) immunogens, antibodies prepared therefrom, labeled conjugates, synthetic intermediates, and the use of such antibodies and labeled conjugates in immunoassays for determining such drug. The immunogens comprise the drug coupled at its 2'-position to an immunogenic carrier material. Similarly, the labeled conjugates and synthetic intermediates are 2'-derivatives of the drug or a precursor thereof. The antibodies and labeled reagents are particularly useful in certain homogeneous nonradioisotopic immunoassays for measuring tricyclic antidepressant drugs in biological fluids such as serum. Excerpt(s): This invention relates to novel derivatives of tricyclic antidepressant drugs. The derivatives pertain to immunoassays for determining tricyclic antidepressant drugs in liquid media such as biological fluids and include immunogens used to stimulate production of antibodies to the drugs in host animals by conventional techniques. Also provided are labeled conjugates used as reagents, along with the antibodies, in particularly preferred immunoassays. Intermediates in the synthesis of the aforementioned immunogens and labeled conjugates are also provided. The tricyclic antidepressants are a recognized class of structurally related drugs used for the treatment of depression [The Pharmacological Basis of Therapeutics, 5th ed., ed. Goodman and Gilman, MacMillan Publ. Co. (New York 1975) pp. 174 et seq]. All of the drugs have an annealated three ring nucleus, a "tricyclic" nucleus, which is often, but by no means exclusively, dibenzazepinyl, dibenzocycloheptadienyl, dibenzoxepinyl, or phenothiazinyl in nature. A further common feature found in this class of compounds is the presence of a side chain of substantial length off one of the atoms, usually carbon or nitrogen, in the central ring of the tricylic nucleus. The most commonly administered drugs of this class are imipramine, desipramine, amitriptyline, nortriptyline, protriptyline, doxepin, and desmethyldoxepin. Because of large individual variation in steady state concentrations of tricyclic antidepressants in patients receiving the same therapeutic dose and a correlation between blood levels and clinical response, it is desirable to monitor the concentration of the drugs in the blood of patients under treatment for depression [Kaul et al, J. Anal. Toxicol. 1: 236-243 (1977)]. Immunoassay is a useful analytical technique for measuring the concentrations of substances (analytes) appearing in biological fluids in the range in which the tricyclic antidepressants appear in blood. In order to establish an immunoassay for a particular analyte it is necessary to synthesize appropriate derivatives of the drug in order to obtain immunogens by which to stimulate specific antibody production and labeled conjugates by which to monitor the immunoassay reaction.
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Web site: http://www.delphion.com/details?pn=US04495281__ •
Use of antidepressants for local analgesia Inventor(s): Reid; Allison (Nova Scotia, CA), Esser; Mike (Nova Scotia, CA), Sawynok; Jana (Nova Scotia, CA) Assignee(s): Dalhousie University (Nova Scotia, CA) Patent Number: 6,211,171 Date filed: May 19, 1998 Abstract: When administered locally, tricyclic, second generation and third generation antidepressants, such as amitriptyline and desipramine, have been shown to produce analgesia in a subject having a site of local discomfort. The analgesic effect of such antidepressants, when administered locally is equal to that achieved by systemic administration and lasts longer. The invention provides compositions containing tricyclic, second generation, and third generation antidepressants for local administration, such as those formulated for topical application, or for injection in slow release delivery vehicles, and methods for their use for producing local analgesia. Excerpt(s): The present invention relates to therapeutic compositions and methods for their use. In a particular aspect, the present invention relates to compositions for producing pain relief and methods of their use. Neuropathic pain is a form of chronic pain that can persist for months, years or decades following an injury, and results from damage to peripheral nerves, nerve roots, the spinal cord or certain brain regions. It differs from nociceptive pain in terms of duration, characteristics, underlying mechanisms and treatment (Bennett G. J. (1994a) In: Textbook of Pain (Ed. Wall P D, Melzack R) Churchill Livingstone, London 3rd edn, 201). Neuropathic pain can consist of spontaneous pain (e.g., burning, cutting, tingling), evoked pain (e.g., allodynia evoked by stimulation of non-nociceptive afferents, and hyperalgesia evoked by stimulation of nociceptive afferents) and paroxysmal pain (e.g., originating from a trigger point, described as stabbing, lancinating, shocklike) (Bennett G. J. (1994a) In: Textbook of Pain (Ed. Wall P D, Melzack R) Churchill Livingstone, London 3rd edn, 201). Neuropathic pain can accompany nociceptive pain, and multiple treatment strategies may be required for optimal alleviation of pain (Portenoy R. K. (1991) In: Towards a New Pharmacology of Pain (Ed. Basbaum A I, Besson J. M.) John Wiley & Sons Ltd, New York, 393; Devor M, Basbaum A. I., Bennett., Blumeberg H, Campbell et al (1991) In: Towards a New Pharmacotherapy of Pain (Ed. Basbaum A I, Besson J. M.) John Wiley & Sons, New York, 417). Neuropathic syndromes are traditionally classified according to the disease or event that precipitated them (e.g., postherpetic neuralgia following shingles, causalgia following partial damage to a major nerve, central pain following a thalamic infarct) (Portenoy R. K. (1991) In: Towards a New Pharmacology of Pain (Ed. Basbaum A. I., Besson J. M.) John Wiley & Sons Ltd, New York, 393; Merskey H, Bogaduk N (1994) In: Classification of Chronic Pain. Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms, 2nd edn, IASP Press, Seattle, page 40). The involvement of the sympathetic nervous system in a number of these conditions has been appreciated for some time. Pain syndromes with a sympathetic component are considered as sympathetically maintained pain (reflect sympathetic dystrophy, causalgia) (Bonica J. J. (1990) In: The Management of Pain (Ed. Bonica J. J.) Lea & Fibiger, Philadelphia 2nd edn. Bonica (1990, 220; Blumeberg H., Janig W. (1994) In: Textbook of Pain (Ed. Wall P D, Melzack R) Churchill Livingstone, London 3rd edn, 685). Neuropathic pain is particularly difficult to treat clinically. The use of opioids is
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controversial, with issues of contention being the relative refractoriness of neuropathic pain compared to nociceptive pain, the need for higher doses with an increased incidence of side effects to achieve partial effects, and concerns over the long term use of opioids in a non-malignant context (Arner S, Meyerson B A (1988) Pain 22: 11; Kuypers H., Konig H., Adriaenson H., Gybels J. M. (1991) Pain 47: 5; Portenoy R. K., Foley K. M., Inturrisi C. E. (1990) Pain 43: 273; Portenoy R. K. (1994) In: Progress in Pain Research and Management (Ed. Fields H. L., Liebskind J. C.) IASP Press, Seattle, 247). The major classes of agents currently used to treat neuropathic pain include systemically delivered antidepressants, anticonvulsants, local anesthetics, and specialized agents such as muscle relaxants, and sympatholytic drugs (reviewed Portenoy R. K. (1991) In: Towards a New Pharmacology of Pain (Ed. Basbaum A I, Besson J. M.) John Wiley & Sons Ltd, New York, 393; Portenoy R. K. (1993) Drug Therapy 23: 41; Max M B (1994) In: Progress in Pain Research and Management (Ed. Fields H. L., Liebskind J. C.) IASP Press, Seattle, 229). However, many of these treatments show limited effectiveness (complete pain relief is rarely achieved), and there is a high incidence of debilitative side effects (Portenoy R. K. (1993) Drug Therapy 23: 41; Bennett G. J. (1994a) In: Textbook of Pain (Ed. Wall P D, Melzack R) Churchill Livingstone, London 3rd edn, 201; Mac Farlane et al., (1997) Pharmacol. Ther. 75:1). Web site: http://www.delphion.com/details?pn=US06211171__
Patent Applications on Amitriptyline As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to amitriptyline: •
Topical pain relief composition and carrier Inventor(s): Ford, Peter R.; (Moncton, CA) Correspondence: SPENCER, FANE, BRITT & BROWNE; 1000 WALNUT STREET; SUITE 1400; KANSAS CITY; MO; 64106-2140; US Patent Application Number: 20020028789 Date filed: July 12, 2001 Abstract: A cream carrier is provided which has use as a cream-type carrier for topical delivery of medicaments including analgesics. The carrier comprises a mixture of: squalane NF, an emulsifier such as Tween 80, glycerin, cetyl alcohol NF, glyceryl monostearate, lecithin organogel preserved, BHT, urea USP, EDTA, water, stearic acid, simethicone USP, and ethoxy diglycol reagent. The invention also comprises a combination of the carrier, with either or both of ketamine hydrochloride and amitriptyline hydrochloride, which has use as a topically applied analgesic. Excerpt(s): The invention relates to topical pain relief compositions for applying to the skin of a patient, and to cream-type carrier compositions or bases for use with topical pain relief medicaments. It has been proposed to use compounds for topical pain relief which have not had widespread use as such, such as ketamine and amitriptyline. These compounds may provide pain relief in some circumstances when applied topically.
6
This has been a common practice outside the United States prior to December 2000.
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However, it has been found that their use as topical pain relief medicaments is highly dependent on the selection of a suitable carrier. Previous proposals have related to mixing such medicaments with a cream-type base, for applying on the skin of a patient. However, suitable topical pain relief properties of these compounds require admixture with a carrier which achieves a suitable delivery to the skin of a patient. Improved delivery of such medicaments may be achieved with a suitable carrier having enhanced properties for delivering the medicinal compounds to the skin of a patient in a manner which enhances absorption by the patient's skin over a suitable period of time. The invention further relates to an improved method for preparing a cream-based carrier for use with a topical pain relief medication such as ketamine or amitriptyline. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with amitriptyline, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “amitriptyline” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on amitriptyline. You can also use this procedure to view pending patent applications concerning amitriptyline. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 5. BOOKS ON AMITRIPTYLINE Overview This chapter provides bibliographic book references relating to amitriptyline. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on amitriptyline include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “amitriptyline” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “amitriptyline” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “amitriptyline” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Amitriptyline in the management of depression; ISBN: 0911910743; http://www.amazon.com/exec/obidos/ASIN/0911910743/icongroupinterna
Chapters on Amitriptyline In order to find chapters that specifically relate to amitriptyline, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and amitriptyline using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “amitriptyline” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on amitriptyline:
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•
Other Medicines for ADHD Source: in Barkley, R.A. Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. New York, NY: Guilford Press. 2000. p. 288-293. Contact: Available from Guilford Publications. 72 Spring Street, New York, NY 10012. (800) 365-7006. Fax (212) 966-6708. E-mail:
[email protected]. Website: www.guilford.com. PRICE: $18.95 plus shipping and handling. ISBN: 1572305606. Summary: Children whose problems with attention, overactivity, and lack of inhibition reach a certain level have a developmental disability known as attention deficit hyperactivity disorder (ADHD). This chapter on medications (drug therapy) is from a book intended to help parents who are raising a child with ADHD and for others who wish to know more about the disorder and its management. The author's main goal is to empower parents to take charge of the care of these often demanding children in a way that ensures the health of the entire family, collectively and individually. In this chapter, the author focuses on drugs other than stimulants, the drugs most commonly used. Although they are not as effective as the stimulants, several drugs called antidepressants and a drug called clonidine, used to treat high blood pressure, can be of some benefit to those with ADHD. The author reviews the tricyclic antidepressants, including Norpramin or Pertofrane (desipramine), Tofranil (imipramine), and Elavil (amitriptyline), covering side effects, drug interactions, and how these drugs are used with children. The author then discusses Wellbutrin (buproprion hydrochloride), and clonidine (usually marketed under its generic name), including side effects and how these drugs are used with children.
