Schiffer R B, Herndon R M, Rudick R A
N Engl J Med. 1985 Jun 6;312(23):1480-2. doi: 10.1056/NEJM198506063122303.
Patients with bilateral forebrain disease may commonly manifest the syndrome of pathologic laughing and weeping. We investigated the efficacy of low-dose amitriptyline in 12 patients in whom this syndrome was a consequence of multiple sclerosis. In a double-blind crossover study comparing amitriptyline with placebo, eight patients experienced dramatic and significant improvement with amitriptyline (P = 0.02). The mean dose of amitriptyline was 57.8 mg per day and did not exceed 75 mg per day in any patient. Concurrent measurements of depression showed no change during the study. We conclude that amitriptyline is effective in the treatment of this disturbance of affective expression, and that this effect is distinct from the antidepressant effect of the medication.
患有双侧前脑疾病的患者通常会表现出病理性哭笑综合征。我们调查了低剂量阿米替林对12例因多发性硬化症导致该综合征患者的疗效。在一项将阿米替林与安慰剂进行比较的双盲交叉研究中，8例患者使用阿米替林后有显著且明显的改善（P = 0.02）。阿米替林的平均剂量为每日57.8毫克，且没有任何患者的剂量超过每日75毫克。同时进行的抑郁测量显示，在研究期间没有变化。我们得出结论，阿米替林对治疗这种情感表达障碍有效，且这种效果与该药物的抗抑郁效果不同。
