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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by ed_uk on October 8, 2005, at 12:31:12
I just used some amitriptyline to numb the pain of a large mouth ulcer. Shame about the taste.
Pain. 2004 Nov;112(1-2):106-12.
Intrathecal tri-cyclic antidepressants produce spinal anesthesia.Chen YW, Huang KL, Liu SY, Tzeng JI, Chu KS, Lin MT, Wang JJ.
Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan, ROC.
Tri-cyclic antidepressants (TCAs) have been widely used in treating major depressive disorders. Recent studies further demonstrated that TCAs have potent sodium channel blocking effect, and amitriptyline, one of the TCAs, has a potent spinal anesthetic effect. The aim of the study was to evaluate the spinal anesthetic effect of various TCAs and to see whether these TCAs could likewise act as local anesthetics after a single intrathecal injection. Bupivacaine, a potent and long-acting traditional local anesthetic, acted as control. The spinal anesthetic effect of nine TCAs (amitriptyline, doxepin, imipramine, trimipramine, clomipramine, protriptyline, desipramine, nortriptyline, and amoxapine) and three traditional local anesthetics (bupivacaine, lidocaine, and mepivacaine) was evaluated in rats and so were dose-response studies of amitriptyline, bupivacaine, and lidocaine. Under a given concentration of 5mM, bupivacaine had the most potent spinal blockade of motor, propioception, and nociception (P<0.001) and the longest duration of action of nociception (P<0.01) among the three traditional local anesthetics. Under this concentration, amitriptyline had a similar potency but longer duration of spinal blockade of motor, propioception, and nociception (P<0.001) than did bupivacaine, whereas several other TCAs had similar or less potencies of spinal blockade than did bupivacaine. In dose-response studies, amitriptyline had a more potent (P<0.005) and longer duration (P<0.001) of spinal blockade than did bupivacaine. We concluded that intrathecal amitriptyline had a more potent and longer duration of spinal anesthetic effect than did bupivacaine, whereas several other TCAs had similar or less potencies than did bupivacaine.
Posted by tecknohed on October 8, 2005, at 16:32:33
In reply to Amitriptyline (Elavil) is a local anesthetic, posted by ed_uk on October 8, 2005, at 12:31:12
Yes, I remember the numbing on the tongue from amitriptyline. And I'm pretty sure at least one other tricyclic I've tried (possibly lofepramine) did the same thing.
I think Amitriptyline has been indicated for chronic pain for many years.
Posted by ed_uk on October 8, 2005, at 16:40:00
In reply to Re: Amitriptyline (Elavil) is a local anesthetic » ed_uk, posted by tecknohed on October 8, 2005, at 16:32:33
Hi Kev
Lofepramine never numbed my tongue. I have to swallow amitriptyline quickly or else my tongue will feel weird! Mirtazapine had a mild numbing effect, much less than amitriptyine.
Regards
~ed
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