Bombay Hospital Journal ContentsHomeArchivesSearchBooksFeedback


Home > Table of Contents > Disease Pattern in India
 
 
Disease Pattern in India
 
Amitriptylin - A Psychiatric Drug very useful in few Medical Illnesses

O P Kapoor
 

I would like to cite a few medical illnesses where Amitriptylin works wonders. They are:

  1. Diabetic neuritis : Although it is a very difficult condition to treat, in a few patients, there is a dramatic improvement within 3-5 days, if Amitriptylin is given in a dose of 25-75 mg/day. Though such patients cannot be identified, all the above patients should be first given this treatment.

  2. Fibro-myalgia syndrome : This syndrome is also very difficult to treat and the only drug which can be offered is Amitriptylin.

  3. Prophylaxis of migraine : It is one of the good drugs, which can be taken at bedtime to prevent attacks of migraine.

  4. Post herpetic neuralgia : It is a very difficult condition to treat, yet such patients could be offered Amitriptylin. In fact, in an acute attack, Amitriptylin can be started along with Acyclovir to reduce the chances of developing post herpetic neuralgia.

As per my knowledge, Amitriptylin can be compared to any of the most modern drugs used for treating depression as it is the safest drug with minimal chances of addiction.

Since most of the patients with organic diseases have associated depression and anxiety, family physicians can safely give 10-25 mg of Amitriptylin at bedtime without consulting the psychiatrist.

Above all it is a very cheap and effective drug with minimal side effects, as compared to new anti-depressant drugs.
 

ULTRASONOGRAPHY IS NOT THE ONLY WAY TO DIAGNOSE DVT

Patients with abnormal results on D-dimer testing and a low clinical probability of deep venous thrombosis (DVT) do not need ultrasonography to exclude the diagnosis. Reviewing 12 studies including 5431 patients, Fancher and colleagues found that normal results from a less sensitive D-dimer test would exclude the likelihood of DVT in 99.5% of patients with a low clinical probability of DVT, and a normal highly sensitive D-dimer test would exclude the diagnosis among all patients at low or moderate risk. These patients would not require additional tests, say the authors.

BMJ, 2004; 329 : 821.