This is the first case report presenting intoxication in a child with amitriptyline cream. It stresses the importance of keeping children away from the medicine cabinet, even from creams or ointments. [ncbi.nlm.nih.gov]

• Shivering

  Tell your doctor immediately or ring HealthLine 0800 611 116 Signs of an allergic reaction such as skin rash Tell your doctor immediately or ring HealthLine 0800 611 116 Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering [healthnavigator.org.nz]

  Taking lithium along with tramadol (Ultram) might cause too much serotonin in the brain causing confusion, shivering, stiff muscles, and other side effects. This interaction is listed with Drugs.com, rxlist.com and others. [wiki.answers.com]

  Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. [drugs.com]

  If you take other medicines or drugs that enhance serotonin activity in the brain while you're taking amitriptyline, you’re more at risk of getting a side effect called 'serotonin syndrome', with symptoms such as agitation, tremor, shivering, increased [netdoctor.co.uk]

• Unconsciousness

  Severe symptoms include unconsciousness, convulsions and myoclonus, hyperreflexia, hypotension, and respiratory and cardiac depression, with life-threatening cardiac arrhythmias that may recur some days after apparent recovery. [home.intekom.com]

  If the affected person is unconscious or has an impaired gag reflex, a nasogastric tube may be used to deliver the activated charcoal into the stomach. [en.wikipedia.org]

• Cough

  We performed univariate analysis comparing cough improvement to age, gender, symptoms of throat irritation, cough duration, concurrent speech therapy, and dosage. [ncbi.nlm.nih.gov]

  | Diarrhea | Digestive Symptoms | Fatigue | Fever | Frequent Urination | Green Stool | Blurred Vision | Chest Pain | Abdominal Swelling | Headache | Itching Skin | Jaw Pain | Chills | Cough Cold | Diabetes | Eczema | Genital Herpes | Gonorrhea | Heart [fairypopins.co.uk]

  Symptoms of an allergic reaction may include: cough, shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue, throat or other parts of the body; rash, itching or hives on the skin; fainting; or hay fever-like symptoms [news-medical.net]

• Increased Appetite

  Although side effects, such as dry mouth, increased appetite and constipation may occur, consultation with the physician may help minimize the likelihood and severity of these effects. It can cause sedation and can be taken at night to help sleep. [headaches.org]

  Some of the side effects of amitriptyline include (but aren’t limited to): Weight gain Increased appetite Dry mouth Drowsiness Headache Fatigue A drop in blood pressure upon standing Constipation Nausea Low libido Sexual performance problems Weakness [psyweb.com]

  Amitriptyline elevates mood, increase physical activity, improves appetite and restores interest in everyday activities. Because of its effect on appetite, many taking amitriptyline may experience unwelcome weight gain. [health24.com]

  Amitriptyline may increase appetite, cause weight gain, or produce an unpleasant taste in the mouth. It may also cause diarrhea, vomiting, or heartburn. Taking this medication with food may decrease digestive side effects. [minddisorders.com]

• Tachycardia

  Diagnosis of amitriptyline-induced ventricular tachycardia is difficult when there is no history of an overdose obtained. [ncbi.nlm.nih.gov]

• Orthostatic Hypotension

  Orthostatic hypotension and tachycardia, sometimes associated with tricyclic antidepressant agents, may also pose a problem in the elderly. [ncbi.nlm.nih.gov]

  hypotension Use caution in patients with cardiovascular disease, diabetes, mania, hepatic and renal impairment, thyroid dysfunction, and seizure disorder May worsen mania symptoms or precipitate mania in patients with bipolar disorder Clinical worsening [web.archive.org]

  Cardiovascular: Frequently: hypotension, particularly orthostatic hypotension with associated vertigo, tachycardia, ECG changes (including flattening or inversion of T waves). [rxmed.com]

• Blurred Vision

  […] precipitate mania in patients with bipolar disorder Clinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (18-24 years) Risk of anticholinergic side effects; may cause constipation, urinary retention, blurred [web.archive.org]

