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Low dose amitriptyline in chronic pain: the gain is modest
F G Zitman1, A C G Linssen, P M Edelbroek
1Department of Psychiatry, Catholic University Nijmegen, 6500 HB NijmegenThe Netherlands Department of Psychiatry, University Hospital, 2300 RC LeidenThe Netherlands Toxicology Laboratory, University Hospital, 2300 RC LeidenThe Netherlands Department of Medical Statistics, University of Leiden, 2300 RC LeidenThe Netherlands.
Abstract:
In the double-blind placebo-controlled study presented here, the effects were investigated of a low dose of amitriptyline (75 mg) in patients with chronic pain of various origins. The active drug was superior to placebo in reducing pain intensity. The reduction was small. In the second treatment week, the amitriptyline treated patients slept longer. No differences between active drug and placebo were found with respect to daily activities or use of analgesics. Based on our data and those of other studies, it is concluded that amitriptyline (and other antidepressants) in low doses does have a positive effect on the intensity and some other aspects of chronic pain, but that the effect is modest. It must be kept in mind that chronic pain is a very treatment-resistant condition. Therefore, even modest positive effects may be worthwhile.