Tricyclic Antidepressants

What is the evidence for the use of amitriptyline in the management of agitation and aggressive behavior?

  1. There is Level 2 evidence based on one non-RCT that amitriptyline decreases the incidence of aggressive behaviours.
  2. Overall, amitriptyline may be used to decrease aggressive behaviour.
  • The effect of amitriptyline(a tricyclic antidepressant with both serotonergic and noradrenergic reuptake inhibition) on decreasing agitation while the individual was still experiencing post-traumatic amnesia has been investigated 42.
  • Study results indicated that within 7 days of amitriptyline therapy (mean dosage was 75 mg), 90% of the patients had a dramatic decrease in agitation with no concomitant increase in cognitive difficulties (as measured by the Orientation Group Monitoring System).