What is the evidence for the use of amitriptyline in the management of agitation and aggressive behavior?
There is Level 2 evidence based on one non-RCT that amitriptyline decreases the incidence of aggressive behaviours.
- 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).