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Oral Medications Source: in Moldwin, R.M. Interstitial Cystitis Survival Guide: Your Guide to the Latest Treatment Options and Coping Strategies. Oakland, CA: New Harbinger Publications, Inc. 2000. p. 81-112. Contact: Available from Interstitial Cystitis Association. 51 Monroe Street, Suite 1402, Rockville, MD 20850. (800) HELP-ICA or (301) 610-5300. Fax (301) 610-5308. E-mail:
[email protected]. Website: www.ichelp.org. PRICE: $12.00 plus shipping and handling. ISBN: 1572242108. Summary: More than 700,000 Americans have interstitial cystitis (IC), a condition that includes symptoms of recurring bladder pain and discomfort on urination. This chapter on oral medications used to treat IC is from a self care book designed to empower readers by simplifying the diagnostic and treatment process for IC. The primary object of the book is to build a framework for delivering proper care to the IC patient. Oral medications, used alone or in combination with other medications, will improve symptoms in most patients with IC. Patients may still have some symptoms while on oral medications, but they may be improved to the point where they wish to wait before undergoing more invasive therapy. Most of the medications used cause few significant side effects. The author notes that most of the medications discussed in this chapter have been used for many years but for other purposes. Medications and dosages may need to be changed due to side effects or poor responses. The author first discusses medications thought to coat the bladder's surface, including pentosan polysulfate sodium (Elmiron), chondroitin sulfate, and glucosamine. The author then discusses the use of antidepressants (primarily to reduce pain), including amitriptyline (Elavil); selective serotonin reuptake inhibitors (SSRIs); antihistamines, including hydroxyzine (Atarax, Vistaril); cromolyn sodium (Gastrocrom); cimetidine (Tagamet); antiseizure medications, including gabapentin (Neurontin), and carbamazepine (Tegretol);
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nonsteroidal antiinflammatory drugs (NSAIDs); immunosuppressants, including steroids; muscle relaxants, notably diazepam (Valium); narcotic therapy; urinary anesthetics, including phenazopyridine hydrochloride (Pyridium), atropine sulfate, benzoic acid, hyoscyamine, methenamine, methylene blue, and phenyl salicylate (Urised); anticholinergic therapy; L arginine; calcium channel blockers, including nifedipine (Procardia); and alpha blockers. The author reviews the use of each of these drugs, along with the hypothesis about why they may be of use in IC. •
Effective Therapies Source: in Manu, P. Pharmacotherapy of Common Functional Syndromes: EvidenceBased Guidelines for Primary Care Practice. Binghamton, NY: Haworth Medical Press. 2000. p. 125-130. Contact: Available from Haworth Medical Press, an imprint of Haworth Press, Inc. 10 Alice Street, Binghamton, New York 13904-1580. (800) HAWORTH or (800) 429-6784. Outside United States and Canada (607) 722-5857. Fax (800) 895-0582. E-mail:
[email protected]. Website: www.haworthpressinc.com. PRICE: $69.95 plus shipping and handling. ISBN: 0789005883. Summary: This chapter is from a book that evaluates drug therapies for each of the four major functional disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), and premenstrual syndrome. In this chapter, the second of six short chapters that focus on IBS, the author introduces and reviews the effective therapies for the condition. The author focuses on the tricyclic antidepressants, notably amitriptyline, trimipramine, and desipramine. The author discusses some of the basic research on each drug's use in patients with IBS. Amitriptyline improved the symptoms of 79 percent of the patients studied. The improvement reached a highly significant level when baseline symptoms were compared to the status immediately following the administration of the tricyclic drug. Amitriptyline induced improvement was more frequently observed among patients whose IBS was of moderate severity and among those whose baseline evaluation indicated high depression and anxiety scores. Compared with placebo, treatment with trimipramine significantly reduced the severity of vomiting, sleeplessness, and depression, as well as the presence of mucus in stool. However, for the other six target symptoms, including the main complaint of abdominal pain, the frequency and severity was reduced to a similar degree in both the placebo and trimipramine groups. Closely related to trimipramine, desipramine resulted in improvement in 54 percent of the patients in one study reported. The diarrhea predominant cases were more likely to respond to desipramine (68 percent) than the constipation predominant subgroup (22 percent).
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Interstitial Cystitis Source: in Kursh, E.D., and McGuire, E.J., eds. Female Urology. Philadelphia, PA: Lippincott-Raven Publishers. 1994. p. 421-438. Contact: Available from Lippincott-Raven Publishers. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-3030 or (301) 714-2300. Fax (301) 824-7390. PRICE: $108.00 plus shipping. ISBN: 039751154X. Summary: This chapter, from a textbook on female urology, reviews interstitial cystitis (IC), a syndrome characterized by severe urinary frequency, urgency, or lower abdominal or perineal pain. This review of IC is based on the viewpoint that IC is a relatively heterogeneous disorder with a Poisson population distribution in regard to severity. Topics include the definition of IC; its pathogenesis, including an epithelial
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leak and the role of glycosaminoglycans; incidence and epidemiology, including demographic factors; pathology; signs and symptoms; evaluation; urodynamics; cystoscopy; and treatment options, including antidepressant therapy, hydrodistension of the bladder under anesthesia, dimethylsulfoxide (DMSO), amitriptyline, antihistamines, steroids, intravesical silver nitrate, intravesical sodium oxycholorosene, heparin, pentosanpolysulfate, surgery, cystolysis, bladder augmentation, urinary diversion alone, cystectomy and diversion, and bladder training. 6 figures. 5 tables. 93 references.
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CHAPTER 6. PERIODICALS AND NEWS ON AMITRIPTYLINE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover amitriptyline.
News Services and Press Releases One of the simplest ways of tracking press releases on amitriptyline is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “amitriptyline” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to amitriptyline. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “amitriptyline” (or synonyms). The following was recently listed in this archive for amitriptyline: •
Lamotrigine is good alternative to amitriptyline for central poststroke pain Source: Reuters Industry Breifing Date: January 22, 2001
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Paroxetine safer for patients with rheumatoid arthritis than amitriptyline Source: Reuters Industry Breifing Date: January 19, 2001
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Gabapentin better than amitriptyline in relieving painful diabetic neuropathy Source: Reuters Industry Breifing Date: November 20, 2000
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Amitriptyline, long-acting benzodiazepines inappropriately prescribed for elderly Source: Reuters Industry Breifing Date: October 03, 2000
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Amitriptyline effective prophylaxis for headache in childhood Source: Reuters Medical News Date: August 23, 2000
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Amitriptyline and mexiletine ineffective for HIV-related neuropathy Source: Reuters Medical News Date: December 21, 1998
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Acupuncture and amitriptyline ineffective for HIV-related peripheral neuropathy Source: Reuters Medical News Date: November 11, 1998
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Amitriptyline has moderate effect on chronic tension-type headache Source: Reuters Medical News Date: August 25, 1998
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Youths With Refractory Major Depression Do Not Benefit From Amitriptyline Source: Reuters Medical News Date: April 24, 1998
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Amitriptyline, Similar Compounds Best For Polyneuropathic Pain Relief Source: Reuters Medical News Date: December 30, 1997
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Fluoxetine and Amitriptyline Effective In Treatment Of Fibromyalgia Source: Reuters Medical News Date: October 10, 1995 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.
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Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “amitriptyline” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “amitriptyline” (or synonyms). If you know the name of a company that is relevant to amitriptyline, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “amitriptyline” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “amitriptyline” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on amitriptyline: •
Functional Bowel Disease: Looking Into Gut Feelings Source: Harvard Health Letter. 24(8): 4, 5. June 1999. Contact: Available from Harvard Medical School Health Publications Group. Harvard Health Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail:
[email protected]. Summary: This health newsletter article familiarizes readers with functional bowel disease, notably irritable bowel syndrome (IBS). For people with functional bowel diseases, gastrointestinal symptoms such as bloating, cramping, or diarrhea are frequent occurrences that may plague them off and on for months or years. The problem is
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termed 'functional' because doctors cannot determine any structural abnormality in the gut. Treatment is aimed at easing symptoms, but it is an inaccurate science, and complete relief is difficult to obtain. IBS is characterized by lower abdominal cramping and alternating constipation or diarrhea; functional dyspepsia, a sensation of nausea, bloating or pain in the upper abdomen; and noncardiac chest pain, a sharp or dull pain in the central chest that cannot be ascribed to heart disease. The author reviews various hypotheses that have been proposed to explain IBS, including irregularities in peristalsis, hyperalgesia (a heightened awareness of painful stimuli in the gut), and certain psychological traits (such as anxiety). The article concludes with a discussion of the drugs used to manage IBS, including tricyclic antidepressants (such as amitriptyline, Elavil), a migraine reliever (sumatriptan, Imitrex), an antihypertensive (clonidine, Catapres), and an experimental drug (fedotozine) and an opiate that appears to suppress transmission of pain signals from the gut to the brain. Dietary changes may be enough to manage the most troublesome symptoms; drugs enter the picture if dietary changes fail to bring relief. •
Fibromyalgia Source: Minnesota Lupus News. 23(4): 1,7,9. August/September 1999. Contact: Available from Minnesota Chapter, Lupus Foundation of America, Inc. International Market Square, 275 Market Street, Suite C19, Minneapolis, MN 55405-1620. (800) 645-1131 or (612) 375-1131. Summary: This newsletter article provides people who have fibromyalgia (FM) with information on this syndrome, which is characterized by chronic widespread pain. FM more often affects women than men, and high incidence of FM has been described in patients who have connective tissue disease. The presence of chronic widespread pain and 11 out of 18 specified tender points best distinguishes FM patients from patients who have other musculoskeletal diseases. FM is not an inflammatory condition because muscle biopsies have failed to show inflammatory changes, physical examinations have not revealed joint swelling, and laboratory tests of inflammation have been found to be normal. Although FM has been suspected of having an autoimmune basis, most studies have not found an increase in autoimmune markers. Evidence suggests that there may be a causal link between certain types of trauma and FM. Most studies suggest that FM is a chronic condition that does not change much over time. There is no cure for FM, but nonpharmacologic modalities such as aerobic exercise, cognitive behavioral therapy, and drug injections at tender points have been shown to be modestly beneficial. The tricyclic drugs amitriptyline and cyclobenzaprine have been shown to be effective in controlled trials, but their long term efficacy has been questioned. There is no evidence that nonsteroidal anti-inflammatory drugs and glucocorticoids are effective therapeutic agents.
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Fibro and Interstitial Cystitis Source: Fibromyalgia Wellness Letter. 2(2): 3. April 1999. Contact: Available from Fibromyalgia Wellness Letter (Arthritis Foundation). P.O. Box 921907, Norcross, GA 30010-1907. (877) 775-0343. Summary: This newsletter article uses a question and answer format to provide people who have fibromyalgia with information on interstitial cystitis (IC). This chronic inflammatory bladder condition, which is characterized by pain in the bladder and pelvic region and is often accompanied by urinary urgency and frequency, affects about 10 percent of those who have fibromyalgia. Although the cause of IC is unknown, some
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evidence suggests that it may be an autoimmune disorder. Other researchers speculate that bacteria may play a role. There is no definitive test to diagnose IC, so a doctor must rule out other conditions. A urologist may then perform a cystoscopy to look for glomerulations, a stiff bladder wall, or Hunner's ulcers. Cystoscopic hydrodistension is useful for both the diagnosis and the treatment of IC. Oral medications are the least invasive treatment for IC. Medications that may help include antidepressants such as amitriptyline, antihistamines such as hydroxyzine, and pentosan polysulfate sodium. Another treatment for IC is instillation, or a bladder wash, which involves using a catheter to fill the bladder with a medicinal solution for 10 to 15 minutes. Dimethyl sulfoxide is the only drug approved for instillation, but sodium hyaluronate and bacillus Calmette-Guerin are being studied as well. Other treatment options include transcutaneous electrical stimulation, sacral nerve stimulation, and surgery.