  Common side effects of amitriptyline include dry mouth, loss of appetite, dizziness, drowsiness, and blurred vision. Other side effects may include trouble concentrating, nightmares, and a decreased sex drive. [everydayhealth.com]

  The most common side effects of amitriptyline include drowsiness, weight gain, dry mouth, constipation, sedation, and blurred vision. In one study, about 60 percent of the patients reported gaining weight, with an average gain of almost 12 pounds. [consumerreports.org]

• Diplopia

  Diplopia was solved in time after anticholinergic medication cessation. During the recovery period, Fresnell prisms have been used in order to eliminate diplopia. [ncbi.nlm.nih.gov]

  Quality of life is also important because patients may be confined to bed because of pain or may be pain free after receiving drugs but unable to walk due to ataxia, diplopia and drowsiness. [doi.org]

• Suicidal Ideation

  ideation may occur despite medication in adolescents and young adults (18-24 years) Risk of anticholinergic side effects; may cause constipation, urinary retention, blurred vision, and xerostomia Use caution in patients with urinary retention, open-angle [web.archive.org]

• Withdrawn

  The ECG changes usually disappear when the antidepressant drug is withdrawn. Note! [home.intekom.com]

  For these reasons, the Food and Drug Administration (FDA) did not approve the drug’s marketing, but sertindole was approved for use in Europe in 1997. [69] After reports of increased rates of SCD, sertindole was voluntarily withdrawn from the European [medscape.com]

  Amitriptyline is not addictive but if discontinued, it should be withdrawn slowly over two to three weeks in order to avoid withdrawal symptoms of headache and malaise. [painconcern.org.uk]

  Furthermore, whenever one of these other drugs is withdrawn from co-therapy, an increased dose of tricyclic antidepressant may be required. [ncbi.nlm.nih.gov]

• Visual Hallucination

  Overdosage Manifestations High doses may cause temporary confusion, disturbed concentration, or transient visual hallucinations. [web.archive.org]

  Other signs of overdose may include: impaired myocardial contractility, confusion, disturbed concentration, transient visual hallucinations, dilated pupils, disorders of ocular motility, agitation, hyperactive reflexes, polyradiculoneuropathy, stupor, [dailymed.nlm.nih.gov]

• Sexual Dysfunction

  KEYWORDS: amitriptyline; ejaculation; impotence; libido; orgasm; sexual dysfunction [ncbi.nlm.nih.gov]

  Amitriptyline also caused more anticholinergic side effects, tachycardia, dizziness, nervousness, sedation, tremor, dyspepsia, sedation, sexual dysfunction and weight gain. [cochrane.org]

  Sometimes troublesome side effects include: fast heart rate, blurred vision, urinary retention, dry mouth, constipation, sexual dysfunction weight gain or loss, and low blood pressure on standing (orthostatic hypotension ). [medicinenet.com]

  dysfunction Slow or garbled speech Chest pain Muscle spasms and tremors Excessive bruising or bleeding Sensitivity to ultraviolet radiation Interactions Amitriptyline can have a dangerous interaction with monamine oxidase inhibitor antidepressants that [anti-depressants.com]

• Polyuria

  Nocturia, nocturnal polyuria, and sleep quality in the elderly. J Psychosom Res 2004; 56 :517–525 [ PubMed ] [ Google Scholar ] 15. Resnick HE, Redline S, Shahar E, et al. [ncbi.nlm.nih.gov]

• Seizure

  She was admitted to hospital because of lethargy and seizures. It was estimated that she took approximately 75 mg/kg of amitriptyline 2 h before admission. On examination she was comatose, had ventricular tachycardia and multifocal clonic seizures. [ncbi.nlm.nih.gov]

  Seizures: Tricyclic antidepressants can lower the seizure threshold and should be used with caution in patients with a history of seizures or those who may be predisposed to seizures. [rxmed.com]

  Seizures have been known to happen with tramadol and mixing it with dravocet can increase this but only in those who are prone to seizure. [wiki.answers.com]

