Amitriptyline and Chlordiazepoxide Brand Name– Limbitrol | Limbitrol DS
What is Amitriptyline and Chlordiazepoxide
Amitriptyline and chlordiazepoxide are used together in an oral preparation to treat depression associated with moderate to severe anxiety.
Amitriptyline is a tricyclic antidepressant agent used to treat depression. Chlordiazepoxide is a benzodiazepine agent used for anxiety.
Doses of each ingredient should be titrated and individualized. If the optimal dose corresponds to the ratio contained in the combination drug, this product can be used for convenient dosing.
In a 28-day, randomized, blinded, comparative trial (n=434), patients received either 25 mg amitriptyline; 10 mg chlordiazepoxide PO (Limbitrol) or amitriptyline (25 mg PO) at bedtime as a single daily dose. The dose was titrated to a maximum of 4 capsules per night.
Both groups showed significant improvement at each visit and significantly more patients improved after 7 days in the amitriptyline; chlordiazepoxide group. There was no significant difference in adverse effects between groups.
Amitriptyline and chlordiazepoxide was initially approved by the FDA in December, 1977.
Indications
- anxiety
- depression
For the treatment of moderate to severe depression with concurrent symptoms of moderate to severe anxiety in adult patients
Side Effects
- abdominal pain
- amnesia
- anorexia
- ataxia
- blurred vision
- breast enlargement
- cardiomyopathy
- confusion
- constipation
- cycloplegia
- depression
- diarrhea
- dizziness
- drowsiness
- EEG changes
- ejaculation dysfunction
- elevated hepatic enzymes
- erythema
- euphoria
- fatigue
- fever
- galactorrhea
- gynecomastia
- hallucinations
- heart failure
- hypertension
- hyponatremia
- ileus
- impaired cognition
- impotence (erectile dysfunction)
- jaundice
- lethargy
- libido decrease
- libido increase
- mania
- menstrual irregularity
- mydriasis
- myocardial infarction
- nausea
- neuroleptic malignant syndrome-like symptoms
- ocular hypertension
- orthostatic hypotension
- palpitations
- paresthesias
- photosensitivity
- physiological dependence
- PR prolongation
- pruritus
- pseudoparkinsonism
- psychological dependence
- purpura
- QT prolongation
- restlessness
- seizures
- serotonin syndrome
- SIADH
- stroke
- suicidal ideation
- syncope
- teratogenesis
- testicular swelling
- tolerance
- torsade de pointes
- tremor
- urinary retention
- urticaria
- vasculitis
- ventricular tachycardia
- visual impairment
- vomiting
- weight gain
- withdrawal
- xerostomia
Monitoring Parameters
- blood pressure
- CBC
- ECG
- heart rate
- LFTs
- serum amitriptyline concentrations
- thyroid function tests (TFTs)
- weight
Contraindications
- abrupt discontinuation
- acute myocardial infarction
- agranulocytosis
- alcoholism
- anticholinergic medications
- asthma
- AV block
- benzodiazepine dependence
- benzodiazepine hypersensitivity
- biliary cirrhosis
- bipolar disorder
- breast-feeding
- bundle-branch block
- carbamazepine hypersensitivity
- cardiac arrhythmias
- cardiac disease
- children
- chronic obstructive pulmonary disease (COPD)
- closed-angle glaucoma
- CNS depression
- coadministration with other CNS depressants
- coma
- constipation
- contact lenses
- dementia
- depression
- diabetes mellitus
- driving or operating machinery
- ethanol ingestion
- ethanol intoxication
- gastroesophageal reflux disease (GERD)
- geriatric
- GI disease
- GI obstruction
- head trauma
- heart failure
- hematological disease
- hepatic disease
- hepatic encephalopathy
- hepatitis
- hyperthyroidism
- hypothyroidism
- ileus
- increased intraocular pressure
- labor
- mania
- MAOI therapy
- myasthenia gravis
- neonates
- neuromuscular disease
- obstetric delivery
- Parkinson’s disease
- porphyria
- pregnancy
- prostatic hypertrophy
- psychosis
- pulmonary disease
- QT prolongation
- radiographic contrast administration
- renal failure
- renal impairment
- respiratory depression
- schizophrenia
- seizure disorder
- seizures
- shock
- sleep apnea
- status epilepticus
- stroke
- substance abuse
- suicidal ideation
- sunlight (UV) exposure
- surgery
- thrombocytopenia
- thyroid disease
- tobacco smoking
- tricyclic antidepressant hypersensitivity
- urinary retention
Interactions
- Abarelix
- Abiraterone
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- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
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- Acetaminophen; Dextromethorphan
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- Acetaminophen; Dextromethorphan; Pseudoephedrine
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