Academic Periodicals covering Amitriptyline Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to amitriptyline. In addition to these sources, you can search for articles covering amitriptyline that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for amitriptyline. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with amitriptyline. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to amitriptyline: Antidepressants, Tricyclic •
Systemic - U.S. Brands: Anafranil; Asendin; Aventyl; Elavil; Endep; Norfranil; Norpramin; Pamelor; Sinequan; Surmontil; Tipramine; Tofranil; Tofranil-PM; Vivactil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202055.html
Chlordiazepoxide and Amitriptyline •
Systemic - U.S. Brands: Limbitrol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202129.html
Perphenazine and Amitriptyline •
Systemic - U.S. Brands: Etrafon; Etrafon-A; Etrafon-Forte; Triavil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202453.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA
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through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
7
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
8
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “amitriptyline” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 6154 29 969 7 1 7160
HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “amitriptyline” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
10
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
11
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
15 Adapted 16
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on amitriptyline can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to amitriptyline. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to amitriptyline. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “amitriptyline”:
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•
Other guides Interstitial Cystitis http://www.nlm.nih.gov/medlineplus/interstitialcystitis.html Migraine http://www.nlm.nih.gov/medlineplus/migraine.html Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on amitriptyline. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Antidepressants for Cyclic Vomiting Syndrome Source: Canal Winchester, OH: Cyclic Vomiting Syndrome Association, USA/Canada. 2002. [3 p]. Contact: Available from Cyclic Vomiting Syndrome Association, USA/Canada. 3585 Cedar Hill Road, NW, Canal Winchester, OH 43110. (614) 837-2586. Fax (614) 837-2586. E-mail:
[email protected]. Website: www.cvsaonline.org. PRICE: Single copy free. Summary: This newsletter article discusses the use of antidepressants in the treatment of cyclic vomiting in mitochondrial disease. Cyclic vomiting refers to discrete and severe episodes of vomiting, nausea, and lethargy (severe tiredness). Episodes are discrete in that the sufferer is free of nausea and vomiting between episodes. Episodes can occur on a routine schedule, be triggered by physical or psychological stress, or appear to come at random. Cyclic vomiting has many known causes, including intestinal blockage, brain disorders, kidney disease, and several different metabolic disorders. Many of these causes are treatable, so a careful diagnostic work up is important. However, in the vast majority of cases, none of the above causes can be found, and these individuals are given the diagnosis of cyclic vomiting syndrome (CVS). Antidepressants are particularly useful in controlling functional symptoms in conditions including irritable bowel syndrome, functional dyspepsia, and fibromyalgia. Benefits on the physical symptoms can be independent of the drugs' psychiatric effects. The tricyclic antidepressants
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(TCAs), such as amitriptyline, nortriptyline, or desipramine, appear particularly useful, even in low daily dosages that would be considered subtherapeutic from the psychiatric standpoint. No single TCA has surfaced as superior to the other for CVS, although amitriptyline is most often utilized. The author offers guidelines for administration and dosage, patient selection, and coping with side effects of these drugs. 1 figure. 9 references. •
Fibromyalgia: What It Is and How to Manage It Source: American Family Physician. 52(3):853-854. September 1995. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail:
[email protected]. Website: www.aafp.org. Summary: This patient information sheet explains what fibromyalgia is, how it is diagnosed, and the drug therapy and patient actions designed to reveal the symptoms. The sheet indicates that fibromyalgia is a condition that causes pain in the muscles, joints, ligaments, and tendons. Increased sensitivity to pain is the main symptom. Drugs such as amitriptyline or cyclobenzaprine are used to reduce pain and other symptoms and improve sleep. Some of the most effective treatments for fibromyalgia are exercise and cutting back on alcohol and caffeine because stress and poor sleep make symptoms worse. The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to amitriptyline. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to amitriptyline. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with amitriptyline. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about amitriptyline. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “amitriptyline” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “amitriptyline”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “amitriptyline” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “amitriptyline” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
18
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
19
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
165
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on amitriptyline: •
Basic Guidelines for Amitriptyline Amitriptyline hydrochloride overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002631.htm Elavil overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002641.htm
•
Signs & Symptoms for Amitriptyline Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Blurred vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm Breathing slowed and labored Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm
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Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Convulsions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Incoordination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003198.htm Irregular heartbeat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Muscle rigidity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Restlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Stupor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Urinary hesitancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003143.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •
Diagnostics and Tests for Amitriptyline Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Gastric lavage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003882.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm
•
Background Topics for Amitriptyline Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm
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Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm Slowed, labored breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm Unconscious Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.htm Vital signs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002341.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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AMITRIPTYLINE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-Hydroxytryptophan: Precursor of serotonin used as antiepileptic and antidepressant. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylgalactosamine: The N-acetyl derivative of galactosamine. [NIH] Acetylglucosamine: The N-acetyl derivative of glucosamine. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adolescence: The period of life beginning with the appearance of secondary sex
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characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aerobic Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low
Dictionary 171
serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alprenolol: 1-((1-Methylethyl)amino)-3-(2-(2-propenyl)phenoxy)-2-propanol. Adrenergic beta-blocker used as an antihypertensive, anti-anginal, and anti-arrhythmic agent. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize
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cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Amitriptyline Hydrochloride: Nasal spray for allergic nasal complaints. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]
Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Anisotropy: A physical property showing different values in relation to the direction in or
Dictionary 173
along which the measurement is made. The physical property may be with regard to thermal or electric conductivity or light refraction. In crystallography, it describes crystals whose index of refraction varies with the direction of the incident light. It is also called acolotropy and colotropy. The opposite of anisotropy is isotropy wherein the same values characterize the object when measured along axes in all directions. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterior chamber: The space in front of the iris and behind the cornea. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidepressive Agents, Tricyclic: Substances that contain a fused three-ring moiety and are used in the treatment of depression. These drugs block the uptake of norepinephrine and
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serotonin into axon terminals and may block some subtypes of serotonin, adrenergic, and histamine receptors. However the mechanism of their antidepressant effects is not clear because the therapeutic effects usually take weeks to develop and may reflect compensatory changes in the central nervous system. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antiepileptic: An agent that combats epilepsy. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antipruritic: Relieving or preventing itching. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU]
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Apnea: A transient absence of spontaneous respiration. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Articular: Of or pertaining to a joint. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Atenolol: A cardioselective beta-adrenergic blocker possessing properties and potency similar to propranolol, but without a negative inotropic effect. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the
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hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. [NIH] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Benztropine: A centrally active muscarinic antagonist that has been used in the symptomatic treatment of Parkinson's disease. Benztropine also inhibits the uptake of dopamine. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH]
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Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a
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neurotransmitter. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Bromazepam: A benzodiazepine that is used in the treatment of anxiety disorders. [NIH] Bromine: A halogen with the atomic symbol Br, atomic number 36, and atomic weight 79.904. It is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH]
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Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Calmodulin: A heat-stable, low-molecular-weight activator protein found mainly in the brain and heart. The binding of calcium ions to this protein allows this protein to bind to cyclic nucleotide phosphodiesterases and to adenyl cyclase with subsequent activation. Thereby this protein modulates cyclic AMP and cyclic GMP levels. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH]
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Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU]
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Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cetirizine: A potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chimera: An individual that contains cell populations derived from different zygotes. [NIH] Chlordiazepoxide: An anxiolytic benzodiazepine derivative with anticonvulsant, sedative, and amnesic properties. It has also been used in the symptomatic treatment of alcohol withdrawl. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chondroitin sulfate: The major glycosaminoglycan (a type of sugar molecule) in cartilage. [NIH]
Chromaffin Cells: Cells that store epinephrine secretory vesicles. During times of stress, the nervous system signals the vesicles to secrete their hormonal content. Their name derives from their ability to stain a brownish color with chromic salts. Characteristically, they are located in the adrenal medulla and paraganglia (paraganglia, chromaffin) of the sympathetic nervous system. [NIH] Chromic: Catgut sterilized and impregnated with chromium trioxide. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of
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prolonged fatigue. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]
Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomipramine: A tricyclic antidepressant similar to imipramine that selectively inhibits the uptake of serotonin in the brain. It is readily absorbed from the gastrointestinal tract and demethylated in the liver to form its primary active metabolite, desmethylclomipramine. [NIH]
Clonic: Pertaining to or of the nature of clonus. [EU] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clorazepate Dipotassium: A water-soluble benzodiazepine derivative effective in the treatment of anxiety. It has also muscle relaxant and anticonvulsant actions. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaethylene: Hard drug formed by cocaine and alcohol. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the
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amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the
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classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete response: The disappearance of all signs of cancer in response to treatment. This does not always mean the cancer has been cured. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH]
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Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constrict: Tighten; narrow. [NIH] Contingent Negative Variation: An increasing negative shift of the cortical electrical potentials associated with an anticipated response to an expected stimulus. It is an electrical event indicative of a state of readiness or expectancy. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsants: Substances that act in the brain stem or spinal cord to produce tonic or clonic convulsions, often by removing normal inhibitory tone. They were formerly used to stimulate respiration or as antidotes to barbiturate overdose. They are now most commonly used as experimental tools. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU]
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Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cromolyn Sodium: A chromone complex that acts by inhibiting the release of chemical mediators from sensitized mast cells. It is used in the prophylactic treatment of both allergic and exercise-induced asthma, but does not affect an established asthmatic attack. [NIH] Cultured cells: Animal or human cells that are grown in the laboratory. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanide: An extremely toxic class of compounds that can be lethal on inhaling of ingesting in minute quantities. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclic Vomiting Syndrome: Sudden, repeated attacks of severe vomiting (especially in children), nausea, and physical exhaustion with no apparent cause. Can last from a few hours to 10 days. The episodes begin and end suddenly. Loss of fluids in the body and changes in chemicals in the body can require immediate medical attention. Also called abdominal migraine. [NIH] Cyproheptadine: A serotonin antagonist and a histamine H1 blocker used as antipruritic, appetite stimulant, antiallergic, and for the post-gastrectomy dumping syndrome, etc. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystectomy: Used for excision of the urinary bladder. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cystoscopy: Endoscopic examination, therapy or surgery of the urinary bladder. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which
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contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Demethylation: Process that releases substantial amounts of carbon dioxide in the liver. [NIH]
Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Deoxyribonucleic: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Deoxyribonucleic acid: A polymer of subunits called deoxyribonucleotides which is the primary genetic material of a cell, the material equivalent to genetic information. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH]
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Dermatitis: Any inflammation of the skin. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Desipramine: A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholingeric activity, through its affinity to muscarinic receptors. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] DEXA: A method (dual energy X-ray absortiometry) used to estimate total body fat and percent of body fat. Potential disadvantages include whole body radiation and the long time required for scanning while the subject lies on a hard table. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dibenzocycloheptenes: A family of tricyclic hydrocarbons whose members include many of the commonly used tricyclic antidepressants (antidepressive agents, tricyclic). [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dilatation: The act of dilating. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH]
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Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dothiepin: A tricyclic antidepressant with some tranquilizing action. [NIH] Doxepin: A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular
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properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]
symptoms
resulting
from
an
absent
or
Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electroencephalography: Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis.
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[EU]
Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Enuresis: Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting, nocturnal enuresis). [EU] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum
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lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethylene Glycol: A colorless, odorless, viscous dihydroxy alcohol. It has a sweet taste, but is poisonous if ingested. Ethylene glycol is the most important glycol commercially available and is manufactured on a large scale in the United States. It is used as an antifreeze and coolant, in hydraulic fluids, and in the manufacture of low-freezing dynamites and resins. [NIH]
Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expiration: The act of breathing out, or expelling air from the lungs. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture
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dishes adhere. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fertilizers: Substances or mixtures that are added to the soil to supply nutrients or to make available nutrients already present in the soil, in order to increase plant growth and productivity. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrositis: Aching, soreness or stiffness of muscles; often caused by inexpedient work postures. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU]
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Flatus: Gas passed through the rectum. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flunarizine: Flunarizine is a selective calcium entry blocker with calmodulin binding properties and histamine H1 blocking activity. It is effective in the prophylaxis of migraine, occlusive peripheral vascular disease, vertigo of central and peripheral origin, and as an adjuvant in the therapy of epilepsy. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescence Polarization: Measurement of the polarization of fluorescent light from solutions or microscopic specimens. It is used to provide information concerning molecular size, shape, and conformation, molecular anisotropy, electronic energy transfer, molecular interaction, including dye and coenzyme binding, and the antigen-antibody reaction. [NIH] Fluorescence Polarization Immunoassay: Fluoroimmunoassay where detection of the hapten-antibody reaction is based on measurement of the increased polarization of fluorescence-labeled hapten when it is combined with antibody. The assay is very useful for the measurement of small haptenic antigens such as drugs at low concentrations. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flupenthixol: This tranquilizer seems to be a dopamine-receptor blocker. It works primarily on the D2 receptors, with some effects on the D1 receptors. Craving in some cocaine addicts becomes manageable but is not eliminated. [NIH] Fluphenazine: A phenothiazine used in the treatment of psychoses. Its properties and uses are generally similar to those of chlorpromazine. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in
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the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH]
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Glucuronides: Glycosides of glucuronic acid formed by the reaction of uridine diphosphate glucuronic acid with certain endogenous and exogenous substances. Their formation is important for the detoxification of drugs, steroid excretion and bilirubin metabolism to a more water-soluble compound that can be eliminated in the urine and bile. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycan: A type of long, unbranched polysaccharide molecule. Glycosaminoglycans are major structural components of cartilage and are also found in the cornea of the eye. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanethidine: An antihypertensive agent that acts by inhibiting selectively transmission in post-ganglionic adrenergic nerves. It is believed to act mainly by preventing the release of norepinephrine at nerve endings and causes depletion of norepinephrine in peripheral sympathetic nerve terminals as well as in tissues. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematemesis: The vomiting of blood. [EU] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache,
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paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoperfusion: Removal of toxins or metabolites from the circulation by the passing of blood, within a suitable extracorporeal circuit, over semipermeable microcapsules containing adsorbents (e.g., activated charcoal) or enzymes, other enzyme preparations (e.g., gel-entrapped microsomes, membrane-free enzymes bound to artificial carriers), or other adsorbents (e.g., various resins, albumin-conjugated agarose). [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH]
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Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydromorphone: An opioid analgesic made from morphine and used mainly as an analgesic. It has a shorter duration of action than morphine. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hydroxyzine: A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite cetirizine, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypotension: Abnormally low blood pressure. [NIH]
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Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of
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neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Incubated: Grown in the laboratory under controlled conditions. (For instance, white blood cells can be grown in special conditions so that they attack specific cancer cells when returned to the body.) [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the
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purpose of observation, care, diagnosis or treatment. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Instillation: . [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intravesical: Within the bladder. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iontophoresis: Therapeutic introduction of ions of soluble salts into tissues by means of electric current. In medical literature it is commonly used to indicate the process of
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increasing the penetration of drugs into surface tissues by the application of electric current. It has nothing to do with ion exchange, air ionization nor phonophoresis, none of which requires current. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Isoproterenol: Isopropyl analog of epinephrine; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant. [NIH] Isozymes: The multiple forms of a single enzyme. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [NIH] Ketoprofen: An ibuprofen-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis. [NIH] Ketotifen: A cycloheptathiophene that interferes with the release of inflammatory mediators and blocks histamine H1 receptors. It has been proposed as an anti-asthmatic and for the treatment of rhinitis, skin allergies, and anaphylaxis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kilobase: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetic: Pertaining to or producing motion. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH]
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Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]
Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Lenses: Pieces of glass or other transparent materials used for magnification or increased visual acuity. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukoencephalopathy: A condition with spongy holes in the brain's white matter. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH]
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Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lofepramine: A psychotropic imipramine derivative that acts as a tricyclic antidepressant and possesses few anticholinergic properties. It is metabolized to desipramine. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and
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spread to other parts of the body. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Maprotiline: A bridged-ring tetracyclic antidepressant that is both mechanistically and functionally similar to the tricyclic antidepressants, including side effects associated with its use. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH]
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Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Meperidine: 1-Methyl-4-phenyl-4-piperidinecarboxylic acid ethyl ester. A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. [NIH] Mephenytoin: An anticonvulsant effective in tonic-clonic epilepsy. It may cause blood dyscrasias. [NIH] Mesterolone: 17 beta-Hydroxy-1 alpha-methyl-5 alpha-androstan-3-one. A synthetic steroid with anabolic and androgenic activities. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methacrylate: A vinyl monomer. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methoxamine: An alpha-adrenergic agonist that causes prolonged peripheral vasoconstriction. It has little if any direct effect on the central nervous system. [NIH] Methylcellulose: Methylester of cellulose. Methylcellulose is used as an emulsifying and suspending agent in cosmetics, pharmaceutics and the chemical industry. It is used therapeutically as a bulk laxative. [NIH] Methylene Blue: A compound consisting of dark green crystals or crystalline powder, having a bronze-like luster. Solutions in water or alcohol have a deep blue color. Methylene blue is used as a bacteriologic stain and as an indicator. It inhibits Guanylate cyclase, and has been used to treat cyanide poisoning and to lower levels of methemoglobin. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Metoprolol: Adrenergic beta-1-blocking agent with no stimulatory action. It is less bound to plasma albumin than alprenolol and may be useful in angina pectoris, hypertension, or cardiac arrhythmias. [NIH] Mexiletine: Antiarrhythmic agent pharmacologically similar to lidocaine. It may have some anticonvulsant properties. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Mianserin: A tetracyclic compound with antidepressant effects. It may cause drowsiness and hematological problems. Its mechanism of therapeutic action is not well understood, although it apparently blocks alpha-adrenergic, histamine H1, and some types of serotonin receptors. [NIH] Mianserine: An antidepressant sometimes used in the pharmacotherapy of bulimia nervosa.
