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]

• Weakness

  The inhibition showed only weak voltage dependence. 3 Using an 'envelope of tails' comprised of pulses to +20 mV of varying durations, the tau of activation was found to be 155+/-30 ms for control and 132+/-26 ms for 3 microM imipramine (n = 5). [ncbi.nlm.nih.gov]

  If you experience any of the following, call 911 and go to an emergency room: slow or difficult speech dizziness or faintness weakness or numbness of an arm or a leg crushing chest pain rapid, pounding, or irregular heartbeat severe skin rash or hives [consumerreports.org]

  They include: Drowsiness Dry mouth Nausea Vomiting Weakness or tiredness Nightmares Headaches Constipation Difficulty urinating Blurred vision Pain, burning or tingling in the hands or feet Changes in sex drive or ability Excessive sweating Changes in [backandneck.about.com]

  […] in sex; or nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness. [drugs.com]

• Nightmare

  Other side effects may include trouble concentrating, nightmares, and a decreased sex drive. This is not a complete list of the side effects associated with amitriptyline. [everydayhealth.com]

  Other reactions have occurred such as agitation, confusion, nightmares, restlessness, hostility, exacerbation of psychosis and extrapyramidal symptoms. Elderly patients may be more susceptible to some of these effects. [rxmed.com]

  Tell your doctor if any of these symptoms occur: nausea vomiting drowsiness weakness or tiredness nightmares headaches dry mouth constipation difficulty urinating blurred vision pain, burning, or tingling in the hands or feet changes in sex drive or ability [consumerreports.org]

• Collapse

  If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. [nlm.nih.gov]

  […] contact your doctor at once if you experience the following: allergic reaction, a skin rash, which may be itchy, sensitivity to the sun or sun lamps, puffy, swollen face or tongue, which may be severe causing shortness of breath, swelling, shock and collapse [macromass.com]

  If you experience any of the following, stop taking your medicine and contact your doctor immediately or go to the Accident and Emergency department at your nearest hospital. severe sunburn, blistering or swelling of the skin fainting or collapse chest [news-medical.net]

• 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]

• Burning Pain

  Subjects were recruited on the basis of symptoms suggestive of DPNP, including one or more of the following: dysesthesia, burning pain, cold or heat allodynia, shooting or lancinating pains, and hyperalgesia affecting both lower extremities at any level [doi.org]

• Constipation

  It may also trigger other side effects, including confusion, constipation, visual changes, or urinary retention. [consumerreports.org]

  […] disorder May worsen mania symptoms or 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 [web.archive.org]

  Increased fiber in the diet and additional fluids may help relieve constipation. Dizziness is usually caused by a drop in blood pressure when suddenly changing position. [minddisorders.com]

• Vomiting

  CONCLUSION: Prevention of vomiting attacks using appropriate agents is essential for the management of pregnancies complicated by cyclic vomiting syndrome. [ncbi.nlm.nih.gov]

  Keywords Migraine Amitriptyline Migraine Headache Episode Frequency High Patient Satisfaction Background Cyclic vomiting syndrome (CVS) is defined as recurrent identical episodes of nausea and vomiting, with the absence of these symptoms between episodes [doi.org]

• 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]

• Heart Disease

  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]

  Do not use it if you are allergic to amitriptyline, other tricyclic antidepressants or other ingredients of the medicine have heart disease such as irregular heartbeats, heart block or failure, coronary artery disease or have recently had a heart attack [euromeds-doctor.com]

  Heart disease: Amitriptyline can increase your risk for certain heart problems such as heart attack, arrhythmia (rapid heart rate or rhythm), and stroke. Hypersensitivity reaction: An allergic reaction to amitriptyline can occur. [rxwiki.com]

  […] attack or cardiovascular (heart) disease Any problems urinating Overactive thyroid Glaucoma It is not known whether Elavil is safe to take during pregnancy or while breastfeeding. [migraine.com]

• Jaundice

  jaundice and pruritus [19-20 months] and ductopenia on liver biopsy). [ncbi.nlm.nih.gov]

  In isolated cases: diarrhea, bitter taste, stomatitis, epigastric distress, abdominal cramps, black tongue, dysphagia, increased salivation, hepatitis with or without jaundice. [rxmed.com]

  Allergic skin reactions and photosensitisation have been reported and, less frequently, cholestatic jaundice and blood disorders, including eosinophilia, bone-marrow depression, thrombocytopenia, leucopenia and agranulocytosis. [home.intekom.com]

