Bryant S G, Fisher S, Kluge R M
J Clin Psychopharmacol. 1987 Apr;7(2):78-82.
As part of a large-scale postmarketing surveillance study, the adverse clinical events (ACEs) reported by 85 outpatients taking amitriptyline were investigated. Two discrete groups of patients were identified based on their duration of amitriptyline treatment: 45 had started the drug within 2 weeks of their interview (mean = 10.1 days, SD = 1.6 days), while 40 were much longer term tricyclic antidepressant patients (mean = 227.2 days, SD = 135 days). Our analysis of amitriptyline side effects reported by each of these two discrete groups challenges the common clinical impression that tricyclic side effects, in general, abate with continued treatment. Shorter term patients were much better able to correctly attribute their adverse clinical events to their drug therapy. Anticholinergic side effects were reported as new symptoms by the long-term patients just as frequently with similar ratings of subjective severity. These reports of adverse drug reactions of recent onset by long-term amitriptyline users may reflect the fact that such symptoms fluctuate in their occurrence and may not be recognized as potentially drug-induced until some threshold for patient tolerance is exceeded.
作为一项大规模上市后监测研究的一部分，对85名服用阿米替林的门诊患者报告的不良临床事件（ACEs）进行了调查。根据患者服用阿米替林的时长确定了两个不同的组：45名患者在访谈前2周内开始服用该药（平均 = 10.1天，标准差 = 1.6天），而另外40名是长期服用三环类抗抑郁药的患者（平均 = 227.2天，标准差 = 135天）。我们对这两个不同组报告的阿米替林副作用进行的分析，对一般认为三环类药物副作用会随着持续治疗而减轻的常见临床印象提出了质疑。短期用药的患者更能够正确地将其不良临床事件归因于药物治疗。长期用药的患者报告抗胆碱能副作用为新出现的症状的频率相同，主观严重程度评分也相似。长期服用阿米替林的患者近期出现药物不良反应的这些报告可能反映出这样一个事实，即此类症状的出现具有波动性，在超过患者耐受阈值之前可能未被识别为潜在的药物诱发症状。