• Insomnia

  However, like other types of anti-depressants, it’s also commonly used as an off-label treatment for insomnia. [insomnia.net]

  Some mothers need to use sedative agents for insomnia. Amitriptyline is a tricyclic antidepressant that has sedative effects. Despite no adverse reports, data on safety for the maternal use of this medication on breastfed infants are limited. [ncbi.nlm.nih.gov]

  Report 5 Stars Posted 5 months ago (12/12/2018) 5 Rated Amitriptyline (Elavil) for Insomnia Report I have had severe chronic insomnia for 8 years and nothing ever worked. [everydayhealth.com]

• Stroke

  Once it was determined that no other focal neurologic findings indicated stroke, her medications were reviewed. The patient had been taking amitriptyline 50 mg/d for the past year for insomnia without any adverse events. [ncbi.nlm.nih.gov]

  Adverse Reactions: Drowsiness, anticholinergic effects, CNS overstimulation, arrhythmias, stroke, coma, confusion, extrapyramidal symptoms, hypo- or hypertension, nausea, fatigue, rash, increased perspiration, headache, photosensitivity, edema, blood [empr.com]

  If you have heart disease, you should be extremely cautious because this type of drug is associated with an increased risk of irregular heart rhythms, heart attacks, and strokes. [consumerreports.org]

• Paresthesia

  About this Medication Brand Name: Elavil (U.S. and Canada) Chemical Name: Amitriptyline (a-mee-trip-ti-leen) Usage in MS: Pain (Paresthesias) Generic Available: Yes Description Amitriptyline is a tricyclic antidepressant used to treat depression. [nationalmssociety.org]

  […] regulation), hepatic/renal impairment, and the elderly Abrupt discontinuation or interruption of antidepressant therapy has been associated with a discontinuation syndrome, which may include vomiting, diarrhea, headaches, dizziness, chills, tremors, paresthesias [reference.medscape.com]

  Patients who received amitriptyline or topiramate had higher rates of several adverse events than those receiving placebo, including fatigue (30% vs. 14%) and dry mouth (25% vs. 12%) in the amitriptyline group and paresthesia (31% vs. 8%) and weight loss [ncbi.nlm.nih.gov]

  Occasionally: insomnia, dizziness, headache, paresthesia (numbness, tingling sensation, symptoms suggestive of peripheral neuropathy). Rarely: seizures. [rxmed.com]

• Wide QRS Complex

  She was in comatose, had generalized tonic clonic seizure, ventricular tachycardia, and wide QRS complexes. [ncbi.nlm.nih.gov]

• Hyponatremia

  The incidence of hyponatremia was more in pediatric patients and severe poisoning groups (38.8 and 53.4%, respectively). [ncbi.nlm.nih.gov]

• Neutropenia

  We also discuss the possible role of the H 2 R antagonism of clozapine for neutropenia/agranulocytosis induced by this compound. Finally, we discuss the methodological, conceptual, and clinical limitations of our study. [doi.org]

• Prolonged PR Interval

  Prolonged PR interval, ST-T wave changes, ventricular tachycardia and fibrillation may also occur. [web.archive.org]

• Torsades De Pointes

  Haloperidol-induced torsade de pointes. Ann Pharmacother. 1999; 33:1046-50. Kriwisky M, Perry GY, Tarchitsky D et al. Haloperidol-induced torsades de pointes. Chest. 1990; 98:482-4. Dineen S, Withrow K, Voronovitch L et al. [web.archive.org]

  Preclinical research demonstrated that the drug prolonged the Q-Tc interval in a non-dose-dependent manner. [69] In small-sample premarketing trials, few cases of Q-Tc interval prolongation, torsades de pointes, and SCD were reported. [medscape.com]

  Zeltser, Torsade de pointes induced by psychotropic drugs and the prevalence of its risk factors, Acta Psychiatrica Scandinavica, 111, 3, (171-176), (2005). [doi.org]

