molecular formula C20H23N B1667244 Amitriptyline CAS No. 50-48-6

Amitriptyline

Cat. No.: B1667244
CAS No.: 50-48-6
M. Wt: 277.4 g/mol
InChI Key: KRMDCWKBEZIMAB-UHFFFAOYSA-N
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Mechanism of Action

Target of Action

Amitriptyline, a tricyclic antidepressant, primarily targets the neuronal reuptake transporters of norepinephrine and serotonin . These neurotransmitters play crucial roles in regulating mood, sleep, and pain perception .

Mode of Action

This compound’s key mechanism of action lies in the elevation of extracellular biogenic amine levels, notably those of norepinephrine and serotonin . By inhibiting the membrane pump mechanism responsible for the re-uptake of these transmitter amines, this compound increases their concentration at the synaptic clefts of the brain .

Biochemical Pathways

This compound interferes with the autophagy-mediated clearance of protein aggregates by inhibiting autophagosome maturation in neuronal cells . This interference exacerbates the accumulation of abnormal aggregates, affecting both the formation of aggresome-like aggregates and the autophagy-mediated clearance of these aggregates . This compound is also metabolized mainly via the CYP2C19 and CYP2D6 pathways .

Pharmacokinetics

This compound is rapidly absorbed from the gastrointestinal tract with a bioavailability of 45%-53% . It undergoes extensive first-pass metabolism in the liver, leading to an average bioavailability of about 50% . The elimination half-life varies from 10 to 50 hours, with an average of 15 hours . This compound is also known to have strong anticholinergic properties and may cause ECG changes and quinidine-like effects on the heart .

Result of Action

The molecular and cellular effects of this compound’s action include the elevation of extracellular biogenic amine levels, interference with autophagy-mediated clearance of protein aggregates, and potential effects on cardiac function . These actions contribute to its therapeutic effects in treating depressive illness, anxiety disorders, and other mental illnesses .

Action Environment

Environmental factors can influence the action, efficacy, and stability of this compound. For instance, exposure to this compound can alter behavior and increase the activity of acetylcholinesterase . Moreover, degradation pathways such as oxidation, hydrolysis, and photodegradation can affect the stability and potency of this compound . It’s also worth noting that this compound can be considered an emerging pollutant with potential consequences for human health and wellbeing .

Biochemical Analysis

Biochemical Properties

Amitriptyline works by increasing the synaptic concentration of serotonin and/or norepinephrine in the central nervous system by inhibiting their reuptake by the presynaptic neuronal membrane pump . This action prolongs the sympathetic activity of these biogenic amines .

Cellular Effects

This compound has been shown to interfere with the formation of aggresome-like aggregates and autophagy-mediated clearance of aggregates . It also has immunomodulatory effects, such as lowering the production of typical T H 2-cytokines in T lymphocytes of asthmatic mice .

Molecular Mechanism

This compound’s key mechanism of action lies in the elevation of extracellular biogenic amine levels, notably those of noradrenaline and serotonin, by its blockade of cellular noradrenaline and serotonin reuptake transporters . This response may underlie chronic this compound action on dopamine and norepinephrine neurotransmission .

Temporal Effects in Laboratory Settings

You may have flu-like symptoms like feeling sick, muscle pain, and feeling tired or restless . To help prevent this from happening, your doctor will probably recommend reducing your dose gradually over several weeks .

Dosage Effects in Animal Models

In animal models, oral administration of this compound provides a valid model for behavioral assessment of antidepressant-like effects . The effectiveness of oral this compound varies depending on sex, duration of treatment, and the depression model used .

Metabolic Pathways

This compound is readily absorbed in the GI tract and subject to extensive hepatic metabolism with less than 5% of the drug eliminated unchanged . The main metabolizing enzymes with clinical significance for this compound are CYP2C19 and CYP2D6 .

Transport and Distribution

This compound is transported and distributed within cells and tissues via absorption in the GI tract . It is subject to extensive hepatic metabolism .

Subcellular Localization

Given its mechanism of action, it is likely that this compound localizes to the synapses in neurons where it can inhibit the reuptake of serotonin and norepinephrine .

Preparation Methods

Synthetic Routes and Reaction Conditions: Amitriptyline can be synthesized through several methods. One common method involves the reaction of dibenzosuberone with dimethylamine in the presence of a reducing agent such as lithium aluminum hydride. The reaction proceeds through the formation of an intermediate, which is then cyclized to form this compound .

Industrial Production Methods: In industrial settings, this compound is typically produced through a multi-step synthesis process that ensures high yield and purity. The process involves the use of advanced techniques such as high-performance liquid chromatography (HPLC) for purification and quality control .

