Veldhuijzen Dieuwke S, van Wijck Albert J M, Verster Joris C, Kenemans J Leon, Kalkman Cor J, Olivier Berend, Volkerts Edmund R
Utrecht Institute for Pharmaceutical Sciences and Rudolf Magnus Institute of Neuroscience, Department of Psychopharmacology, Utrecht University, Utrecht, The Netherlands.
J Psychopharmacol. 2006 Nov;20(6):782-8. doi: 10.1177/0269881106061101. Epub 2006 Jan 9.
The acute and subchronic effects of low doses nocturnally administered amitriptyline were compared to placebo in a double-blind crossover randomized study on driving ability and driving-related skills involving seven chronic neuropathic pain patients. Performance testing occurred at the first and last day of each 15-day drug administration period, which was preceded by a 6-day washout phase. A standardized method of measuring driving ability, the on-the-road driving test, was performed on all visits. Patients were instructed to drive with a steady lateral position while maintaining a constant speed of 95 km/h. The primary outcome of the driving test is the Standard Deviation of Lateral Position (SDLP, cm), which is an index of weaving of the car. At the first treatment day, driving performance was significantly impaired in patients after nocturnal administration of 25 mg amitriptyline compared to placebo. The increase in SDLP of 3 cm was higher than the increment generally observed with a blood alcohol concentration of 0.5 mg/ml or higher, the legal limit for driving in many countries. Also, reaction times on a memory test were significantly increased, indicating worse performance after acute treatment of amitriptyline compared to placebo. In contrast, after 2 weeks of treatment, no significant differences were found between amitriptyline and placebo, suggesting that tolerance had developed to the impairing effects of amitriptyline.
在一项涉及7名慢性神经性疼痛患者的驾驶能力和驾驶相关技能的双盲交叉随机研究中，将夜间服用低剂量阿米替林的急性和亚慢性效应与安慰剂进行了比较。在每个为期15天的药物给药期的第一天和最后一天进行性能测试，给药期之前有一个为期6天的洗脱期。在所有就诊时均采用标准化的测量驾驶能力的方法，即道路驾驶测试。患者被要求在保持95公里/小时恒定速度的同时，以稳定的横向位置驾驶。驾驶测试的主要结果是横向位置标准差（SDLP，厘米），它是汽车摆动的一个指标。在第一个治疗日，与安慰剂相比，夜间服用25毫克阿米替林的患者驾驶性能明显受损。SDLP增加3厘米高于许多国家法定驾驶酒精浓度0.5毫克/毫升或更高时通常观察到的增加幅度。此外，记忆测试中的反应时间显著增加，表明与安慰剂相比，急性治疗阿米替林后的表现更差。相比之下，治疗2周后，阿米替林和安慰剂之间未发现显著差异，这表明对阿米替林的损害作用已产生耐受性。