  An effect on cardiac conduction similar to that of quinidine may be seen with slowing of conduction, prolongation of the QRS complex and QT intervals, right bundle branch and AV block, ventricular tachyarrhythmias (including torsades de pointes and fibrillation [rxmed.com]

• Electrocardiogram Change

  Some of the more major problems that can arise include coma, convulsions, severely low blood pressure, hypothermia, a dangerously high heart rate and electrocardiogram changes. [macromass.com]

  Electrocardiogram changes and therapeutic desipramine and 2-hydroxy-desipramine concentrations in elderly depressives. Br. J. Psychiatry 148: 676–679. Google Scholar Kutcher, S. P., Shulman, K. I., and Reed, K. (1986b). [doi.org]

After 6 week treatment, 71.7% of paroxetine group (33/46) were calculated as treatment response, significantly higher than that in amitriptyline group (46.2%, 24/52) and lansoprazole group (14.0%, 7/50). [ncbi.nlm.nih.gov]

Subjects in the pregabalin treatment group recorded the highest number of treatment-emergent adverse events ( P < 0.0001) with a causal relationship with study drug. [doi.org]

All adult patients were discharged with good prognosis. In pediatric age group, one patient was discharged with severe neurological sequelae and one patient died. [ncbi.nlm.nih.gov]

The prognosis with postherpetic neuralgia. Pain 1991; 46: 195–9 PubMed CrossRef Google Scholar 47. de Moragas JM, Kierland RR. The outcome of patients with herpes zoster. Arch Dermatol 1957; 75: 193–6 CrossRef Google Scholar 48. [doi.org]

These patients with autonomic dysfunction may have slower resolution of their symptoms that may take several years and the prognosis is worse than in postviral gastroparesis without autonomic disorders ( 20, 21 ). [gi.org]

Assessing Psychiatric Comorbidity Anxiety and depression are highly prevalent in patients who have CDH 7 and, when present, may negatively influence prognosis. All patients who have CDH should be screened for psychiatric comorbidity. [aafp.org]

These patients with autonomic dysfunction may have slower resolution of their symptoms that may take several years and the prognosis is worse than in postviral gastroparesis without autonomic disorders (20,21). [web.archive.org]

OBJECTIVE: A neuropathic etiology has been suggested for patients with chronic laryngopharyngitis symptoms without visible structural pathology. [ncbi.nlm.nih.gov]

Postsurgical gastroparesis (PSG), often with vagotomy or vagus nerve injury, represents the third most common etiology of gastroparesis. [web.archive.org]

View Article PubMed Google Scholar Couch JR, Bearss C, Verhulst S: Importance of maternal heredity in the etiology of migraine. [doi.org]

The epidemiology of headache in Germany: a nation wide survey of a representative sample on the basis of the headache classification of the Inter national Headache Society. Cephalalgia. 1994;14:97–106. ... 2. Rasmussen BK. Epidemiology of headache. [web.archive.org]

The epidemiology and impact of gastroparesis are reviewed elsewhere ( 2 ). [gi.org]

Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract 2000; 47 :123–128 [ PubMed ] [ Google Scholar ] 4. O’Connor AB. [ncbi.nlm.nih.gov]

Pathophysiology of itch in lichen amyloidosis may involve both cutaneous and neural components and amitriptyline is known to be useful for neuropathic itch. [ncbi.nlm.nih.gov]

Daniel Segelcke and Karl Messlinger, Putative role of 5-HT2B receptors in migraine pathophysiology, Cephalalgia, 37, 4, (365), (2017). T. S. Gan’shina, A. A. Gorbunov, A. V. Gnezdilova, A. I. Turilova, L. M. Kostochka, B. M. Pyatin, N. I. [doi.org]

Pathophysiology Although tension-type headaches are common, the pathophysiology and likely mechanism remain unclear. [web.archive.org]

Preventive medication therapy is suggested for 5 or more headaches per month. [ncbi.nlm.nih.gov]

It is used as a first-line drug for primary headache prevention in a very low dose range of 10-50 mg. [clinicaltrials.gov]

It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. [fpnotebook.com]