Le Sher: Comparative anticholinergic activity of oxaprotiline and amitriptyline. Drug Dev.Res. 3561-566, 1983. As part of a double-blind multicenter trial comparing oxaprotiline with amitriptyline and placebo in 308 outpatients with moderate depression, objective (salivary flow) and subjective (dry mouth, blurred visionlvisual disorder, and constipation) determinants of anticholinergic activity were assessed. Both active treatments, but not placebo, induced approximately a 40% reduction in salivary flow after one week of treatment with 75 mgl day h.s. Whereas amitriptyline caused a further reduction (26%) in salivary flow by the end of the trial (week 5), no such reduction was noted with oxaprotiline. With regards to subjective complaints, more patients experienced dry mouth and blurred vision/visual disorder after treatment with amitriptyline than after treatment with oxaprotiiine. Significantly more patients complained of constipation after treatment with oxaprotiline than after placebo, but not amitriptyline. The differential nature of the subjective anticholinergic effects induced by the two active drugs are discussed in terms of the possible involvement of neurotransmitter systems other than acetylcholine or of different muscarinic receptors. Also discussed is the possibility that tolerance developed to the drug-induced changes in salivary flow as well as the possible relationships between the sedative properties of antidepressants and some, but not all, of the anticholinergic effects of these drugs.
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