• Skin Rash

  Like all medicines amitriptyline can cause side effects, including: headache, dizziness weakness, tiredness change in weight drowsiness increased sweating hair loss widely dilated pupils difficulty passing water (urine) skin rashes skin rash due to sunlight [euromeds-doctor.com]

  The rash became exfoliating with generalised scaling from the head downwards. An emollient euserine cream was applied. A month later, skin lesions and blood tests normalised. [pmj.bmj.com]

  If you experience any of the following, call 911 and go to an emergency room: slow or difficult speech dizziness or faintness weakness or numbness of an arm or a leg crushing chest pain rapid, pounding, or irregular heartbeat severe skin rash or hives [consumerreports.org]

  Side effects included sedation, vertigo, dry mouth, skin rash, and restlessness. Significantly more patients who took pregabalin had at least one side effect (eight patients vs three patients). [mdedge.com]

• Flushing

  When the two drugs are given together, a lower dose of levodopa can be used, and nausea and flushing occur less often and are less severe. [web.archive.org]

  If there is no take-back program, flush the unused medicine down the toilet. What happens if I miss a dose? Since tramadol is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. [drugs.com]

  However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. [nlm.nih.gov]

  Autonomic: Frequently: dry mouth and rarely associated sublingual adenitis, blurred vision, disturbances of accommodation, constipation, perspiration, flushing. Occasionally: delayed micturition, dilation of the urinary tract. [rxmed.com]

• Eruptions

  These findings were consistent with a drug induced eruption. Figure 2 Skin biopsy: a site of “pigmentary incontinence” and mild eosinophilic infiltration (haematoxylin and eosin × 40) consistent with the diagnosis of drug induced eruption. [pmj.bmj.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]

  Common side effects include: drowsiness dry mouth blurred vision pupil dilation constipation weight gain urinary retention. [nps.org.au]

• 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]

• Aggressive Behavior

  If you, a family member, or a caregiver notice the following changes in your behavior, notify a doctor right away: new or worsening depression suicidal ideas extreme worry, agitation, panic attacks difficulty falling asleep or staying asleep aggressive [consumerreports.org]

  You and a caregiver should monitor your behavior for new or worsening depression, any thoughts of hurting or killing yourself, any impulsive behavior, anxiety, restlessness, worry, agitation, panic attacks, changes in sleep or aggressive behavior. [migraine.com]

  behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. [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]

• 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]

• Tingling

  Brain tingles are still present, no pupil dilation, more and more lethargic. Am wondering if the top up was really needed. [erowid.org]

  Tell your doctor if any of these symptoms occur: nausea vomiting drowsiness weakness or tiredness nightmares headaches dry mouth constipation difficulty urinating blurred vision pain, burning, or tingling in the hands or feet changes in sex drive or ability [consumerreports.org]

  They include: Drowsiness Dry mouth Nausea Vomiting Weakness or tiredness Nightmares Headaches Constipation Difficulty urinating Blurred vision Pain, burning or tingling in the hands or feet Changes in sex drive or ability Excessive sweating Changes in [backandneck.about.com]

  You may get a burning, tingling feeling on your skin when you are in the sun, or you may notice a darker tan or redness. When outside, protect your skin by using an SPF30+ sunscreen and clothing that protects you from the sun. [healthnavigator.org.nz]

• Somnolence

  SD was significantly correlated with insomnia linearly whereas somnolence and nausea dually. [ncbi.nlm.nih.gov]

  Human systemic effects by ingestion: convulsions, respiratory depression, changes in sleep, hallucinations, muscle contractions, somnolence, blood pressure decrease, coma, cyanosis, dyspnea, and ataxia. An experimental teratogen. [guidechem.com]

  […] 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, somnolence [reference.medscape.com]

  These events were related to general and nervous system disorders and specifically fatigue, dizziness, and somnolence. [doi.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]

• Burning Sensation

  Most of the patients reported a burning sensation, often worsened by sitting, urinating or having intercourse. [ncbi.nlm.nih.gov]

  In multiple sclerosis, amitriptyline is often used in lower doses for the treatment of neuropathic or nerve pain, such as burning sensations, pins and needles or stabbing pains. [mstrust.org.uk]

  In multiple sclerosis it is frequently used to treat painful paresthesias in the arms and legs (e.g., burning sensations, pins and needles, stabbing pains) caused by damage to the pain regulating pathways of the brain and spinal cord. [nationalmssociety.org]

  The pain is usually described as having a burning sensation and is often in response to stimuli that do not ordinarily cause pain. This pain originates from the nervous system. [dermnetnz.org]

• 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]

• 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. [aafp.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. [aafp.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]