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C.O. Truxton, Inc. Issues Voluntary Nationwide Recall of Amitriptyline HCL Tablets, USP 50mg and Phenobarbital Tablets, USP 15mg, 30mg, 60mg, 100mg Due to Potential Label Mix-Up
Bellmawr, New Jersey, C.O. Truxton, Inc. is expanding their 04/21/2017 voluntary recall, as a precaution to include the following C.O. Truxton, Inc. products, registered NDC numbers and corresponding lot numbers, to the consumer/user level. C.O. Truxton has not received any complaints for the products listed below. however, due to the initial recall resulting from a label mix-up error, out of an abundance of caution, we are recalling all products that were repackaged into a Truxton Incorporated label. (Source: Food and Drug Administration)
Source: Food and Drug Administration - May 8, 2017 Category: Food Science Source Type: news

Antidepressant may enhance delivery of medication to the brain
An NIEHS rat study suggests amitriptyline temporarily inhibits the blood-brain barrier, so medications can enter the brain. (read more) (Source: Environmental Factor - NIEHS Newsletter)
Source: Environmental Factor - NIEHS Newsletter - May 2, 2017 Category: Environmental Health Source Type: news

Antidepressant may enhance drug delivery to the brain
Pairing the antidepressant amitriptyline with drugs designed to treat central nervous system diseases, enhances drug delivery to the brain by inhibiting the blood-brain barrier in rats, new research shows. The blood-brain barrier serves as a natural, protective boundary, preventing most drugs from entering the brain. (Source: ScienceDaily Headlines)
Source: ScienceDaily Headlines - April 27, 2017 Category: Science Source Type: news

Antidepressant may enhance drug delivery to the brain
(NIH/National Institute of Environmental Health Sciences) New research from the National Institutes of Health found that pairing the antidepressant amitriptyline with drugs designed to treat central nervous system diseases, enhances drug delivery to the brain by inhibiting the blood-brain barrier in rats. The blood-brain barrier serves as a natural, protective boundary, preventing most drugs from entering the brain. The research, performed in rats, appeared online April 27 in the Journal of Cerebral Blood Flow and Metabolism. (Source: EurekAlert! - Biology)
Source: EurekAlert! - Biology - April 27, 2017 Category: Biology Source Type: news

Antidepressant may enhance drug delivery to the brain
NIH rat study suggests amitriptyline temporarily inhibits the blood-brain barrier, allowing drugs to enter the brain (Source: National Institutes of Health (NIH) News Releases)
Source: National Institutes of Health (NIH) News Releases - April 26, 2017 Category: American Health Source Type: news

Not Just for Attention: Stop Teen Suicide
The subject of depression and suicide, especially in the case of children and teens, is a tremendous concern. Unfortunately, many cases go missed not necessarily because those surrounding these young people don’t care or pay enough attention to them, but more because they aren’t aware of what to look out for. I am a suicide survivor. I also grew up with a suicidal mother and witnessed a peer successfully commit suicide, ironically, when I was in the emergency room beside her being treated for the same thing. I was saved, while her family still mourns for her. These experiences, including the fact that my twelve...
Source: Psych Central - March 29, 2017 Category: Psychiatry Authors: Chynna Laird Tags: Antidepressants Children and Teens Depression Medications Personal Stories Self-Esteem Stress Suicide Therapists Spill Treatment Anxiety Coping Skills Depression Mood Depressive Episode Major Depressive Disorder Monoamine Oxi Source Type: news

ECG Reveals Effects of Multi-Substance Suicide Attempt
The Case Medic 49 was called to a wooded area near a private residence for a missing person and concern for overdose. Police were already on scene and had walked approximately 0.5 miles into the wooded area behind the home where they found a 30-year-old female unresponsive with several pill bottles nearby. The family, who had reported the patient missing, stated that the patient had a history of suicidal thoughts. On EMS arrival, the patient was still unresponsive and hypoxic with an oxygen saturation of 76% on RA. The patient was also tachycardic to 130 and had an initial blood pressure of 140/90. The patient was not movi...
Source: JEMS Patient Care - September 29, 2016 Category: Emergency Medicine Authors: Jeffrey J. Bell, RN, BSN, CEN, NREMT-P Tags: Patient Care Source Type: news

Elavil (Amitriptyline) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - September 2, 2016 Category: Drugs & Pharmacology Source Type: news

Depression blood test could lead to personalised treatments
Conclusion This study shows how a new blood test in development can help identify people with depression who are most and least likely to benefit from antidepressants. While promising, the test is far from perfect. For example, it missed 39-43% of non-responders, meaning these people would continue to receive standard antidepressant treatment that is unlikely to work for them. A large proportion of patients (22-38%) also fell into the "intermediate" group who were neither responders nor non-responders, so the test wasn't too useful here. This means there is a significant proportion of people with...
Source: NHS News Feed - June 7, 2016 Category: Consumer Health News Tags: Mental health Medication Source Type: news

