AMITRIPTYLINE, a tricyclic antidepressant, is widely used to treat depression.1,2 Several reports indicate that this drug can induce symptoms of peripheral neuropathy.3–7 In the following case, peripheral paresthesias developed during amitriptyline therapy and were controlled by administration of oral pyridoxine hydrochloride (HCl).
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HollisterLE. Tricyclic antidepressants (second of two parts). N Engl J Med1978; 299: 1168–72.
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CasarinoJP. Neuropathy associated with amitriptyline. NY State J Med1977; 77: 2124–6.
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IsaacsADCarlishS. Peripheral neuropathy after amitriptyline (letter). Br Med J1963; 1: 1739.
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SmithRCGrieveRC. Peripheral neuropathy after amitriptyline (letter). Br Med J1963; 2: 254.
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BlackwellB. Another amitriptyline side effect (letter)?. Lancet1968; 1: 426.
7.
BrechterCL. Another amitriptyline side effect (letter)?. Lancet1968; 1: 590–1.
8.
BhagavanHNKooglerJMCoursinDB. Enzymatic microassay of pyridoxal-5′-phosphate using L-tyrosine apodecarboxylase and L-(1-14C) tyrosine. Int J Vitam Nutr Res1976; 46: 160–4.
9.
UchigataMTanabeHHasueIKuriharaM. Peripheral neuropathy due to lithium intoxication (letter). Ann Neurol1981; 9: 414.
EvansDAManleyKAMcKusickVA. Genetic control of isoniazid metabolism in man. Br Med J1960; 2: 485–91.
12.
HarrisHW. Current concepts of the metabolism of antituber-culous agents. Ann NY Acad Sci1963; 106: 43–7.
13.
AdamsPWRoseDPFolkardJWynnVSeedMStrongR. Effect of pyridoxine hydrochloride (vitamin B6) upon depression associated with oral contraception. Lancet1973; 1: 897–907.
14.
ShaneBContractorSF. Assessment of vitamin B6 status. Studies on pregnant women and oral contraceptive users. Am J Clin Nutr1975; 28: 739–47.
15.
GramLFOveroKF. Drug interaction: Inhibitory effect of neuroleptics on metabolism of tricyclic antidepressants in man. Br Med J1972; 1: 463–5.
16.
GramLFChristiansenJOveroKF. Pharmacokinetic interaction between tricyclic antidepressants and other psychopharmaceuticals. Acta Psychiatr Scand1973; 243(Suppl): 52–3.
17.
El-YousefMFManierDH. Tricyclic antidepressants and phenothiazines (letter). JAMA1974; 229: 1419.
