Amitriptyline efficacy in control of acute opioid withdrawal syndrome

Introduction: This study was conducted to evaluate the efficacy of Amitriptyline treatment in opioid withdrawal syndrome. Materials and Methods: A total of 44 opium dependent patients who met the DSMIV-TR criteria for opioid dependency were randomly assigned to treat with Amitriptyline or placebo during a 25- day double blind clinical trial. Opioid misuse was replaced by oral methadone during a 3 days stabilization period. Methadone was reduced to zero from the beginning of the study to 10th day and Amitriptylin or placebo also was administered. Amitriptylin prescribed as 25 mg tablets or placebo tablets that were completely similar to Amitriptylin tablet prescribed too. Amitriptylin group were prescribed 25 mg tablet per day and placebo tablet too. From second week, drug dosages for both groups were doubled. Rapid detoxification was performed by naloxon after 5 days washout period. The severity of opioid withdrawal and pain was measured by sows and MPQ at days 7/15/17 and 25. Results: There was significant difference between Amitriptyline and placebo in reduction of opioid – withdrawal pain and mental symptoms. No significant difference was noted between the two groups on physical symptoms of withdrawal syndromes. Conclusion: Amitriptyline can be considered as an adjuvant drug for opioid withdrawal pain Management.