Limbitrol (Chlordiazepoxide Amitriptyline DS Tablets) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - May 5, 2016 Category: Drugs & Pharmacology Source Type: news

Survival after severe amitriptyline poisoning with prolonged ventricular tachycardia and cardiac arrest - Abeyaratne DD, Liyanapathirana C, Gamage A, Karunarathne P, Botheju M, Indrakumar J.
We report the first cas... (Source: SafetyLit)
Source: SafetyLit - March 19, 2016 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

What Are Potential Treatments for Irritable Bowel Syndrome?
Discussion Abdominal pain is a common problem for children and a review can be found here.here. Functional gastrointestinal diseases are one of the most common problems not only in children but throughout the lifespan and a review can be found here. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal diseases with 10 to 15% of children suffering from IBS. The cause is unknown but it is considered a brain-gut disorder. “It is postulated that the state of disregulation exists/occurs within the enteric and the central nervous systems in patients with IBS and this results in alteration in sensat...
Source: PediatricEducation.org - November 9, 2015 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

amitriptyline (Elavil, Endep)
Title: amitriptyline (Elavil, Endep)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 9/18/2015 12:00:00 AM (Source: MedicineNet Depression General)
Source: MedicineNet Depression General - September 18, 2015 Category: Psychiatry Source Type: news

Medication and Sleep
This article was adapted from a previous article written by Dr. Moore for his column “Kevlar for the Mind.” (Source: Psych Central)
Source: Psych Central - March 30, 2015 Category: Psychiatry Authors: Bret Moore, PsyD Tags: Anti-anxiety Antidepressants Atypical Antipsychotics Benzodiazepines Depression Disorders General Medications Sleep Insomnia sleep disorder Sleeping Pills Source Type: news

Excellent review of lipid rescue therapy
3.5 out of 5 stars Intravenous Lipid Emulsion in the Emergency Department: A Systematic Review of Recent Literature. Cao D et al. J Emerg Med 2014 Dec 19 [Epub ahead of print] Abstract This excellent comprehensive review of lipid rescue therapy (LRT) is vitiated only by the unavoidable fact that available clinical evidence  is so inconclusive. As the authors point out, published literature consists mostly of case reports and small case series. The vast majority of these reported cases have good outcomes and reflect positive effects from ILE, but the evidence is marred by multiple confounding variables (such ...
Source: The Poison Review - February 25, 2015 Category: Toxicology Authors: Leon Tags: Medical intralipid lipid emulsion lipid rescue therapy lipid sink Review Source Type: news

Amitriptyline poisoning of a baby: how informative can hair analysis be? - Allibe N, Eysseric-Guerin H, Kintz P, Bartoli M, Bost-Bru C, Grenier F, Scolan V, Stanke-Labesque F.
We reported a case of a 6-month-old baby girl who was hospitalized in the pediatric emergency for central nervous system disorders then coma. Toxicology analysis showed the presence of amitriptyline (AMI) and its metabolite nortriptyline (NOR) in blood and... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - February 20, 2015 Category: Global & Universal Tags: Age: Infants and Children Source Type: news

amitriptyline. (Elavil, Endep)
Title: amitriptyline. (Elavil, Endep)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 7/28/2014 12:00:00 AM (Source: MedicineNet Depression General)
Source: MedicineNet Depression General - July 28, 2014 Category: Psychiatry Source Type: news

amitriptyline. (Elavil, Endep)
Title: amitriptyline. (Elavil, Endep)Category: MedicationsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 7/28/2014 12:00:00 AM (Source: MedicineNet Medications General)
Source: MedicineNet Medications General - July 28, 2014 Category: Drugs & Pharmacology Source Type: news

Can Tricyclic Antidepressants Help Your Bipolar...
This article covers how tricyclic antidepressants work, allergies, pregnancy and breast-feeding, side effects common to the medication family, and interactions with drugs and alcohol. (Source: About.com Bipolar Disorder)
Source: About.com Bipolar Disorder - July 6, 2014 Category: Psychiatry Authors: bipolar.guide at about.com Tags: health Source Type: news

Antidepressants differ in effect on weight gain
Less weight gain with bupropion, nortriptyline and amitriptyline than citalopramRelated items from OnMedicaOlder generation antidepressants linked to heart diseaseMental and physical healthcare should be integratedCommunity mental health service users left out of decisionsDepressed patients stick with phone CBTLithium cuts suicide risk in people with mood disorders (Source: OnMedica Latest News)
Source: OnMedica Latest News - June 6, 2014 Category: UK Health Source Type: news

