title: Intravenous amitriptyline in pediatrics.
abstract: Oral amitriptyline has been used as an analgesic in a wide range of pain settings. Despite long-term availability of a parenteral form, the few reports about this formulation have been limited to pharmacokinetic studies in normal volunteers, trials in depressed patients, and analyses of electroencephalogram (EEG) activation. We retrospectively reviewed our experience using intravenous (IV) amitriptyline at Children's Hospital, Boston and at Children's Hospital at Stanford. Eight children (aged 5-16.6 years), who were unable to tolerate medications by the oral route, received IV amitriptyline for a variety of indications, including neuropathic pain, depression, sleep disturbance, and as an adjuvant agent for opioid analgesia. One patient experienced an extrapyramidal reaction temporally related to the administration of IV amitriptyline, which was successfully managed with diphenhydramine. Further prospective, controlled studies are needed to further assess the safety, efficacy and tolerability of this novel use of amitriptyline.
authors.affiliation: Pain Treatment Service, Children's Hospital, Boston, Massachussetts 02115, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Collins
authors.forename: J
authors.initials: J
authors.lastname: Kerner
authors.forename: S
authors.initials: S
authors.lastname: Sentivany
authors.forename: C B
authors.initials: CB
authors.lastname: Berde
mesh_terms: D000293:Adolescent; D000328:Adult; D000639:Amitriptyline / Q000008:administration & dosage*; D000700:Analgesics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D000639:Amitriptyline