Chemical Reactions Analysis

Types of Reactions: Amitriptyline undergoes various chemical reactions, including:

Common Reagents and Conditions:

Major Products Formed:

Scientific Research Applications

Depression Treatment

Amitriptyline is primarily recognized for its efficacy in treating major depressive disorder. A meta-analysis of randomized controlled trials indicated that this compound has a slightly higher response rate compared to other antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and other tricyclic antidepressants . The odds ratio favored this compound, suggesting its effectiveness in alleviating depressive symptoms.

Neuropathic Pain Management

This compound is frequently prescribed off-label for neuropathic pain conditions, such as diabetic neuropathy and postherpetic neuralgia. Research has shown that this compound can reduce pain intensity and improve quality of life in patients suffering from these chronic pain syndromes. A systematic review highlighted its role as a first-line treatment option for neuropathic pain .

Case Study: Diabetic Neuropathy

In a clinical study involving diabetic patients, those treated with this compound reported significant reductions in pain scores compared to placebo groups. The drug's mechanism appears to involve modulation of neurotransmitter levels and inhibition of pain pathways in the central nervous system .

Fibromyalgia

Fibromyalgia is another condition where this compound has shown promise. Studies indicate that low-dose this compound can help alleviate fibromyalgia symptoms, including widespread pain and sleep disturbances. A randomized controlled trial demonstrated that patients receiving this compound experienced significant improvements in their fibromyalgia impact scores compared to those receiving placebo .

Migraine Prophylaxis

This compound is also utilized for migraine prevention. Clinical evidence supports its efficacy in reducing the frequency and severity of migraine attacks. A study found that patients taking this compound had fewer migraine days per month compared to those on placebo, making it a valuable option for chronic migraine sufferers .

Irritable Bowel Syndrome (IBS)

Recent research has explored the use of this compound in managing irritable bowel syndrome symptoms. A large trial indicated that low-dose this compound significantly improved IBS symptom scores after six months of treatment, demonstrating its potential as an effective therapy for this condition .

Anxiety Disorders

This compound's anxiolytic properties have led to its use in treating anxiety disorders, particularly when these conditions co-occur with depression or chronic pain syndromes. While not first-line therapy for anxiety alone, it can be beneficial in complex cases where multiple symptoms overlap .

Chronic Pain Syndromes

Beyond neuropathic pain, this compound has been investigated for various chronic pain conditions, including complex regional pain syndrome (CRPS) and tension-type headaches. Its ability to modulate pain perception through central mechanisms makes it a relevant option in these contexts .

Summary Table of this compound Applications

ConditionEvidence LevelKey Findings
DepressionHighEffective as a first-line treatment
Neuropathic PainHighReduces pain intensity; enhances quality of life
FibromyalgiaModerateImproves symptom scores; enhances sleep quality
Migraine ProphylaxisModerateDecreases frequency and severity of attacks
Irritable Bowel SyndromeHighSignificant symptom improvement over placebo
Anxiety DisordersModerateBeneficial in co-morbid cases
Chronic Pain SyndromesModerateEffective in various chronic pain conditions

Comparison with Similar Compounds

Amitriptyline is often compared with other tricyclic antidepressants such as:

This compound is unique due to its broad spectrum of action, affecting multiple neurotransmitter systems and receptors, which contributes to its efficacy in treating a variety of conditions .

Biological Activity

Amitriptyline is a tricyclic antidepressant (TCA) that has been widely used for the treatment of major depressive disorder and various pain conditions. Its biological activity extends beyond its antidepressant effects, involving complex interactions at the cellular and molecular levels. This article delves into the various aspects of this compound's biological activity, including its mechanisms of action, effects on cell viability, autophagy modulation, and additional pharmacological properties.

This compound primarily functions by inhibiting the reuptake of neurotransmitters, specifically serotonin and norepinephrine, thereby enhancing their availability in the synaptic cleft. This mechanism is crucial for its antidepressant effects and is mediated through the following pathways:

  • Serotonin Transporter (SERT) Inhibition : this compound blocks SERT, leading to increased serotonin levels.
  • Norepinephrine Transporter (NET) Inhibition : It also inhibits NET, enhancing norepinephrine availability.
  • Receptor Binding : this compound exhibits strong binding affinities for various receptors, including:
    • Alpha-adrenergic receptors
    • Histamine (H1) receptors
    • Muscarinic (M1) receptors

These interactions contribute to its sedative effects and anticholinergic properties, which are more pronounced compared to other TCAs .