Episode #4: Poisoning and the diagnosis of brain death
Conclusion: unclear how long to wait before pronouncing brain death as many factors such as pharmacogenetics can alter normal metabolism   Summary Drug overdose can mimic brain death Be especially cautious in overdose involving the scary B’s: baclofen, barbiturate, benzodiazepine The 3-5 half life rule for drug clearance cannot be applied in the cases of overdose Half lives are measured at therapeutic levels Multiple other factors can alter metabolism in overdoses, such as pharmacogenetics, and cross reactivity with other ingestants Consult a toxicologist if there is any question regarding possible overdose...
Source: The Poison Review - May 20, 2014 Category: Toxicology Authors: LeonThe Poison Review Tags: Podcast Source Type: news

Severe childhood amitriptyline intoxication and plasmapheresis: a case report - Karacı M, Ozçetin M, Dilsiz G, Güçlü Songür YG.
Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepre... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - March 15, 2014 Category: Global & Universal Tags: Age: Adolescents Source Type: news

The Dark Side of Acetaminophen, and more: Tox on the Web
  The Dark Side of Acetaminophen: The Toronto Star has a long article this weekend about the hepatotoxicity of acetaminophen, both when taken in deliberate overdose as a suicidal gesture or attempt, or ingested in supra-therapeutic (or even therapeutic) doses.   It was put together with the help of the investigative unit ProPublica and goes over much of the material covered in the recent “This American Life” episode but with a Canadian twist. The piece states that a 2009 report “found a dozen cases in Health Canada’s adverse drug events database where people suffered li...
Source: The Poison Review - February 23, 2014 Category: Toxicology Authors: Leon Tags: Medical acetaminophen amitriptyline cyclobenzaprine ethylene glycol hepatotoxicity nasal naloxone tox on the web Source Type: news

Amitriptyline overdose in emergency department of university hospital: Evaluation of 250 patients - Paksu S, Duran L, Altuntas M, Zengin H, Salis O, Ozsevik S, Albayrak H, Murat N, Guzel A, Paksu M.
OBJECTIVE:The purpose of this study was to evaluate the patients with acute amitriptyline poisoning and investigate predictive factors for the development of life-threatening complications.METHODS:Demographics, clinical, laboratory, and electrocardiographi... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - February 15, 2014 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

Featured in NEJM Journal Watch: Cognitive Behavioral Therapy Plus Amitriptyline for Pediatric Chronic Migraine (FREE)
By the NEJM Journal Watch Editors Cognitive behavioral … (Source: Physician's First Watch current issue)
Source: Physician's First Watch current issue - January 15, 2014 Category: Primary Care Source Type: news

Lipid rescue therapy can interfere with critical lab values
3 out of 5 stars Caution with interpreting laboratory results after lipid rescue therapy. Punja M et al. Am J Emerg Med 2013 Oct;1536.e1-1536.e1 Reference (No abstract available) This case report describes a 54-year-old man who presented to the emergency department after ingesting a suicidal ingestion of diphenhydramine, amitriptyline, and acetaminophen (APAP). On arrival the patient had evidence of cardiotoxicity with unstable vital signs and a prolonged QRS interval (136 msec). His initial aspartate aminotransferase (AST) level was elevated (138 U/L). After treatment with sodium bicarbonate, N-acetylcystei...
Source: The Poison Review - November 13, 2013 Category: Toxicology Authors: Leon Tags: Medical amylase antidote aspartate intralipid laboratory error lipase lipid emulsion lipid rescue therapy pancreatitis transaminase Source Type: news

Lipid rescue therapy can cause lab errors
3 out of 5 stars Caution with interpreting laboratory results after lipid rescue therapy. Punja M et al. Am J Emerg Med 2013 Aug 8 [Epub ahead of print] No abstract available This short case report from Emory University and the Georgia Poison Center makes the point that administering lipid rescue therapy (LRT) may affect laboratory results in ways that may be unanticipated. In the case, a 54-year-old man who ingested a mixed overdose of diphenhydramine, amitriptyline and acetaminophen. His initial aspartate aminotransferase level (measured on a Siemens Vista 1500 analyzer) was 138 U/L. After 20% IV lipids were given, ...
Source: The Poison Review - August 22, 2013 Category: Toxicology Authors: Leon Tags: Medical aspartate aminogransferase AST erroneous lab values laboratory error lipid rescue therapy Source Type: news

