Treatment of progressive supranuclear palsy with tricyclic antidepressants

After a single patient with progressive supranuclear palsy (PSP) improved when given amitriptyline, we compared the effects of amitriptyline, desipramine, and placebo on the symptoms and signs of four patients with PSP in a double-blind, double-crossover manner. There was good correlation between the use of tricyclic agents and symptomatic improvement, although all patients remained disabled. Amitriptyline produced better overall improvement, whereas desipramine preferentially improved apraxia of eyelid opening.