Article type: Review Article
Article
title: The link between amitriptyline and movement disorders: clinical profile and outcome
Journal: Annals,
Academy of Medicine, Singapore
Year: 2020
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Introduction:
Amitriptyline (AMT) is a tricyclic antidepressant. In this review, we evaluate
the clinical and epidemiological profile, pathological mechanisms and
management of AMT-associated movement disorders. Materials and methods: A
search for relevant reports in 6 databases was performed. Studies that reported
patients developed only ataxia or tremor after AMT use were excluded. Results:
A total of 48 reports on 200 cases were found. AMT-associated movement
disorders included myoclonus (n = 26), dyskinesia (n = 11), dystonia (n = 8),
stutter (n = 5), akathisia (n = 3) and restless legs syndrome (n = 1). For less
well-defined cases, 99 patients had dyskinesia, 19 had psychomotor
disturbances, 3 had myoclonus, 11 had dystonia, 12 had Parkinsonism and 1 each
had akathisia and extrapyramidal symptoms. Mean and standard deviation (SD) and
median ages were 45.40 years (SD 16.78) and 40 years (range 3.7-82 years),
respectively. Over half were women (58.13%) and the most common indication was
depression. Mean and median AMT doses were 126 mg (SD 128.76) and 75 mg (range
15-800 mg), respectively. In 68% of patients, onset of movement disorders was
<1 month; time from AMT withdrawal to complete recovery was <1 month in
70% of cases. A weak negative linear correlation (r = -0.0904) was found
between onset of movement disorders and AMT dose. AMT withdrawal was the most
common treatment. Conclusion: Amitriptyline is associated with various movement
disorders, particularly myoclonus, dystonia and dyskinesias. Stutters and
restless legs syndrome are some of the less common associations.
Key-words: Akathisia, drug-induced, dyskinesia, dystonia, myoclonus
Full text available at:
https://www.annals.edu.sg/pdf/49VolNo4Apr2020/V49N4p236.pdf
DOI
10.47102/annals-acadmedsg.202023
Citation
Rissardo JP, Caprara ALF. The link between amitriptyline and movement disorders: clinical profile and outcome. Ann Acad Med Singap 2020;49:236-251.
