Comparative anticholinergic activity of oxaprotiline and amitriptyline

Roffman, Mark; Gould, Eugene; Brewer, Samuel M.; Lau, Helen; Sachais, B. A.; Dixon, Nina; Kaczmarek, Linda; Sher, Anne Le

doi:10.1002/ddr.430030608

Cited by 9 publications

(11 citation statements)

References 6 publications

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“…1). [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Where stated, all were in out-patient settings. Fourteen studies were conducted in healthy subjects and four in people with depression (Tables 1 and 2).…”

Section: Resultsmentioning

confidence: 99%

“…24,37 When compared with placebo, there were mixed findings for desipramine, with it causing more severe dry mouth than placebo in two studies but the same as placebo in another. 24,37,40 In terms of TeCAs, both mianserin and oxaprotiline caused less severe dry mouth than amitriptyline on objective measures in two studies, 39,41 although mianserin had similar effects to other TCAs in two others. 28,38 It caused less severe dry mouth than nortriptyline subjectively in a further study.…”

Section: Differences By Drug Classmentioning

confidence: 97%

“…Tricyclic antidepressants (TCAs) were the most commonly studied class and were included in all the studies, either as the agent of interest or the comparison drug (k = 18). [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] These were followed by selective serotonin reuptake inhibitors (SSRIs, k = 5) 28,29,34,36,38 and tetracyclic antidepressants (TeCAs, k = 6). 28,31,32,38,39,41 The remaining studies were on monoamine oxidase inhibitors (MAOIs, k = 2), 28,38 norepinephrine-dopamine reuptake inhibitors (NDRIs, k = 2), 28,38 serotonin antagonist and reuptake inhibitors (k = 2), 26,35 lithium citrate (k = 2) 28,38 and reboxetine, a norepinephrine reuptake inhibitor (NRI) (k = 1).…”

Section: Differences By Drug Classmentioning

confidence: 99%

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] These were followed by selective serotonin reuptake inhibitors (SSRIs, k = 5) 28,29,34,36,38 and tetracyclic antidepressants (TeCAs, k = 6). 28,31,32,38,39,41 The remaining studies were on monoamine oxidase inhibitors (MAOIs, k = 2), 28,38 norepinephrine-dopamine reuptake inhibitors (NDRIs, k = 2), 28,38 serotonin antagonist and reuptake inhibitors (k = 2), 26,35 lithium citrate (k = 2) 28,38 and reboxetine, a norepinephrine reuptake inhibitor (NRI) (k = 1). 36 In general, TCAs caused more severe dry mouth on both objective and subjective measures in comparison with placebo and other drug classes.…”

Section: Differences By Drug Classmentioning

confidence: 99%

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Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review

et al. 2023

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Background Poor oral health is increasingly recognised as an important comorbidity in people with psychiatric illness. One risk factor is psychotropic-induced dry mouth. Aims To perform a systematic review of the severity of dry mouth due to psychotropic drugs in adults (CRD42021239725). Study quality was assessed using the Cochrane risk of bias tool. Method We searched the following databases: PubMed, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL and Web of Science. We included randomised controlled trials (RCTs) measuring the severity of drug-induced hyposalivation and xerostomia. Results Eighteen RCTs with 605 participants were included. Severity of drug-induced dry mouth was compared among eight drug classes and/or against placebo. All studies were published 20 to 40 years ago and included tricyclic antidepressants (TCAs), serotonin specific reuptake inhibitors (SSRIs) and other drug classes. Meta-analysis was not feasible owing to design heterogeneity. TCAs caused more severe dry mouth, both objectively and subjectively, than placebo or other drug classes. SSRIs were generally associated with less severe symptoms. However, there was no information on antipsychotics or more recently available antidepressants, and there was minimal information on mood stabilisers. Most studies were on healthy subjects, limiting the generalisability of findings. Only one study measured both objective and subjective dry mouth, which have different clinical implications. Conclusions Psychotropic-induced dry mouth is a poorly researched area, and well-designed RCTs of newer psychotropic drugs using standardised objective and subjective measures are indicated. Given the ongoing use of TCAs for treatment-resistant depression, prescribers need to remain vigilant for xerostomia.