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[NIH]
Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum formed after disruption and centrifugation of cells. [EU] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Minocycline: A semisynthetic staphylococcus infections. [NIH]
antibiotic
effective
against
tetracycline-resistant
Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU]
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Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the drugs less effective. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculoskeletal Diseases: Diseases of the muscles and their associated ligaments and other connective tissue and of the bones and cartilage viewed collectively. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycosis: Any disease caused by a fungus. [EU] Mycosis Fungoides: A chronic malignant T-cell lymphoma of the skin. In the late stages the lymph nodes and viscera are affected. [NIH] Mydriasis: Dilation of pupils to greater than 6 mm combined with failure of the pupils to constrict when stimulated with light. This condition may occur due to injury of the pupillary fibers in the oculomotor nerve, in acute angle-closure glaucoma, and in Adie syndrome. [NIH]
Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia
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is a characteristic feature of myotonic disorders. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU]
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Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]
Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nimodipine: A calcium channel blockader with preferential cerebrovascular activity. It has marked cerebrovascular dilating effects and lowers blood pressure. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal
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transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Oculomotor Nerve: The 3d cranial nerve. The oculomotor nerve sends motor fibers to the levator muscles of the eyelid and to the superior rectus, inferior rectus, and inferior oblique muscles of the eye. It also sends parasympathetic efferents (via the ciliary ganglion) to the muscles controlling pupillary constriction and accommodation. The motor fibers originate in the oculomotor nuclei of the midbrain. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU]
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Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Oxytocic: 1. Pertaining to, characterized by, or promoting oxytocia (= rapid labor). 2. An agent that hastens evacuation of the uterus by stimulating contractions of the myometrium. [EU]
Oxytocin: A nonapeptide posterior pituitary hormone that causes uterine contractions and stimulates lactation. [NIH] Pain Threshold: Amount of stimulation required before the sensation of pain is experienced. [NIH]
Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it
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may be inherited as an autosomal dominant trait. [NIH] Paraganglia, Chromaffin: Small bodies containing chromaffin cells occurring outside of the adrenal medulla, most commonly near the sympathetic ganglia and in organs such as the kidney, liver, heart and gonads. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]
Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial response: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment. [NIH] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pemoline: A central nervous system stimulant used in fatigue and depressive states and to treat hyperkinetic disorders in children. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentosan polysulfate: A drug used to relieve pain or discomfort associated with chronic inflammation of the bladder. It is also being evaluated for its protective effects on the gastrointestinal tract in people undergoing radiation therapy. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the
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principal digestive enzyme of gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Perphenazine: An antipsychotic phenothiazine derivative with actions and uses similar to
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those of chlorpromazine. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Phenazopyridine: A local anesthetic that has been used in urinary tract disorders. Its use is limited by problems with toxicity (primarily blood disorders) and potential carcinogenicity. [NIH]
Phenyl: Ingredient used in cold and flu remedies. [NIH] Phonophoresis: Use of ultrasound to increase the percutaneous adsorption of drugs. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physostigmine: A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe anticholinergic toxicity. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piroxicam: 4-Hydroxy-2-methyl-N-2-pyridyl-2H-1,2-benzothiazine-3-carboxamide 1,1dioxide. A non-steroidal anti-inflammatory agent that is well established in the treatment of rheumatoid arthritis and osteoarthritis. Its usefulness has also been demonstrated in the treatment of musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. The drug has also been shown to be effective if administered rectally. Gastrointestinal complaints are the most frequently reported side effects. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected
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to the hypothalamus by a short stalk. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plastic surgeon: A surgeon who specializes in reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyradiculoneuropathy: Diseases characterized by injury or dysfunction involving multiple peripheral nerves and nerve roots. The process may primarily affect myelin or nerve axons. Two of the more common demyelinating forms are acute inflammatory polyradiculopathy (Guillain-Barre syndrome) and polyradiculoneuropathy, chronic inflammatory demyelinating. Polyradiculoneuritis refers to inflammation of multiple peripheral nerves and spinal nerve roots. [NIH]
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Polyradiculopathy: Disease or injury involving multiple spinal nerve roots. Polyradiculitis refers to inflammation of multiple spinal nerve roots. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potassium Chloride: Potassium chloride. A white crystal or crystalline powder used as an electrolyte replenisher, in the treatment of hypokalemia, in buffer solutions, and in fertilizers and explosives. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Prazosin: A selective adrenergic alpha-1 antagonist used in the treatment of heart failure, hypertension, pheochromocytoma, Raynaud's syndrome, prostatic hypertrophy, and urinary retention. [NIH] Precordial: Pertaining to the precordium (= region over the heart and lower part of the thorax). [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and
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painful breasts. [NIH] Prenalterol: A partial adrenergic agonist with functional beta 1-receptor specificity and inotropic effect. It is effective in the treatment of acute cardiac failure, postmyocardial infarction low-output syndrome, shock, and reducing orthostatic hypotension in the ShyDrager syndrome. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Preoptic Area: Region of hypothalamus between the anterior commissure and optic chiasm. [NIH]
Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Primary central nervous system lymphoma: Cancer that arises in the lymphoid tissue found in the central nervous system (CNS). The CNS includes the brain and spinal cord. [NIH]
Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Procainamide: A derivative of procaine with less CNS action. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progeny: The offspring produced in any generation. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty
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acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]
Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to
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macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protriptyline: Tricyclic antidepressant similar in action and side effects to imipramine. It may produce excitation. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychomotor Performance: The coordination of a sensory or ideational (cognitive) process and a motor activity. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of
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pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH]
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Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]
Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH]
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Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restless legs: Legs characterized by or showing inability to remain at rest. [EU] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Riboflavin: Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as FMN and FAD. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of
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developing a disease. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rolipram: A phosphodiesterase inhibitor with antidepressant properties. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secobarbital: A barbiturate that is used as a sedative. Secobarbital is reported to have no anti-anxiety activity. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Secretory Vesicles: Vesicles derived from the golgi apparatus containing material to be released at the cell surface. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs
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discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Syndrome: An adverse drug interaction characterized by altered mental status, autonomic dysfunction, and neuromuscular abnormalities. It is most frequently caused by use of both serotonin reuptake inhibitors and monoamine oxidase inhibitors, leading to excess serotonin availability in the CNS at the serotonin 1A receptor. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet
