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Amitriptyline for the treatment of depression

Amitriptyline is a tricyclic antidepressant drug that has been used for decades in the treatment of depression. The current review includes 39 trials with a total of 3509 participants and confirms its efficacy compared to placebo or no treatment. This finding is important, because the efficacy of antidepressants has recently been questioned. However, the review also demonstrated that amitriptyline produces a number of side effects such as vision problems, constipation and sedation. It is a limitation of this review that many studies have been poorly reported, which might have led to bias.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Amitriptyline for depression

Amitriptyline still has a place in the pharmacological management of depressive episodes. The findings of this systematic review showed that in comparison with control agents, amitriptyline was slightly more effective, but the burden of side‐effects was greater for patients receiving it.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Amitriptyline for neuropathic pain in adults

Neuropathic pain is pain coming from damaged nerves, and can have a variety of different names. Some of the more common are painful diabetic neuropathy, postherpetic neuralgia, or post‐stroke pain. It is different from pain messages that are carried along healthy nerves from damaged tissue (for example, a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines to those used for pain from damaged tissue. Medicines such as paracetamol or ibuprofen are not usually effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Amitriptyline for fibromyalgia in adults

Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is poor. Common pain relieving medicines such as paracetamol and ibuprofen are not usually considered effective in fibromyalgia. Medicines that are sometimes used to treat epilepsy or depression can be very effective in some people with fibromyalgia, as they are in some other forms of chronic pain where there may be nerve damage (neuropathic pain).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

A meta-analysis of the therapeutic effects of amitriptyline for treating irritable bowel syndrome

OBJECTIVE: We aimed to evaluate the efficacy of amitriptyline as a therapeutic option for irritable bowel syndrome (IBS) through a meta-analysis of randomized controlled trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Cyclobenzaprine drug treatment for myofascial pain in adults

Myofascial pain (MP) is a painful condition of the muscles characterized by pain transmitted from trigger points (TP) within connective tissue surrounding and separating muscles (myofascial structures). TP can be located where the pain is felt, or can be at a distance from it. Cyclobenzaprine, one of the drugs used to treat MP, is taken as a pill. It is a muscle relaxant, particularly used to improve quality of sleep and to reduce pain. It suppresses muscle spasms ‐ and so may prevent pain caused by MP ‐ without interfering with muscle function. The purpose of this review was to assess how effective cyclobenzaprine is at reducing pain and improving sleep in patients with MP. We searched extensively through scientific publications and found two trials, with a total of 79 participants. These tested cyclobenzaprine against another drug called clonazepam, and fake medication (placebo), or against injections of a local anesthetic called lidocaine. A total of 35 of the 79 participants in the two trials were given cyclobenzaprine. Cyclobenzaprine was slightly better than clonazepam and placebo at reducing jaw pain, but was no better at improving sleep quality. The results from the other trial were not scientifically reliable because of the small number of participants involved, but lidocaine injections seemed to reduce pain slightly better than cyclobenzaprine pills. Despite this result, it is likely that, because it is uncomfortable to receive any form of injection, people who suffer from MP will prefer to be treated with cyclobenzaprine pills. There were no life‐threatening adverse events associated with any of the medications studied. Further studies are needed to show whether cyclobenzaprine really works for treating MP, but at the moment doctors cannot say whether it is really useful.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis

OBJECTIVES: To evaluate and compare the efficacy and acceptability of the antidepressants amitriptyline (AMT), duloxetine (DLX) and milnacipran (MLN) for FM syndrome (FMS).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Antidepressants for patients with tinnitus

Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation, and it is frequently associated with depression or depressive symptoms. Six studies involving a total of 610 patients matched the inclusion criteria for this review. Four evaluated three tricyclic antidepressant agents (amitriptyline, nortriptyline and trimipramine) for the treatment of tinnitus. These studies did not find enough evidence to prove the efficacy of these agents in the management of tinnitus. One study evaluated paroxetine, a selective serotonin reuptake inhibitor antidepressant, and one evaluated trazodone, an atypical antidepressant. Neither of these studies showed benefit of paroxetine or trazodone in the treatment of tinnitus. Side effects, though relatively minor, were common in all groups of antidepressants. Further research is required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antidepressants for the treatment of children and adolescents with functional abdominal pain