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Section: Resultsmentioning

confidence: 99%

Section: Differences By Drug Classmentioning

confidence: 97%

Section: Differences By Drug Classmentioning

confidence: 99%

Section: Differences By Drug Classmentioning

confidence: 99%

See 2 more Smart Citations

Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review

et al. 2023

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“…Consequently, in the development of newer antidepressants great emphasis has been placed on reducing their anticholinergic potency (Roffman et al 1983).…”

Section: Discussionmentioning

confidence: 99%

Binding affinities of four tricyclic antidepressive drugs to muscarinic cholinergic receptors in human parotid gland

Batra

Biörklund

1986

Psychopharmacology

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The binding kinetics of tritiated quinuclidinyl benzilate (QNB) were studied in membrane preparations from human parotid and rabbit submandibular glands. Inhibition of 3H-QNB was then used to compare the anticholinergic activity of lofepramine, desipramine, imipramine and amitriptyline for muscarinic receptor in the salivary glands. The apparent dissociation constant (KD) for 3H-QNB binding in human parotid and rabbit submandibular gland was 33 and 61 pM and the Bmax value 507 and 169 f mol/mg protein, respectively. The mean values for the inhibition constant (Ki) for lofepramine, desipramine, imipramine and amitriptyline in human parotid gland were 285, 135, 102 and 13 nM, respectively. Very similar values were obtained for the rabbit submandibular gland. The binding affinity of tricyclic antidepressants for muscarinic cholinergic receptor sites in human parotid gland closely paralleled clinical data on the inhibition of salivary flow by these drugs.

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Individual Differences in Response to Antidepressants

et al. 2020

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IMPORTANCE Antidepressants are commonly used worldwide to treat major depressive disorder. Symptomatic response to antidepressants can vary depending on differences between individuals; however, this variability may reflect nonspecific or random factors.OBJECTIVES To investigate the assumption of systematic variability in symptomatic response to antidepressants and to assess whether this variability is associated with severity of major depressive disorder, antidepressant class, or year of study publication.DATA SOURCES Data used were from a recent network meta-analysis of acute treatment with licensed antidepressants in adults with major depressive disorder. The following databases were searched from inception to January 8, 2016: the Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, and PsycINFO. Additional sources were international trial registries, drug approval agency websites, and key scientific journals.STUDY SELECTION Analysis was restricted to double-blind, randomized placebo-controlled trials with available data at the study's end point. DATA EXTRACTION AND SYNTHESISBaseline and end point means, SDs, number of participants in each group, antidepressant class, and publication year were extracted. The data were analyzed between August 14 and November 18, 2019. MAIN OUTCOMES AND MEASURESWith the use of validated methods, coefficients of variation were derived for antidepressants and placebo, and their ratios were calculated to compare outcome variability between antidepressant and placebo. Ratios were entered into a random-effects model, with the expectation that response to antidepressants would be more variable than response to placebo. Analysis was repeated after stratifying by baseline severity of depression, antidepressant class (selective serotonin reuptake inhibitors: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and vilazodone; serotonin and norepinephrine reuptake inhibitors: desvenlafaxine and venlafaxine; norepinephrinedopamine reuptake inhibitor: bupropion; noradrenergic agents: amitriptyline and reboxetine; and other antidepressants: agomelatine, mirtazapine, and trazodone), and publication year. RESULTSIn the 87 eligible randomized placebo-controlled trials (17 540 unique participants), there was significantly more variability in response to antidepressants than to placebo (coefficients of variation ratio, 1.14; 95% CI, 1.11-1.17; P < .001). Baseline severity of depression did not moderate variability in response to antidepressants. Variability in response to selective serotonin reuptake inhibitors was lower than variability in response to noradrenergic agents (coefficients of variation ratio, 0.88; 95% CI, 0.80-0.97; P = .01), as was the variability in response to other antidepressants compared with noradrenergic agents (coefficients of variation ratio, 0.87; 95% CI, 0.79-0.97; P = .001). Variability also tended to be lower in studies that were published more recently, with coefficients of variation chang...

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Comparative anticholinergic activity of oxaprotiline and amitriptyline

Cited by 9 publications

References 6 publications

Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review

Dry mouth effects from drugs used for depression, anxiety, schizophrenia and bipolar mood disorder in adults: systematic review

Binding affinities of four tricyclic antidepressive drugs to muscarinic cholinergic receptors in human parotid gland

Individual Differences in Response to Antidepressants

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