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activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Sleep Bruxism: A sleep disorder characterized by grinding and clenching of the teeth and forceful lateral or protrusive jaw movements. Sleep bruxism may be associated with tooth injuries; temporomandibular joint disorders; sleep disturbances; and other conditions. [NIH] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important
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physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Somnambulism: A parasomnia characterized by a partial arousal that occurs during stage IV of non-REM sleep. Affected individuals exhibit semipurposeful behaviors such as ambulation and are difficult to fully awaken. Children are primarily affected, with a peak age range of 4-6 years. [NIH] Sparteine: An alkaloid isolated from lupin beans, Lupinus luteus and Lupinus niger. It has been used as an oxytocic and an anti-arrhythmia agent. It has also been of interest because of genetic variation in its metabolism. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincters: Any annular muscle closing an orifice. [NIH] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylitis: Inflammation of the vertebrae. [EU]
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Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Steady state: Dynamic equilibrium. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Structure-Activity Relationship: The relationship between the chemical structure of a compound and its biological or pharmacological activity. Compounds are often classed together because they have structural characteristics in common including shape, size, stereochemical arrangement, and distribution of functional groups. Other factors contributing to structure-activity relationship include chemical reactivity, electronic effects, resonance, and inductive effects. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subspecies: A category intermediate in rank between species and variety, based on a
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smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sumatriptan: A serotonin agonist that acts selectively at 5HT1 receptors. It is used in the treatment of migraines. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Systemic: Affecting the entire body. [NIH]
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Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH]
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Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tooth Injuries: Traumatic or other damage to teeth including fractures (tooth fractures) or displacements (tooth luxation). [NIH] Topical: On the surface of the body. [NIH] Torsades de Pointes: A ventricular tachycardia characterized by periodic twisting of the points of the QRS complexes and rates between 200 and 250 beats per minute. It may be selflimited or may progress to ventricular fibrillation. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Traction: The act of pulling. [NIH] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transaminases: A subclass of enzymes of the transferase class that catalyze the transfer of
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an amino group from a donor (generally an amino acid) to an acceptor (generally a 2-keto acid). Most of these enzymes are pyridoxyl phosphate proteins. (Dorland, 28th ed) EC 2.6.1. [NIH]
Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triazolam: A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trimipramine: Tricyclic antidepressant similar to imipramine, but with more antihistaminic and sedative properties. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubocurarine: A neuromuscular blocker and active ingredient in curare; plant based alkaloid of Menispermaceae. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic
Dictionary 233
receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uridine Diphosphate: A uracil nucleotide containing a pyrophosphate group esterified to C5 of the sugar moiety. [NIH] Uridine Diphosphate Glucuronic Acid: A nucleoside diphosphate sugar which serves as a source of glucuronic acid for polysaccharide biosynthesis. It may also be epimerized to UDP iduronic acid, which donates iduronic acid to polysaccharides. In animals, UDP glucuronic acid is used for formation of many glucosiduronides with various aglycones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary urgency: Inability to delay urination. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamics: The mechanical laws of fluid dynamics as they apply to urine transport. [NIH] Urologist: A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]
234 Amitriptyline
Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium channels. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viloxazine: A morpholine derivative used as an antidepressant. It is similar in action to imipramine. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca
Dictionary 235
alkaloids. It is a mitotic inhibitor. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]
Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zygote: The fertilized ovum. [NIH]
237
INDEX 5 5-Hydroxytryptophan, 76, 117, 169 A Abdomen, 138, 169, 177, 201, 204, 214, 227, 228, 230, 235 Abdominal, 133, 138, 169, 186, 195, 202, 212, 214, 217 Abdominal Pain, 133, 169, 195, 202 Aberrant, 16, 169, 183 Acceptor, 169, 212, 232 Acetaminophen, 91, 169 Acetylcholine, 169, 181, 210 Acetylgalactosamine, 169 Acetylglucosamine, 169 Adaptation, 169, 181, 208 Adenine, 169 Adenosine, 106, 169, 178, 215 Adipocytes, 169, 184, 203 Adjustment, 88, 169 Adjuvant, 169, 194 Adolescence, 169, 213 Adrenal Cortex, 170, 186, 223 Adrenal Medulla, 170, 180, 181, 192, 210, 213 Adverse Effect, 8, 170, 225 Aerobic, 138, 170, 212 Aerobic Exercise, 138, 170 Aerobic Metabolism, 170, 212 Aerobic Respiration, 170, 212 Afferent, 14, 170, 203, 227 Affinity, 9, 16, 170, 175, 188, 226 Agarose, 170, 197 Agonist, 38, 170, 178, 189, 191, 206, 218, 229 Agoraphobia, 170, 199, 212 Albumin, 170, 197, 206 Alertness, 171, 178 Algorithms, 171, 177 Alimentary, 171, 202 Alkaline, 171, 172, 178 Alkaloid, 171, 175, 178, 179, 182, 183, 207, 221, 227, 232 Allergen, 171, 188, 225 Allylamine, 171 Alpha Particles, 171, 221 Alpha-1, 37, 171, 172, 217 Alprenolol, 171, 206 Alternative medicine, 137, 171
Amenorrhea, 171, 173 Amine, 10, 27, 42, 171, 197 Amino Acid Sequence, 171, 173 Amino Acids, 120, 124, 171, 210, 214, 216, 219, 229, 233 Amitriptyline Hydrochloride, 64, 68, 113, 124, 128, 172 Ammonia, 171, 172, 229, 233 Amnestic, 172, 194 Amphetamines, 172, 183 Amygdala, 7, 172, 203, 230 Anabolic, 172, 206 Anaesthesia, 20, 38, 63, 172, 200 Anal, 10, 104, 126, 172, 193, 204 Analog, 9, 172, 202 Analogous, 172, 190, 232 Analytes, 10, 126, 172 Anaphylaxis, 172, 202 Anastomosis, 20, 172 Anatomical, 172, 175, 199, 224 Androgenic, 172, 206 Anesthesia, 8, 18, 37, 53, 104, 134, 172, 173, 186, 202, 218 Anesthetics, 8, 15, 128, 133, 172, 176, 192 Angina, 172, 206, 218 Angina Pectoris, 172, 206, 218 Anginal, 171, 172, 210 Anisotropy, 172, 194 Anorexia, 21, 61, 116, 172, 173, 195 Anorexia Nervosa, 21, 61, 116, 173 Antagonism, 56, 173, 178, 189 Anterior chamber, 173, 202 Antiallergic, 173, 186 Anti-Anxiety Agents, 173, 220, 231 Antibacterial, 173, 227 Antibiotic, 173, 207, 213, 227, 230 Antibodies, 120, 126, 173, 196, 204, 216 Anticholinergic, 23, 121, 133, 171, 173, 181, 189, 204, 215 Anticoagulant, 68, 173, 219 Anticonvulsant, 173, 179, 181, 182, 206, 234 Antidepressive Agents, 173, 188, 220 Antidepressive Agents, Tricyclic, 173, 188 Antiemetic, 174, 181, 189, 198, 206 Antiepileptic, 169, 174 Antifungal, 174, 194, 202
238 Amitriptyline
Antigen, 170, 172, 173, 174, 183, 194, 197, 198, 199, 200, 205, 221, 225 Antihypertensive, 138, 171, 174, 196 Anti-inflammatory, 122, 138, 169, 174, 188, 195, 199, 200, 202, 215, 224 Antimicrobial, 174, 188 Antipruritic, 174, 186 Antipsychotic, 174, 181, 209, 214, 224, 231 Antipyretic, 169, 174, 202, 221 Antitussive, 174, 189, 211 Anus, 172, 174, 177, 214 Anxiety, 14, 27, 31, 32, 33, 48, 64, 71, 133, 138, 173, 174, 178, 182, 194, 198, 212, 218, 224 Anxiety Disorders, 174, 178, 212 Anxiolytic, 174, 181 Aorta, 174, 179, 234 Apathy, 174, 209 Apnea, 87, 175 Aqueous, 113, 121, 123, 175, 176, 187, 191 Arachidonic Acid, 175, 219 Arginine, 133, 175, 210 Arrhythmia, 175, 227 Arterial, 171, 175, 179, 185, 198, 219, 230 Arteries, 174, 175, 176, 177, 181, 185, 206, 208, 220 Arterioles, 175, 177, 179, 207 Arteriovenous, 175, 207 Articular, 33, 175, 203, 212 Assay, 10, 45, 114, 175, 194, 199, 221 Astrocytes, 175, 207 Atenolol, 57, 175 Atrial, 175, 185, 232 Atrioventricular, 175, 185 Atrium, 175, 179, 185, 232, 234 Atropine, 133, 175, 176 Attenuated, 175, 188, 233 Atypical, 175, 211, 224 Auditory, 175, 192 Autacoids, 175, 200 Autonomic, 31, 42, 52, 54, 91, 169, 174, 175, 176, 210, 214, 225, 226, 227, 229 Autonomic Nervous System, 91, 175, 176, 214, 226, 229 Autoradiography, 7, 176 Axons, 176, 214, 216, 218, 227 B Bacillus, 139, 176 Bacteria, 139, 173, 174, 176, 184, 187, 190, 193, 207, 227, 228, 232, 233 Bactericidal, 176, 192 Bacterium, 176, 184
Barbiturate, 125, 176, 185, 224 Base, 12, 124, 129, 169, 176, 187, 202, 216, 226, 230 Basilar Artery, 84, 176 Belladonna, 175, 176 Benign, 176, 196, 221 Benzene, 176 Benzodiazepines, 90, 136, 176 Benzoic Acid, 133, 176 Benztropine, 5, 11, 176 Bewilderment, 176, 184 Bile, 176, 177, 195, 196, 202, 204, 228 Bile Pigments, 177, 202 Bilirubin, 170, 177, 196, 198 Binding Sites, 9, 177 Bioavailability, 30, 90, 177 Biochemical, 25, 50, 177, 212, 225 Biological Transport, 177, 188 Biotechnology, 17, 137, 149, 177 Bladder, 11, 132, 134, 138, 177, 186, 200, 201, 213, 219, 233 Blastocyst, 177, 216 Bloating, 137, 177, 202 Blood Coagulation, 177, 178 Blood Platelets, 96, 177, 225, 230 Blood pressure, 8, 26, 132, 166, 174, 177, 179, 198, 207, 210, 214, 220, 226 Blood vessel, 177, 178, 179, 181, 185, 191, 214, 226, 234 Blood-Brain Barrier, 177, 209, 215 Body Fluids, 80, 177, 190, 226 Bowel, 137, 172, 177, 188, 201, 203, 214, 228 Bowel Movement, 177, 188, 228 Brachytherapy, 177, 201, 221 Bradykinin, 177, 210 Brain Stem, 178, 181, 185 Branch, 163, 178, 213, 227, 230 Breakdown, 178, 188, 195 Bromazepam, 33, 178 Bromine, 120, 178 Bronchi, 178, 192, 202 Bronchodilator, 178, 202 Bruxism, 178, 226 Bulimia, 19, 178, 206 Bupivacaine, 15, 178, 203 Buprenorphine, 78, 106, 178 Bupropion, 26, 36, 111, 178 C Caffeine, 105, 155, 178 Calcium, 16, 105, 121, 133, 178, 179, 182, 183, 194, 210, 225
