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¿La amitriptilina evitará la reacción de "queso" de los inhibidores de la monoamina-oxidasa?
Lancet (London, England)
|July 24, 1982
Resumen
La amitriptilina redujo significativamente la respuesta del presor a la tiramina en pacientes que tomaban inhibidores de la monoamina-oxidasa (IMAO). Esta combinación puede ofrecer protección contra los alimentos ricos en tiramina, pero aún se recomienda precaución.
Área de la Ciencia:
- Farmacología Farmacología.
- La neurociencia es la neurociencia.
- La medicina clínica es la medicina clínica.
Sus antecedentes:
- Los inhibidores de la monoamina-oxidasa (IMAO) se asocian con respuestas hipertensivas peligrosas a los alimentos ricos en tiramina.
- Los antidepresivos tricíclicos (ACT) como la amitriptilina, la dothiepina y la trimipramina se prescriben comúnmente.
- La interacción entre los TCA y los IMAO con respecto a la sensibilidad a la tiramina requiere una mayor aclaración.
Objetivo del estudio:
- Para investigar el efecto de diferentes antidepresivos tricíclicos (amitriptyline, dothiepin, trimipramine) en la respuesta del tiraminopresor en pacientes que reciben inhibidores de la monoamina-oxidasa (IMAO).
- Evaluar el potencial de la combinación de amitriptilina con IMAO para mitigar las crisis hipertensivas inducidas por la tiramina.
Principales métodos:
- A los pacientes que recibieron IMAO se les administró tiramina por vía intravenosa.
- La respuesta del presor a la tiramina se midió antes y después de la administración de amitriptilina, dothiepin o trimipramina.
Principales resultados:
- La amitriptilina disminuyó significativamente la respuesta del presor a la tiramina intravenosa en pacientes en tratamiento con IMAO.
- Dothiepin y trimipramina mostraron un impacto mínimo en la sensibilidad a la tiramina en este grupo de pacientes.
- La combinación de amitriptilina y IMAO, iniciada en una dosis modesta y aumentada gradualmente, puede ofrecer protección contra los alimentos que contienen tiramina.
Conclusiones:
- La amitriptilina demuestra un efecto protector contra las respuestas presores inducidas por la tiramina en pacientes tratados con IMAO.
- Si bien la amitriptilina puede reducir los riesgos, los pacientes con IMAO aún deben evitar los alimentos ricos en tiramina debido a la potencial absorción sistémica.
- Se justifica una mayor investigación sobre las estrategias de dosificación óptimas para la terapia combinada de amitriptilina e IMAO.
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