The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지

Resting Tremor during Low-dose Tricyclic Antidepressant Treatment -A case report-

저용량의 삼환계항우울제 사용 중 발생한 안정떨림 -증례보고-

  • Lee, Young Bok (Department of Anesthesioloogy and Pain Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Jong Taek (Department of Anesthesioloogy and Pain Medicine, Yonsei University Wonju College of Medicine) ;
  • Jeon, Ja Youn (Department of Anesthesioloogy and Pain Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Kwang Ho (Department of Anesthesioloogy and Pain Medicine, Yonsei University Wonju College of Medicine)
  • 이영복 (연세대학교 원주의과대학 마취통증의학교실) ;
  • 박종택 (연세대학교 원주의과대학 마취통증의학교실) ;
  • 전자연 (연세대학교 원주의과대학 마취통증의학교실) ;
  • 이광호 (연세대학교 원주의과대학 마취통증의학교실)
  • Received : 2007.01.15
  • Accepted : 2007.04.25
  • Published : 2007.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Tricyclic antidepressant (TCA) is a useful drug for treating neuropathic pain. However, tremors are one of the relatively frequent side effects of TCA. A female patient, who was suffering from postherpetic neuralgia, was treated with amitriptyline starting with 10 mg/day. She developed resting tremors on the second day after increasing the dose to 30 mg/day. This case highlights the need for the careful use of amitriptyline in the treatment of neuropathic pain in elderly patients.

Keywords

References

  1. Wall PD, Melzack R: Textbook of Pain. 4th ed. Phildelphia, Churchill Livingstone. 1999, pp 1498-527
  2. Loeser JD: Bonica's Management of Pain. 3rd ed. Philadelphia, Lippincott Williams & Wilkins. 2001, pp 1716-7
  3. Ghouinard G: A double-blind controlled clinical trial of fluoxetine and amitriptyline in the treatment of outpatients with major depressive disorder. J Clin Psychiatry 1985; 45: 32-7
  4. Fruensgaard K, Hansen CE, Korsgaard S, Nymgaard K, Vaag UH: Amoxapine versus amitriptyline in endogenous depression. A double-blind study. Acta Psychiatr Scand 1979; 59: 502-8 https://doi.org/10.1111/j.1600-0447.1979.tb00249.x
  5. Kranfol Z, Greden JF, Zis AP: Imipramine-induced tremor: effects of a beta-adrenergic blocking agent. J Clin Psychiatry 1983; 44: 225-6
  6. Lejoyeux M, Rouillon F, Ades J, Gorwood P: Neural symptoms induced by tricyclic antidepressants: phenomenology and pathophysiology. Acta Psychiatr Scand 1992; 85: 249-56 https://doi.org/10.1111/j.1600-0447.1992.tb01465.x
  7. Raethjen J, Lemke MR, Lindemann M, Wenzelburger R, Krack P, Deuschl G: Amitriptyline enhances the central component of physiological tremor. J Neurol Neurosurg Psychiatry 2001; 70: 78-82 https://doi.org/10.1136/jnnp.70.1.78
  8. Miller LG, Jankovic J: Neurologic approach to drug-induced movement disorders: a study of 125 patients. South Med J 1990; 83: 525-32 https://doi.org/10.1097/00007611-199005000-00011