Index 239
Calcium channel blocker, 16, 133, 178 Calcium Channel Blockers, 16, 133, 178 Calcium Channels, 105, 179 Calmodulin, 179, 194 Candidiasis, 179, 194 Capillary, 10, 79, 87, 177, 179, 234 Capsaicin, 13, 179 Captopril, 121, 179 Carbamazepine, 122, 132, 179 Carbohydrates, 170, 179, 180, 212 Carbon Dioxide, 179, 187, 193, 216, 223 Cardiac arrest, 8, 179 Cardiopulmonary, 113, 179 Cardiopulmonary Bypass, 113, 179 Cardiorespiratory, 170, 179 Cardioselective, 175, 179, 218 Cardiovascular, 27, 52, 54, 113, 179, 225, 226 Carpal Tunnel Syndrome, 15, 179 Carrier Proteins, 180, 221 Case report, 4, 94, 98, 180, 182 Case series, 180, 182 Catecholamine, 92, 105, 173, 180, 189, 215 Cauda Equina, 16, 180 Caudal, 180, 188, 199, 217 Causal, 138, 180 Cell Differentiation, 180, 225 Cell Division, 176, 180, 205, 216, 218 Cell membrane, 177, 178, 179, 180, 187, 217, 226, 235 Cell proliferation, 180, 225 Cell Respiration, 170, 180, 212, 223 Cellulose, 179, 180, 194, 206, 216 Central Nervous System Infections, 180, 196 Centrifugation, 180, 207 Cerebellar, 95, 180, 181, 232 Cerebellar Diseases, 181, 232 Cerebellum, 180, 181, 217 Cerebral, 21, 84, 176, 177, 178, 181, 185, 192, 220, 227, 230 Cerebral Arteries, 176, 181 Cerebrospinal, 27, 42, 68, 181 Cerebrospinal fluid, 27, 42, 68, 181 Cerebrovascular, 178, 181, 210 Cetirizine, 181, 198 Chemotherapy, 22, 181 Chest Pain, 138, 181 Chimera, 9, 181 Chlordiazepoxide, 28, 31, 62, 88, 142, 181 Chlorine, 120, 181
Chlorpromazine, 9, 80, 84, 113, 181, 194, 215 Cholinergic, 172, 174, 181 Chondroitin sulfate, 132, 181 Chromaffin Cells, 105, 181, 213 Chromic, 181 Chromosome, 181, 184, 203 Chronic Disease, 11, 181 Chronic Fatigue Syndrome, 133, 181 Chronic renal, 65, 182 Cimetidine, 28, 132, 182 CIS, 89, 182 Citalopram, 32, 33, 35, 91, 182 Citric Acid, 124, 182 Citrus, 182 Clamp, 8, 15, 182 Clinical Medicine, 105, 182, 217 Clinical study, 91, 99, 182, 185 Clinical trial, 5, 6, 11, 12, 15, 29, 38, 82, 106, 114, 149, 182, 185, 208, 213, 221, 222 Clomipramine, 35, 46, 49, 56, 104, 113, 114, 182 Clonic, 182, 185, 206 Cloning, 177, 182 Clorazepate Dipotassium, 25, 182 Coca, 182 Cocaethylene, 104, 182 Cocaine, 7, 34, 104, 182, 194 Cochlear, 183, 231, 234 Cochlear Diseases, 183, 231 Coenzyme, 183, 194 Cognition, 125, 183, 209 Cognitive Therapy, 95, 183 Colchicine, 183, 232 Colitis, 183, 202 Collagen, 114, 183, 216, 218 Combination chemotherapy, 12, 183 Combination Therapy, 8, 183 Complement, 183, 184, 225 Complementary and alternative medicine, 111, 118, 184 Complementary medicine, 111, 184 Complete response, 4, 184 Computational Biology, 149, 184 Computer Simulation, 11, 184 Confusion, 4, 184, 189, 209 Conjugated, 176, 184, 187, 197 Conjugation, 120, 184 Conjunctiva, 184, 215 Connective Tissue, 138, 183, 184, 193, 195, 204, 208, 214, 223 Connective Tissue Cells, 184
240 Amitriptyline
Consciousness, 172, 173, 185, 189, 223 Constipation, 104, 112, 133, 138, 174, 185, 194, 202 Constrict, 185, 208 Contingent Negative Variation, 31, 185 Contraindications, ii, 185 Contralateral, 14, 185, 211 Control group, 14, 185 Controlled clinical trial, 5, 6, 11, 12, 18, 48, 185, 222 Controlled study, 12, 13, 18, 21, 28, 30, 46, 63, 67, 91, 185 Convulsants, 122, 185 Convulsions, 121, 166, 173, 176, 185 Coordination, 12, 181, 185, 220 Cor, 27, 185, 186 Coronary, 172, 185, 206, 208 Coronary Thrombosis, 185, 206, 208 Cortex, 181, 185, 186, 192 Cortical, 89, 185, 186, 224 Corticosteroids, 186, 195 Corticotropin-Releasing Hormone, 27, 186 Cortisol, 24, 170, 186 Cortisone, 186, 188 Cranial, 181, 186, 196, 201, 209, 211, 214, 234 Craniocerebral Trauma, 186, 196, 231 Cromolyn Sodium, 132, 186 Cultured cells, 9, 186 Curare, 186, 208, 232 Curative, 186, 210, 230 Cutaneous, 13, 29, 82, 90, 179, 186 Cyanide, 186, 206 Cyclic, 3, 42, 45, 154, 178, 179, 186, 196, 210, 215, 219 Cyclic Vomiting Syndrome, 3, 42, 154, 186 Cyproheptadine, 3, 42, 186 Cyst, 60, 186 Cystectomy, 134, 186 Cystitis, 6, 11, 97, 132, 133, 138, 154, 186 Cystoscopy, 134, 139, 186 Cytochrome, 10, 44, 45, 47, 65, 69, 106, 182, 186 Cytomegalovirus, 12, 187 Cytoplasm, 180, 187, 191, 196 Cytosine, 12, 187 Cytoskeleton, 9, 187 Cytotoxic, 50, 179, 187, 221, 225 D Databases, Bibliographic, 149, 187 Deamination, 187, 207, 233 Decidua, 187, 216
Demethylation, 10, 34, 45, 48, 57, 69, 92, 106, 187 Dendritic, 187, 205, 227 Dental Caries, 187, 194 Deoxyribonucleic, 187, 223 Deoxyribonucleic acid, 187, 223 Depolarization, 187, 225 Depressive Disorder, 18, 67, 91, 92, 99, 104, 187, 204 Dermatitis, 75, 188, 198 Desensitization, 9, 188 Desipramine, 10, 11, 31, 32, 43, 47, 50, 57, 79, 86, 87, 97, 106, 126, 127, 132, 133, 155, 188, 204 Detergents, 9, 188 Detoxification, 188, 196 Deuterium, 188, 198 DEXA, 111, 188 Dexamethasone, 28, 35, 36, 68, 82, 104, 188 Diagnostic procedure, 119, 137, 188 Dialysate, 52, 188 Dialyzer, 188, 197 Diarrhea, 133, 137, 188, 194, 202 Diastolic, 188, 198 Dibenzocycloheptenes, 120, 188 Diencephalon, 188, 199, 230 Diffusion, 121, 177, 188 Digestion, 171, 176, 177, 188, 190, 201, 204, 228 Digestive system, 123, 188 Dihydroxy, 188, 192 Dilatation, 188, 218 Dilution, 10, 188 Dimethyl, 139, 188, 226 Diphenhydramine, 25, 31, 189 Direct, iii, 9, 141, 182, 183, 189, 206, 221, 222, 229 Discrimination, 94, 189 Disease Progression, 12, 189 Disinfectant, 189, 192 Disorientation, 184, 189 Disposition, 25, 30, 34, 70, 78, 80, 107, 189 Dissociation, 9, 170, 189, 201 Dissociative Disorders, 189 Distal, 9, 189, 214, 218, 220 Diuresis, 178, 189 Dominance, 48, 189 Dopamine, 7, 174, 176, 178, 181, 183, 189, 194, 206, 207, 224 Dothiepin, 31, 56, 100, 189 Doxepin, 19, 23, 41, 58, 63, 87, 89, 90, 98, 122, 125, 126, 189
Index 241
Drug Design, 8, 189 Drug Interactions, 93, 132, 142, 190 Drug Monitoring, 32, 36, 37, 46, 47, 55, 70, 88, 93, 94, 98, 114, 190 Drug Tolerance, 190, 231 Duct, 190, 224, 229 Dumping Syndrome, 186, 190 Dyskinesia, 174, 182, 190 Dysmenorrhea, 190, 215 Dyspareunia, 16, 190 Dyspepsia, 41, 138, 154, 190 Dysphoric, 187, 190 Dystrophy, 69, 127, 190 E Ejaculation, 56, 190, 225 Elastin, 183, 190 Elective, 85, 190 Electroencephalography, 55, 88, 190 Electrolyte, 190, 217, 226 Electrons, 176, 190, 201, 212, 221 Embolus, 190, 200 Emesis, 22, 166, 190 Emulsion, 176, 191, 193 Endocarditis, 83, 179, 191 Endocardium, 191 Endothelium, 191, 210 Endothelium-derived, 191, 210 End-stage renal, 182, 191 Energy balance, 191, 203 Enkephalin, 76, 191 Enuresis, 61, 104, 191 Environmental Health, 148, 150, 191 Enzymatic, 178, 184, 187, 191, 197 Eosinophilia, 59, 191 Eosinophilic, 19, 191 Eosinophils, 191, 196, 203 Ephedrine, 20, 191 Epidermis, 191, 198 Epinephrine, 45, 170, 181, 189, 192, 202, 210, 233 Epithelial, 11, 133, 177, 187, 192 Epithelial Cells, 11, 192 Epithelium, 191, 192, 202 Erythrocytes, 192, 225 Esophagus, 188, 192, 228 Ethanol, 23, 38, 43, 46, 182, 192 Ethylene Glycol, 32, 105, 192 Eukaryotic Cells, 192, 200 Evacuation, 185, 192, 203, 212, 221 Evoked Potentials, 89, 192 Excitability, 192, 209, 221 Excitation, 172, 192, 220
Exhaustion, 173, 186, 192 Exogenous, 6, 179, 192, 196 Expiration, 192, 223 External-beam radiation, 192, 221 Extracellular, 175, 184, 192, 226 Extracellular Matrix, 184, 192 Extracorporeal, 193, 197 Extraction, 9, 35, 42, 52, 72, 193 Extrapyramidal, 174, 189, 193 Extremity, 15, 193, 205, 213, 224 F Facial, 71, 193, 226 Family Planning, 149, 193 Fat, 169, 175, 185, 188, 190, 193, 203, 204, 223 Fatigue, 181, 193, 197, 213 Fatty acids, 170, 193, 219 Fecal Incontinence, 72, 193, 200 Feces, 185, 193, 228 Femoral, 179, 193 Femoral Artery, 179, 193 Fertilizers, 193, 217 Fetus, 193, 216, 218, 233 Fibrillation, 193 Fibrosis, 171, 193, 224 Fibrositis, 46, 55, 193 Fixation, 193, 225 Flatus, 193, 194, 195 Fluconazole, 77, 90, 194 Flunarizine, 92, 194 Fluorescence, 55, 194 Fluorescence Polarization, 55, 194 Fluorescence Polarization Immunoassay, 55, 194 Fluorine, 120, 194 Flupenthixol, 77, 194 Fluphenazine, 20, 22, 36, 49, 71, 74, 194 Fluvoxamine, 31, 49, 74, 90, 194 Forearm, 177, 194, 205 Functional Disorders, 133, 194 Fungi, 174, 184, 194, 195, 207, 233 Fungistatic, 176, 194 Fungus, 179, 194, 208 G Gallbladder, 169, 188, 195 Gamma Rays, 195, 221 Ganglia, 169, 174, 195, 203, 209, 213, 214, 227, 229 Gas, 10, 50, 51, 79, 83, 87, 172, 179, 181, 188, 194, 195, 198, 202, 210, 234 Gastrectomy, 186, 195 Gastric, 166, 182, 195, 197, 214, 222
242 Amitriptyline
Gastric Acid, 182, 195 Gastrin, 182, 195, 197 Gastroenteritis, 178, 195 Gastrointestinal, 123, 137, 177, 182, 190, 192, 195, 213, 215, 222, 225, 226, 227, 229 Gastrointestinal tract, 182, 192, 195, 213, 225, 227 Gene, 177, 189, 195, 197 Genetics, 184, 189, 195 Genital, 195, 233 Gestation, 195, 216 Gestational, 7, 195 Gland, 25, 170, 186, 195, 204, 212, 215, 219, 224, 228, 229, 230 Glioma, 9, 195 Glucocorticoid, 82, 188, 195 Glucuronic Acid, 195, 196, 197, 233 Glucuronides, 31, 80, 195, 196 Glycine, 176, 196 Glycoprotein, 37, 55, 107, 196 Glycosaminoglycan, 181, 196 Governing Board, 196, 217 Graft, 196, 198, 199 Granulocytes, 196, 203, 225, 235 Gravis, 196, 209 Growth, 11, 52, 93, 170, 173, 174, 180, 193, 194, 196, 204, 211, 216, 226, 230, 232 Guanethidine, 56, 196 Guanylate Cyclase, 196, 210 H Haematemesis, 190, 196 Half-Life, 47, 196, 215 Hallucinogens, 196, 220 Haloperidol, 55, 69, 74, 85, 196 Haptens, 170, 196, 221 Headache, 22, 23, 27, 28, 42, 68, 76, 97, 104, 114, 115, 117, 136, 178, 196, 217 Headache Disorders, 196 Heart failure, 191, 197, 217 Heartbeat, 166, 197, 234 Heme, 177, 186, 197 Hemodialysis, 19, 188, 197 Hemoperfusion, 52, 114, 197 Hemorrhage, 186, 196, 197 Hemostasis, 197, 225 Heparin, 114, 134, 197 Hepatic, 50, 171, 197, 207 Hereditary, 45, 197 Heterogeneity, 170, 197 Heterozygotes, 189, 197 Hiccup, 181, 197
Histamine, 174, 181, 182, 186, 189, 194, 197, 198, 202, 206, 222 Homogeneous, 79, 120, 126, 197 Homologous, 197, 225, 229 Homozygotes, 189, 197 Hormonal, 181, 197 Hormone, 41, 52, 93, 95, 186, 192, 195, 197, 203, 212, 223, 225, 226, 230 Host, 16, 126, 198, 199, 235 Hybrid, 198 Hybridization, 7, 198 Hydrogen, 120, 169, 171, 176, 179, 188, 198, 207, 210, 211, 212, 219 Hydrolysis, 31, 198, 215, 216, 219 Hydromorphone, 14, 198 Hydrophilic, 121, 188, 198 Hydrophobic, 16, 188, 198 Hydroxylation, 10, 34, 57, 198 Hydroxylysine, 183, 198 Hydroxyproline, 183, 198 Hydroxyzine, 53, 132, 139, 198 Hyperalgesia, 13, 14, 127, 138, 198 Hyperbilirubinemia, 198, 202 Hyperpigmentation, 90, 198 Hypersensitivity, 53, 75, 171, 172, 188, 189, 198, 223, 225 Hypertension, 53, 64, 178, 198, 201, 206, 217, 218 Hyperthyroidism, 198, 218 Hypertrophy, 185, 198, 217, 232 Hypnotic, 53, 176, 189, 198 Hypotension, 107, 174, 185, 198, 218 Hypothalamic, 55, 199 Hypothalamus, 7, 176, 186, 188, 191, 199, 203, 216, 218, 226, 230 I Ibuprofen, 199, 202 Id, 108, 115, 155, 162, 164, 199 Idiopathic, 72, 113, 199 Imidazole, 197, 199, 222 Immune response, 169, 174, 186, 196, 199, 225, 229, 235 Immune system, 199, 204, 235 Immunity, 199 Immunization, 199, 225 Immunoassay, 55, 120, 126, 199 Immunodeficiency, 12, 199 Immunogenic, 126, 199, 221 Immunoglobulin, 173, 199, 207 Immunologic, 199, 221 Immunology, 169, 170, 199 Immunosuppressive, 195, 199