Sleep and Bipolar Episodes - A Vicious Circle
Scientists are exploring the link between "clock" genes and bipolar disorder. For example, 2008 study found that a mutation in the core clock gene in mice produced hyperactivity and mania-like behavior. And as I wrote in Mood Disorders and Sleep, a short night can actually cause manic or hypomanic episodes. There's a lot of variance. I find that insomnia has a depressive effect on my mood, while hypersomnia (sleeping too much) is a symptom of my depression. Yet when I am hypomanic, I do have a decreased need for sleep. I am at my best when I consistently get 8 or 9 hours of restful sleep - or is it that I get 8 ...
Source: About.com Bipolar Disorder - August 12, 2013 Category: Psychiatry Source Type: news

Elavil / Endep / Amitriptyline Side Effects
Elavil - generic Amitriptyline - is a tricyclic antidepressant. This is a catalog of side effects for the medication Amitriptyline - brand names Elavil and Endep, which is sometimes prescribed for the treatment of bipolar disorder and other mental illnesses. (Source: About.com Bipolar Disorder)
Source: About.com Bipolar Disorder - July 6, 2013 Category: Psychiatry Authors: bipolar.guide at about.com Tags: health Source Type: news

Cognitive Tx Helps Kids with Migraines (CME/CE)
BOSTON (MedPage Today) -- Adding cognitive behavioral therapy to amitriptyline improved migraine control in children with near-daily headaches, a researcher reported here. (Source: MedPage Today Psychiatry)
Source: MedPage Today Psychiatry - July 2, 2013 Category: Psychiatry Source Type: news

Melatonin for Migraine?Melatonin for Migraine?
A promising study compares melatonin with amitriptyline for the prevention of migraine headache. Medscape Neurology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 21, 2013 Category: Consumer Health News Tags: Neurology & Neurosurgery Commentary Source Type: news

'Star Trek' headband for migraine shows promise
Conclusion While this news may seem like something out of science fiction, it appears that there is indeed some cause to think that a device looking similar to that worn by Star Trek’s Geordi La Forge (pictured above) could have the potential to be used by people who have migraines. This news story is based on a well-designed study that benefits from using identical STS and sham devices. It also benefits from having a high follow-up rate and the fact that neither participants nor investigators were aware of which treatment each person used. The study demonstrates that the STS had some effect in improving the main ou...
Source: NHS News Feed - February 8, 2013 Category: Consumer Health News Tags: Medical practice Neurology Source Type: news

Antidepressant link to heart changes confirmed
Conclusion This study shows a link between three antidepressants (two SSRIs and one tricyclic) and prolonged QT interval (a risk factor for rare but serious heart rhythm problems). The study did not assess the risk of these heart rhythm problems directly (which is difficult to measure because of their rarity). The researchers point out that the recent FDA warning over the risks of citalopram was based on its association with prolonged QT interval only, and “in spite of the epidemiological data showing no difference in risk for arrhythmia [heart rhythm abnormality]”. The researchers say that certain SSRIs were n...
Source: NHS News Feed - January 31, 2013 Category: Consumer Health News Tags: Medication Mental health Source Type: news

Amitriptyline Shows Promise as Local Dental AnestheticAmitriptyline Shows Promise as Local Dental Anesthetic
A controlled trial of the antidepressant amitriptyline applied in a mucoadhesive tablet suggests the drug has promise as a topical anesthetic in dentistry. Medscape Medical News (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - January 11, 2013 Category: Consumer Health News Tags: Dental & Oral Health News Source Type: news

Amitriptyline versus placebo for major depressive disorder
Source: Cochrane Area: Evidence> Drug Specific Reviews Background   Amitriptyline is a tricyclic antidepressant that was synthesised in 1960 and introduced as early as 1961 in the USA, but is still regularly used. It has also been frequently used as an active comparator in trials on newer antidepressants and can therefore be called a 'benchmark' antidepressant. However, its efficacy and safety compared to placebo in the treatment of major depression has not been assessed in a systematic review and meta-analysis.     Objectives   To assess the effects of amitriptyline compared to ...
Source: NeLM - Mental Health - January 3, 2013 Category: Psychiatry Source Type: news

Amitriptyline for neuropathic pain and fibromyalgia in adults
Source: Cochrane Area: Evidence> Drug Specific Reviews Background   Amitriptyline is a tricyclic antidepressant that is widely used to treat chronic neuropathic pain (pain due to nerve damage) and fibromyalgia, and is recommended in many guidelines. These types of pain can be treated with antidepressant drugs in doses below those at which the drugs act as antidepressants.         Objectives   To assess the analgesic efficacy of amitriptyline for chronic neuropathic pain and fibromyalgia.To assess the adverse events associated with the clinical use of amitriptyline...
Source: NeLM - Drug Specific Reviews - January 3, 2013 Category: Drugs & Pharmacology Source Type: news