Crit Rev Clin Lab Sci. Clin Med Lond. Elsevier; Skip to main content. Register Sign In. Test Catalog Account. Outreach Solutions Tactics Articles Events. Utilization Management Algorithms.
The relative blood levels of Amitriptyline and Nortriptyline are highly variable among patients. Amitriptyline is the drug of choice in treatment of depression when the side effect of mild sedation is desirable.
Nortriptyline is used when its stimulatory side effect is considered to be of clinical advantage. It was not possible to combine information from the different studies, but individually most studies indicated equivalent benefit from nortriptyline usually at a dose between 50 mg and mg daily when compared with amitriptyline or chlorimipramine other antidepressants , gabapentin an antiepileptic , morphine an opioid , or placebo very low quality evidence.
More people experienced adverse events with nortriptyline than with placebo, but numbers were similar for nortriptyline and other active medicines very low quality evidence. There was too little information of adequate quality to be sure that nortriptyline works as a pain medicine in the type of neuropathic pain studies in this review.
Other medicines have been shown to be effective. We found little evidence to support the use of nortriptyline to treat the neuropathic pain conditions included in this review. There were no studies in the treatment of trigeminal neuralgia. The studies were methodologically flawed, largely due to small size, and potentially subject to major bias. The results of this review do not support the use of nortriptyline as a first line treatment.
Effective medicines with much greater supportive evidence are available, such as duloxetine and pregabalin. Antidepressants are widely used to treat chronic neuropathic pain pain due to nerve damage , usually in doses below those at which they exert antidepressant effects. An earlier review that included all antidepressants for neuropathic pain is being replaced by new reviews of individual drugs examining individual neuropathic pain conditions.
Nortriptyline is a tricyclic antidepressant that is occasionally used for treating neuropathic pain, and is recommended in European, UK, and USA guidelines. To assess the analgesic efficacy and associated adverse events of nortriptyline for chronic neuropathic pain in adults. We also searched two clinical trials databases for ongoing or unpublished studies.
We included randomised, double-blind studies of at least two weeks' duration comparing nortriptyline with placebo or another active treatment in chronic neuropathic pain.
0コメント