Abdominal pain‐related functional gastrointestinal disorders (FGIDs) are common in childhood and adolescence. In most cases no medical reason for the pain can be found. Various drug treatment approaches for the different types of abdominal pain‐related FGIDs exist. These drug treatments include: prokinetics and antisecretory agents for functional dyspepsia; pizotifen, propranolol, cyproheptadine or sumatriptane for abdominal migraine; and antispasmodic and antidiarrhoeal regimen for irritable bowel syndrome. Antidepressants have been shown to be effective in some studies of adults with functional gastrointestinal disorders. As a result young patients with similar complaints are sometimes treated with antidepressants. The purpose of this review was to examine the evidence assessing the advantages and disadvantages of such an approach. Only two studies met the inclusion criteria. Both of these studies were randomised controlled trials and assessed the effectiveness and safety of amitriptyline in children with FGIDs. Amitriptyline is a first generation antidepressant (tricyclic antidepressant). Amitriptyline is no longer an agent of first choice for the treatment of depressive disorders because of potentially serious side effects including overdose. Amitriptyline has not been approved for the treatment of functional abdominal pain in children or adolescents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Drugs other than those used for epilepsy for treating trigeminal neuralgia

The purpose of this review was to assess the effects of non‐antiepileptic drugs in trigeminal neuralgia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy

The authors concluded that there was some evidence to support the short-term efficacy of amitriptyline 25mg/day for fibromyalgia, but no evidence to support the efficacy of amitriptyline at higher doses or for periods longer than eight weeks. Much of the review was well conducted, but the analyses may be misleading and the overall results should not be considered as reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Amitriptyline for inpatients and SSRIs for outpatients with depression: systematic review and meta-regression analysis

This review examined the influence of study setting on the effect of amitriptyline compared with other antidepressants. The authors concluded that it may be reasonable to use newer antidepressants as first-line treatment in out-patients with depression, and to use amitriptyline for in-patients with severe depression. Differences among the studies were not examined adequately, thus the conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Comparing Fibromyalgia Drugs

How do drugs for fibromyalgia compare in improving symptoms?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: June 12, 2011

[Drug therapy of fibromyalgia syndrome: systematic review, meta-analysis and guideline.]

BACKGROUND: The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Treatment of fibromyalgia with cyclobenzaprine: a meta-analysis

OBJECTIVE: To systematically review the effectiveness of cyclobenzaprine in the treatment of fibromyalgia.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Drug Class Review: Drugs for Fibromyalgia: Final Original Report [Internet]

We compared the effectiveness and harms of tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, selective serotonin and norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic reuptake inhibitor, norepinephrine and dopamine reuptake inhibitor, serotonin receptor antagonist, antiepileptic drugs, and skeletal muscle relaxants in adults with fibromyalgia.

Drug Class Reviews - Oregon Health & Science University.

Version: April 2011
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Drug Class Review: Neuropathic Pain: Final Update 1 Report [Internet]

We compared the effectiveness and harms of anticonvulsants, tricyclic antidepressants, serotonin–norepinephrine reuptake inhibitors (SNRIs), and the lidocaine patchin adults with neuropathic pain.

Drug Class Reviews - Oregon Health & Science University.

Version: June 2011
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Antipsychotics for fibromyalgia symptoms in adults

Quetiapine may be considered for 4 to 12 weeks to reduce pain, sleep problems, depression and anxiety in fibromyalgia patients with major depression. Potential side effects such as weight gain should be balanced against the potential benefits.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

A systematic review on the effectiveness of treatment with antidepressants in fibromyalgia syndrome

This review concluded that amitriptyline was effective in reducing the symptoms of patients with fibromyalgia syndrome, and some other antidepressants may also be useful. Despite the methodological strengths of the review processes, the inappropriate statistical analyses mean that these findings cannot be considered reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials

This review of psychological interventions for major depression in primary care concluded that brief treatments were more effective than GP-delivered usual care in reducing symptoms and may be equivalent to antidepressant therapy. Many aspects of this review were well-conducted, but due to a paucity of reporting in several areas the conclusions should not be regarded as reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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