Index 243
Immunotherapy, 188, 199 Impairment, 68, 88, 104, 176, 190, 199, 220 Implant radiation, 199, 201, 221 Impotence, 122, 199 In situ, 7, 199 In Situ Hybridization, 7, 200 In vitro, 8, 10, 11, 15, 32, 34, 46, 48, 66, 69, 82, 84, 104, 105, 106, 200, 231 In vivo, 5, 8, 10, 15, 46, 51, 57, 82, 105, 197, 200 Incision, 200, 201 Incontinence, 4, 191, 200 Incubated, 96, 200 Indicative, 131, 185, 200, 213, 234 Indomethacin, 78, 200 Induction, 174, 200, 202 Infarction, 200, 218 Infection, 68, 179, 187, 195, 199, 200, 204, 210, 213, 223, 228, 233, 235 Infertility, 200, 233 Inflammation, 138, 171, 174, 183, 186, 188, 193, 195, 200, 205, 213, 216, 217, 219, 223, 227 Infusion, 13, 200 Ingestion, 27, 200, 206, 216 Inhalation, 104, 197, 200, 216 Innervation, 189, 200, 205, 214, 224, 230 Inorganic, 200, 208 Inotropic, 56, 175, 189, 200, 218 Inpatients, 31, 33, 39, 63, 68, 74, 76, 200 Insomnia, 124, 125, 201, 217, 232 Instillation, 139, 201 Intermittent, 201, 214 Internal Medicine, 50, 77, 80, 201 Internal radiation, 201, 221 Interstitial, 6, 11, 97, 132, 133, 138, 154, 177, 201 Intervertebral, 201, 204 Intervertebral Disk Displacement, 201, 204 Intestinal, 27, 154, 201, 204 Intestine, 177, 201, 202, 214 Intoxication, 52, 84, 114, 201, 235 Intracellular, 178, 200, 201, 210, 217, 219, 222, 225 Intracranial Hypertension, 196, 201, 231 Intramuscular, 70, 201 Intrathecal, 5, 201 Intravenous, 41, 58, 74, 76, 200, 201 Intravesical, 134, 201 Intrinsic, 9, 170, 201 Invasive, 16, 132, 139, 199, 201
Involuntary, 191, 193, 201, 208, 225 Ion Exchange, 180, 201, 202 Ionization, 79, 201, 202 Ions, 176, 179, 189, 190, 198, 201, 207, 217, 226 Iontophoresis, 91, 201 Iris, 57, 173, 202 Irritable Bowel Syndrome, 89, 133, 137, 154, 194, 202 Isoproterenol, 60, 202 Isozymes, 44, 202 J Jaundice, 47, 58, 59, 198, 202 Joint, 28, 138, 175, 202, 212, 226, 228 K Kb, 148, 202 Ketamine, 19, 124, 128, 202 Keto, 202, 232 Ketoconazole, 10, 202 Ketoprofen, 122, 202 Ketotifen, 30, 202 Kidney Disease, 148, 154, 202 Kilobase, 47, 202 Kinetic, 10, 45, 66, 93, 202 L Lactation, 60, 202, 212 Large Intestine, 188, 201, 202, 222, 226 Lavage, 166, 202 Laxative, 104, 112, 203, 206 Least-Squares Analysis, 203, 222 Lenses, 20, 203, 222 Leptin, 42, 203 Lesion, 203, 204, 230, 233 Lethargy, 154, 203 Leucocyte, 171, 203 Leukocytes, 191, 196, 200, 203 Leukoencephalopathy, 12, 203 Library Services, 162, 203 Lidocaine, 9, 107, 203, 206 Ligaments, 155, 185, 203, 208 Ligands, 6, 203 Likelihood Functions, 203, 222 Limbic, 172, 203 Limbic System, 172, 203 Linear Models, 203, 222 Linkages, 203, 213 Lipid, 107, 202, 204 Lithium, 26, 27, 30, 33, 62, 68, 73, 89, 105, 106, 174, 204 Liver Transplantation, 72, 204 Localization, 9, 204
244 Amitriptyline
Localized, 187, 193, 200, 204, 207, 216, 224, 233 Lofepramine, 38, 75, 204 Logistic Models, 204, 222 Longitudinal study, 42, 65, 204 Low Back Pain, 91, 204 Lumbar, 180, 201, 204, 224, 230 Lymph, 191, 204, 208 Lymph node, 204, 208 Lymphatic, 191, 200, 204, 216, 227 Lymphocyte, 51, 174, 204, 205 Lymphoid, 173, 186, 203, 204, 218 Lymphoma, 204, 208 M Malabsorption, 123, 204 Malignant, 13, 45, 64, 69, 72, 128, 204, 208, 221 Mania, 205 Manic, 96, 174, 204, 205, 220 Manic-depressive psychosis, 96, 205, 220 Maprotiline, 37, 42, 64, 65, 85, 88, 89, 205 Medial, 7, 205, 211, 230 Median Nerve, 179, 205 Mediate, 48, 189, 205, 222 Mediator, 205, 225 MEDLINE, 149, 205 Meiosis, 205, 229 Melanin, 202, 205, 233 Melanocytes, 198, 205 Membrane, 9, 175, 180, 184, 187, 188, 192, 197, 205, 211, 221, 223, 225, 227, 229 Membrane Glycoproteins, 205 Memory, 37, 42, 88, 173, 205 Meninges, 180, 186, 205 Meningitis, 194, 205 Menopause, 205, 218 Menstrual Cycle, 205, 217 Menstruation, 171, 187, 190, 205, 217 Mental Processes, 189, 206, 220 Meperidine, 18, 86, 206 Mephenytoin, 36, 47, 106, 206 Mesterolone, 17, 206 Meta-Analysis, 75, 206 Metabolic disorder, 154, 206 Metabolite, 20, 28, 29, 57, 79, 88, 98, 108, 182, 188, 198, 206, 211 Methacrylate, 121, 206 Methanol, 32, 105, 206 Methionine, 123, 188, 206, 229 Methoxamine, 92, 206 Methylcellulose, 121, 206 Methylene Blue, 133, 206
Metoclopramide, 53, 206 Metoprolol, 57, 206 Mexiletine, 12, 136, 206 MI, 32, 39, 126, 167, 206 Mianserin, 26, 37, 42, 43, 50, 65, 66, 68, 78, 113, 123, 206 Mianserine, 93, 206 Microbe, 207, 231 Microcirculation, 82, 207 Microorganism, 207, 235 Microsomal, 66, 79, 207 Migration, 88, 207 Minocycline, 90, 207 Mitochondrial Swelling, 207, 209 Modeling, 190, 207 Modification, 207, 221 Molecular, 8, 9, 51, 121, 149, 151, 177, 179, 184, 189, 194, 197, 207, 222, 232 Molecular Structure, 207, 232 Molecule, 174, 176, 177, 181, 183, 189, 191, 192, 196, 198, 207, 211, 212, 216, 221, 222, 225 Monitor, 121, 126, 207, 211 Monoamine, 68, 100, 173, 207, 225, 233 Monoamine Oxidase, 173, 207, 225, 233 Monoclonal, 45, 207, 221 Morphine, 21, 104, 121, 178, 198, 206, 207, 209, 211 Motility, 194, 200, 207, 225 Motion Sickness, 208, 209 Motor Activity, 185, 208, 220 Motor nerve, 16, 208, 211 Mucins, 208, 224 Mucus, 133, 208 Multicenter study, 39, 78, 208 Multidrug resistance, 84, 208 Muscle relaxant, 34, 128, 133, 173, 182, 208, 209 Muscle Relaxation, 208 Muscle tension, 208 Muscular Dystrophies, 190, 208 Musculoskeletal Diseases, 138, 208 Mutagenesis, 8, 51, 208 Mutagens, 208 Myasthenia, 208, 209 Mycosis, 93, 208 Mycosis Fungoides, 93, 208 Mydriasis, 121, 208 Myelin, 208, 216 Myocardial infarction, 69, 185, 206, 208, 218 Myocardium, 172, 206, 208
Index 245
Myotonia, 69, 208, 221 N Narcolepsy, 191, 209 Narcosis, 209 Narcotic, 133, 206, 207, 209, 231 Nausea, 138, 154, 174, 186, 195, 209, 212, 217 NCI, 1, 147, 182, 209 Necrosis, 25, 40, 200, 206, 208, 209 Need, 3, 125, 128, 131, 132, 137, 156, 170, 182, 209, 231 Neostigmine, 61, 93, 209 Nephropathy, 202, 209 Nerve Endings, 196, 209 Nervous System, 121, 169, 170, 172, 174, 175, 176, 178, 179, 180, 181, 182, 191, 192, 195, 205, 206, 207, 209, 210, 213, 214, 215, 217, 218, 225, 229, 233 Networks, 81, 209 Neural, 81, 170, 188, 207, 209, 226 Neuralgia, 5, 76, 209, 217 Neuroleptic, 45, 69, 174, 209 Neurologic, 12, 59, 173, 209 Neuromuscular, 169, 209, 225, 232 Neuronal, 9, 15, 179, 182, 209, 214 Neurons, 183, 195, 208, 209, 210, 227, 229, 234 Neuropathy, 5, 43, 45, 50, 70, 74, 136, 210, 214 Neuropeptide, 186, 210 Neurosis, 33, 210 Neurosyphilis, 210, 213 Neurotic, 34, 173, 210 Neurotransmitters, 171, 189, 210, 218, 226 Neutrons, 171, 210, 221 Niacin, 210, 232 Nifedipine, 121, 133, 210 Nimodipine, 12, 210 Nitric Oxide, 48, 107, 210 Nitrogen, 51, 79, 87, 126, 170, 171, 193, 210, 232 Nonverbal Communication, 210, 220 Norepinephrine, 7, 170, 171, 173, 188, 189, 191, 196, 210 Nuclear, 184, 190, 192, 195, 203, 209, 211 Nuclei, 171, 172, 184, 190, 203, 210, 211, 219, 234 Nucleic acid, 187, 198, 200, 208, 210, 211, 223 Nucleic Acid Hybridization, 198, 211
Nucleus, 7, 120, 126, 186, 187, 188, 191, 192, 195, 201, 205, 210, 211, 218, 219, 226, 230, 234 O Oculomotor, 71, 208, 211 Oculomotor Nerve, 208, 211 On-line, 52, 72, 165, 211 Opium, 207, 211 Optic Chiasm, 199, 211, 218 Organ Culture, 211, 231 Orgasm, 190, 211 Orthostatic, 174, 211, 218 Osmosis, 211 Osmotic, 121, 170, 207, 211, 225 Osteoarthritis, 202, 212, 215 Outpatient, 39, 69, 84, 212 Overdosage, 81, 212 Overdose, 20, 22, 24, 28, 29, 42, 51, 57, 69, 72, 77, 83, 85, 86, 94, 100, 165, 185, 212 Oxidation, 85, 169, 186, 212 Oxidative metabolism, 82, 107, 170, 212 Oxygen Consumption, 212, 223 Oxygenator, 179, 212 Oxytocic, 212, 227 Oxytocin, 7, 212 P Pain Threshold, 91, 212 Palliative, 93, 104, 212, 230 Palsy, 4, 95, 212, 227 Pancreas, 169, 188, 212, 227 Panic, 194, 199, 212 Panic Disorder, 194, 199, 212 Paraganglia, Chromaffin, 181, 213 Paralysis, 186, 213, 227 Paresis, 51, 94, 213 Paroxetine, 17, 19, 20, 24, 27, 37, 39, 42, 52, 68, 73, 75, 76, 82, 90, 95, 106, 122, 135, 213 Paroxysmal, 127, 172, 197, 213 Partial response, 4, 213 Particle, 85, 124, 213, 232 Patch, 75, 213, 232 Pathogenesis, 11, 133, 213 Pathologic, 185, 198, 213, 234 Patient Education, 16, 154, 160, 162, 167, 213 Patient Selection, 155, 213 Pediatrics, 3, 42, 58, 213 Pelvic, 6, 138, 213, 219 Pemoline, 122, 213 Penicillin, 173, 213 Penis, 190, 213
246 Amitriptyline
Pentosan polysulfate, 132, 139, 213 Pepsin, 182, 213 Pepsin A, 182, 213 Peptide, 11, 203, 213, 214, 216, 219, 230 Perception, 36, 41, 90, 196, 214, 224 Perforation, 27, 214 Perineal, 133, 214 Perineum, 214 Peripheral Nerves, 127, 214, 216, 227 Peripheral Nervous System, 20, 212, 214, 218, 227, 229 Peripheral Neuropathy, 12, 23, 29, 50, 80, 107, 112, 113, 136, 214 Peripheral Vascular Disease, 194, 214 Peristalsis, 138, 214 Peritoneal, 46, 188, 214 Peritoneal Cavity, 214 Peritoneal Dialysis, 46, 188, 214 Peritoneum, 214 Peroneal Nerve, 214, 224 Perphenazine, 10, 23, 50, 58, 59, 61, 65, 142, 214 Pharmaceutical Preparations, 124, 180, 192, 215 Pharmacist, 124, 215 Pharmacodynamic, 74, 215 Pharmacokinetic, 37, 46, 74, 78, 105, 215 Pharmacologic, 122, 172, 175, 196, 215, 231, 233 Pharmacotherapy, 21, 23, 30, 86, 90, 98, 127, 133, 206, 215 Phenazopyridine, 133, 215 Phenyl, 16, 120, 133, 206, 215 Phonophoresis, 202, 215 Phosphodiesterase, 215, 224 Phospholipases, 215, 225 Phosphorus, 87, 178, 215 Physical Examination, 138, 215 Physiologic, 81, 170, 196, 205, 215, 219, 222, 225, 232 Physostigmine, 84, 209, 215 Pigmentation, 198, 215 Pilot study, 19, 22, 36, 39, 50, 64, 215 Piroxicam, 122, 215 Pituitary Gland, 186, 215 Placebo Effect, 15, 216 Placenta, 94, 216 Plague, 137, 216 Plants, 171, 175, 176, 179, 182, 211, 216, 231 Plasma cells, 173, 216 Plastic surgeon, 40, 216
Platelet Activation, 216, 226 Platelet Aggregation, 210, 216 Platelets, 210, 216, 230 Plexus, 205, 216, 224 Point Mutation, 16, 216 Poisoning, 44, 45, 56, 60, 61, 64, 68, 72, 90, 94, 113, 116, 195, 201, 206, 209, 216 Polymorphism, 85, 216 Polypeptide, 171, 183, 198, 213, 216, 226 Polyradiculoneuropathy, 29, 216 Polyradiculopathy, 216, 217 Pons, 176, 178, 217 Posterior, 172, 176, 181, 202, 212, 217 Postherpetic Neuralgia, 14, 20, 70, 91, 127, 217 Postoperative, 9, 63, 206, 215, 217 Postsynaptic, 217, 225, 229 Potassium, 16, 56, 59, 217, 221 Potassium Channels, 56, 217 Potassium Chloride, 59, 217 Potentiate, 38, 217 Potentiating, 171, 217 Potentiation, 217, 225 Practicability, 217, 232 Practice Guidelines, 150, 217 Prazosin, 121, 217 Precordial, 81, 217 Precursor, 126, 169, 175, 189, 191, 210, 217, 232, 233 Premenstrual, 133, 217 Premenstrual Syndrome, 133, 217 Prenalterol, 56, 218 Prenatal, 7, 218 Preoptic Area, 7, 218 Presynaptic, 9, 189, 209, 218, 229 Presynaptic Terminals, 189, 209, 218 Primary central nervous system lymphoma, 12, 218 Probe, 14, 16, 218 Problem Solving, 80, 218 Procainamide, 104, 218 Procaine, 203, 218 Progeny, 184, 218 Progressive, 4, 12, 95, 180, 182, 190, 196, 208, 209, 212, 216, 218 Projection, 211, 218 Proline, 183, 198, 218 Prone, 123, 218 Prophase, 218, 229 Prophylaxis, 21, 66, 78, 97, 115, 136, 194, 218
Index 247
Propranolol, 66, 78, 100, 115, 121, 122, 175, 218 Prospective study, 69, 204, 218 Prostaglandin, 48, 218 Prostaglandins A, 200, 219 Prostate, 219 Prostatitis, 6, 219 Protease, 183, 219 Protective Agents, 178, 219 Protein C, 170, 171, 219, 233 Protein S, 177, 219, 230 Proteins, 120, 171, 174, 180, 183, 198, 207, 210, 213, 214, 216, 219, 222, 223, 225, 231, 232, 233 Proteolytic, 171, 183, 219 Protons, 171, 198, 219, 221 Protozoa, 184, 207, 219, 233 Protriptyline, 126, 220 Proximal, 189, 218, 220 Pruritus, 189, 198, 220 Psychiatric, 14, 35, 39, 57, 65, 78, 81, 82, 92, 115, 154, 220, 226 Psychic, 210, 220, 224 Psychogenic, 30, 77, 220, 233 Psychology, 111, 189, 220 Psychomotor, 32, 42, 43, 56, 73, 78, 91, 106, 179, 209, 220 Psychomotor Performance, 32, 56, 91, 220 Psychopathology, 25, 75, 220 Psychosis, 61, 174, 195, 220 Psychotherapy, 30, 77, 183, 220 Psychotropic, 34, 123, 204, 220 Psychotropic Drugs, 34, 220 Public Policy, 149, 220 Pulmonary, 177, 181, 185, 191, 220, 234 Pulmonary Artery, 177, 220, 234 Pulmonary Edema, 181, 220 Pulmonary hypertension, 185, 220 Pulse, 166, 207, 220 Purgative, 203, 221 Q Quality of Life, 43, 125, 221 Quaternary, 9, 25, 31, 49, 80, 221 Quinidine, 10, 86, 221 Quinine, 221 R Race, 207, 221 Radiation, 12, 172, 176, 188, 192, 194, 195, 201, 213, 221, 235 Radiation therapy, 12, 192, 201, 213, 221 Radioactive, 176, 196, 198, 199, 201, 211, 221
Radioimmunoassay, 7, 80, 221 Radiolabeled, 221 Radiotherapy, 177, 221 Randomized clinical trial, 114, 222 Randomized Controlled Trials, 15, 29, 222 Ranitidine, 60, 222 Reagent, 124, 128, 181, 222 Receptor, 6, 7, 8, 9, 15, 82, 100, 169, 174, 189, 192, 194, 198, 218, 221, 222, 225 Receptors, Serotonin, 222, 225 Recombination, 184, 222 Rectum, 72, 174, 177, 188, 194, 195, 200, 202, 219, 222 Recurrence, 81, 205, 222 Refer, 1, 183, 193, 194, 204, 209, 210, 220, 222 Refraction, 173, 222, 227 Regimen, 19, 190, 215, 216, 222, 223 Regression Analysis, 84, 222 Relapse, 77, 98, 222 Relaxant, 222 Remission, 205, 222 Renin, 179, 223 Renin-Angiotensin System, 179, 223 Respiration, 73, 106, 175, 179, 185, 186, 207, 223 Restless legs, 88, 223 Restoration, 223 Resuscitation, 44, 223 Retina, 211, 223, 224 Retreatment, 77, 223 Retrospective, 4, 69, 223 Rheumatism, 46, 48, 88, 199, 223 Rheumatoid, 33, 73, 78, 135, 202, 215, 223 Rheumatoid arthritis, 33, 73, 78, 135, 202, 215, 223 Rhinitis, 181, 191, 202, 223 Riboflavin, 109, 223 Ribonucleic acid, 7, 223 Ribose, 169, 223 Rigidity, 166, 216, 223 Risk factor, 204, 218, 223 Risperidone, 59, 85, 224 Rod, 176, 182, 224 Rolipram, 56, 224 S Salicylate, 133, 224 Saliva, 24, 71, 224 Salivary, 82, 187, 188, 224 Salivary glands, 187, 188, 224 Schizoid, 224, 235 Schizophrenia, 224, 235
248 Amitriptyline
Schizotypal Personality Disorder, 224, 235 Sciatic Nerve, 16, 214, 224, 230 Scleroderma, 74, 224 Sclerosis, 29, 154, 224 Screening, 182, 224 Secobarbital, 53, 125, 224 Secretion, 85, 93, 105, 182, 197, 202, 208, 222, 224 Secretory, 181, 224, 229 Secretory Vesicles, 181, 224 Sedative, 38, 85, 171, 176, 181, 189, 198, 199, 224, 232 Seizures, 8, 179, 213, 224 Self Care, 132, 224 Semen, 190, 219, 224 Semisynthetic, 207, 225 Sensibility, 14, 172, 198, 225 Sensitization, 14, 225 Serologic, 199, 225 Serotonin, 6, 7, 30, 45, 52, 56, 82, 86, 98, 100, 122, 132, 169, 171, 174, 182, 186, 188, 194, 206, 207, 213, 215, 222, 224, 225, 229, 232 Serotonin Syndrome, 45, 98, 225 Sertraline, 17, 30, 40, 43, 69, 122, 225 Serum, 5, 23, 29, 32, 46, 50, 51, 52, 63, 71, 72, 79, 86, 87, 104, 126, 170, 183, 221, 225 Serum Albumin, 221, 225 Shivering, 18, 225 Shock, 167, 172, 218, 225, 232 Signal Transduction, 9, 225 Signs and Symptoms, 134, 222, 226 Simethicone, 124, 128, 226 Skeletal, 15, 19, 182, 186, 202, 208, 221, 226 Skeleton, 202, 219, 226 Sleep Bruxism, 91, 226 Sleep Deprivation, 83, 125, 226 Small intestine, 197, 201, 226 Smooth muscle, 171, 172, 175, 178, 184, 197, 207, 223, 226, 229 Social Environment, 221, 226 Sodium, 15, 26, 43, 45, 105, 125, 132, 134, 139, 221, 226, 229, 234 Sodium Bicarbonate, 45, 226 Sodium Channels, 15, 26, 105, 221, 226, 234 Solitary Nucleus, 176, 226 Solvent, 176, 192, 206, 211, 226 Soma, 226 Somatic, 15, 36, 170, 203, 205, 214, 226 Somatostatin, 27, 226 Somnambulism, 21, 227
Sparteine, 47, 106, 227 Spastic, 202, 227 Specialist, 156, 227 Species, 6, 176, 179, 183, 186, 192, 195, 198, 205, 207, 221, 227, 228, 232, 235 Specificity, 9, 170, 179, 218, 227 Spectrum, 17, 37, 45, 202, 227 Sperm, 88, 181, 227, 232 Sphincters, 193, 227 Spike, 96, 123, 227 Spinal cord, 11, 43, 88, 127, 175, 178, 180, 181, 185, 201, 205, 209, 210, 214, 218, 224, 227, 229 Spinal Nerve Roots, 216, 217, 227 Spinal Nerves, 214, 227 Spleen, 187, 204, 227 Spondylitis, 63, 227 Sprains and Strains, 204, 228 Staphylococcus, 195, 207, 228 Steady state, 87, 88, 126, 228 Steel, 182, 228 Steroid, 186, 196, 206, 228 Stimulant, 178, 186, 197, 202, 213, 228 Stimulus, 89, 185, 192, 200, 228, 230 Stomach, 169, 188, 192, 195, 197, 202, 209, 213, 214, 226, 227, 228 Stool, 133, 200, 202, 228 Stress, 76, 90, 154, 155, 175, 180, 181, 186, 194, 195, 202, 209, 223, 228, 233 Stricture, 59, 228 Stroma, 202, 228 Structure-Activity Relationship, 15, 228 Stupor, 96, 166, 203, 209, 228 Subacute, 200, 228 Subarachnoid, 20, 196, 228 Subclinical, 200, 224, 228 Subspecies, 227, 228 Substance P, 206, 224, 229 Substrate, 24, 82, 107, 229, 233 Sulfur, 206, 229 Sumatriptan, 138, 229 Suppression, 28, 35, 36, 68, 229 Sweat, 25, 229 Sweat Glands, 229 Sympathetic Nervous System, 127, 175, 181, 229 Sympathomimetic, 189, 192, 202, 211, 229, 232 Symptomatic, 90, 113, 173, 176, 181, 229 Symptomatic treatment, 173, 176, 181, 229 Synapses, 210, 227, 229 Synapsis, 229
Index 249
Synaptic, 9, 225, 229 Synovial, 48, 229 Systemic, 107, 127, 142, 172, 174, 177, 179, 192, 200, 201, 221, 224, 226, 229, 232 Systolic, 198, 230 T Tachycardia, 121, 230, 231 Tardive, 174, 182, 230 Temporal, 172, 196, 230 Temporal Lobe, 172, 230 Tetracycline, 207, 230 Thalamic, 127, 230 Thermal, 13, 14, 173, 189, 210, 230 Third Ventricle, 199, 230 Thorax, 169, 204, 217, 230 Threshold, 192, 198, 230 Thrombocytopenia, 75, 230 Thrombus, 185, 200, 216, 230 Thyroid, 93, 198, 230, 233 Thyroid Gland, 198, 230 Thyroid Hormones, 230, 233 Thyrotropin, 41, 95, 230 Thyroxine, 170, 230 Tibial Nerve, 224, 230 Tin, 104, 127, 179, 214, 230 Tinnitus, 43, 94, 97, 113, 231, 234 Tissue Culture, 48, 231 Tolerance, 13, 38, 178, 231 Tonic, 185, 206, 231 Tooth Injuries, 226, 231 Topical, 13, 19, 124, 127, 128, 192, 226, 231 Torsades de Pointes, 77, 231 Torsion, 200, 231 Toxic, iv, 4, 34, 51, 95, 175, 176, 184, 186, 199, 206, 210, 231 Toxicity, 72, 97, 107, 113, 190, 215, 231 Toxicokinetics, 86, 94, 231 Toxicology, 24, 28, 35, 37, 42, 49, 51, 57, 78, 83, 85, 86, 94, 104, 106, 107, 150, 231 Toxins, 174, 179, 195, 197, 200, 231 Trace element, 194, 230, 231 Traction, 182, 231 Tramadol, 18, 231 Tranquilizing Agents, 220, 231 Transaminases, 51, 231 Transcutaneous, 139, 232 Transdermal, 98, 122, 232 Transduction, 225, 232 Transfection, 177, 232 Transmitter, 9, 169, 175, 189, 205, 211, 229, 232, 233 Transplantation, 72, 182, 199, 232
Trauma, 138, 209, 232 Treatment Outcome, 4, 232 Tremor, 21, 27, 232 Triazolam, 34, 232 Tricuspid Atresia, 185, 232 Tricyclic, 5, 10, 11, 14, 15, 22, 34, 51, 62, 63, 65, 71, 78, 94, 99, 117, 121, 122, 126, 127, 132, 133, 138, 142, 154, 171, 173, 182, 188, 189, 199, 204, 205, 220, 232 Trimipramine, 125, 133, 232 Tryptophan, 30, 41, 62, 93, 104, 183, 225, 232 Tubocurarine, 209, 232 Tubulin, 9, 232 Tyramine, 17, 207, 232 Tyrosine, 189, 233 U Ulcer, 233 Ulceration, 59, 233 Unconscious, 167, 172, 199, 233 Urea, 124, 128, 229, 233 Urethra, 213, 219, 233 Uridine Diphosphate, 196, 233 Uridine Diphosphate Glucuronic Acid, 196, 233 Urinary, 4, 6, 25, 38, 47, 84, 93, 96, 97, 133, 138, 166, 186, 191, 200, 215, 217, 233 Urinary Retention, 217, 233 Urinary tract, 215, 233 Urinary urgency, 138, 233 Urine, 11, 20, 31, 80, 83, 85, 177, 189, 191, 196, 200, 223, 233 Urodynamics, 134, 233 Urologist, 139, 233 Urology, 93, 97, 133, 233 Urticaria, 172, 181, 198, 233 Uterine Contraction, 212, 233 Uterus, 113, 187, 205, 212, 233 V Vaccines, 233, 235 Valproic Acid, 122, 234 Vascular, 115, 171, 172, 178, 191, 196, 200, 207, 210, 216, 230, 233, 234 Vasoconstriction, 192, 206, 234 Vasodilator, 177, 189, 197, 210, 234 VE, 13, 33, 44, 90, 234 Vein, 175, 201, 211, 234 Venlafaxine, 39, 86, 88, 98, 122, 234 Venous, 24, 175, 219, 232, 234 Ventricle, 172, 175, 185, 220, 221, 230, 232, 234 Ventricular, 64, 69, 98, 185, 231, 232, 234
250 Amitriptyline
Ventricular fibrillation, 64, 231, 234 Venules, 177, 179, 207, 234 Vertebrae, 201, 227, 234 Vertebral, 176, 234 Vertigo, 194, 234 Vesicular, 207, 234 Vestibulocochlear Nerve, 231, 234 Vestibulocochlear Nerve Diseases, 231, 234 Veterinary Medicine, 149, 234 Viloxazine, 40, 99, 234 Vinblastine, 232, 234 Vincristine, 232, 235 Virulence, 175, 231, 235 Virus, 12, 180, 232, 235 Viscera, 208, 226, 235 Visceral, 36, 41, 176, 203, 214, 235
Visceral Afferents, 176, 235 Visual Acuity, 203, 235 Vitro, 197, 235 Vivo, 16, 235 Voltage-gated, 8, 235 W Weight Gain, 123, 235 White blood cell, 173, 200, 203, 204, 208, 216, 235 Withdrawal, 5, 13, 19, 63, 66, 87, 100, 206, 235 Womb, 233, 235 X X-ray, 188, 194, 195, 211, 221, 235 Z Zygote, 184, 235
Index 251
252 Amitriptyline