Effects on Cell Viability and Proliferation

Recent studies have shown that this compound affects cell viability in neuroblastoma cell lines (SH-SY5Y). Notably, it induces a concentration- and time-dependent reduction in cell viability. Key findings include:

  • Cell Viability Reduction : At concentrations of 50 μM, cell viability decreased significantly over time; specifically, 81.03% at 24 hours, dropping to 43.60% by 72 hours .
  • Clonogenic Capacity : this compound treatment reduced the clonogenic capacity of SH-SY5Y cells, indicating its potential cytotoxic effects .

Autophagy Modulation

This compound has been found to modulate autophagy in treated cells. However, its cytotoxic effects appear to be independent of autophagy modulation:

  • Autophagy Inhibition Studies : When SH-SY5Y cultures were pre-treated with chloroquine (an autophagy inhibitor), this compound's effects on cell viability remained consistent, suggesting that its cytotoxicity does not rely on altering autophagic processes .
  • Lysosomal Accumulation : this compound induced lysosomal accumulation without affecting lysosomal pH, further supporting its complex interaction with cellular homeostasis .

Additional Pharmacological Properties

Beyond its antidepressant activity, this compound exhibits several other biological activities:

  • Antimicrobial Activity : Studies indicate that this compound possesses significant antibacterial properties against both Gram-positive and Gram-negative bacteria. In vivo experiments demonstrated a reduction in bacterial counts in mice treated with this compound after exposure to Salmonella typhimurium, highlighting its potential as an antimicrobial agent .
Study TypeFindings
In Vivo StudySignificant reduction in bacterial counts in treated mice (p<0.01)
In Vitro StudyBacteriostatic effects against various bacterial strains

Case Studies and Clinical Implications

This compound's off-label use has been documented extensively. For instance:

  • Chronic Pain Management : this compound is frequently prescribed for neuropathic pain management due to its analgesic properties.
  • Sleep Disorders : Its sedative effects make it a common choice for treating insomnia associated with depression.

Properties

IUPAC Name

N,N-dimethyl-3-(2-tricyclo[9.4.0.03,8]pentadeca-1(15),3,5,7,11,13-hexaenylidene)propan-1-amine
Source PubChem
URL https://pubchem.ncbi.nlm.nih.gov
Description Data deposited in or computed by PubChem

InChI

InChI=1S/C20H23N/c1-21(2)15-7-12-20-18-10-5-3-8-16(18)13-14-17-9-4-6-11-19(17)20/h3-6,8-12H,7,13-15H2,1-2H3
Source PubChem
URL https://pubchem.ncbi.nlm.nih.gov
Description Data deposited in or computed by PubChem

InChI Key

KRMDCWKBEZIMAB-UHFFFAOYSA-N
Source PubChem
URL https://pubchem.ncbi.nlm.nih.gov
Description Data deposited in or computed by PubChem

Canonical SMILES

CN(C)CCC=C1C2=CC=CC=C2CCC3=CC=CC=C31
Source PubChem
URL https://pubchem.ncbi.nlm.nih.gov
Description Data deposited in or computed by PubChem

Molecular Formula

C20H23N
Source PubChem
URL https://pubchem.ncbi.nlm.nih.gov
Description Data deposited in or computed by PubChem

Related CAS

17086-03-2 (pamoate (2:1)), 30227-34-0 (maleate (1:1)), 549-18-8 (hydrochloride)
Record name Amitriptyline [INN:BAN]
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DSSTOX Substance ID

DTXSID7022594
Record name Amitriptyline
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Molecular Weight

277.4 g/mol
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Physical Description

Solid
Record name Amitriptyline
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Boiling Point

410.26°C (rough estimate)
Record name Amitriptyline
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Solubility

freely soluble in water, In water, 9.71 mg/L at 24 °C, 4.50e-03 g/L
Record name Amitriptyline
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Record name AMITRIPTYLINE
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Record name Amitriptyline
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Mechanism of Action

The mechanism of action of this drug is not fully elucidated. It is suggested that amitriptyline inhibits the membrane pump mechanism responsible for the re-uptake of transmitter amines, such as norepinephrine and serotonin, thereby increasing their concentration at the synaptic clefts of the brain,. These amines are important in regulating mood. The monoamine hypothesis in depression, one of the oldest hypotheses, postulates that deficiencies of serotonin (5-HT) and/or norepinephrine (NE) neurotransmission in the brain lead to depressive effects. This drug counteracts these mechanisms, and this may be the mechanism of amitriptyline in improving depressive symptoms. Whether its analgesic effects are related to its mood-altering activities or attributable to a different, less obvious pharmacological action (or a combination of both) is unknown., Acute and chronic effects of the antidepressant drugs tranylcypromine, a monoamine oxidase inhibitor, and amitriptyline, a monoamine uptake inhibitor, were studied on beta-adrenergic receptor function in mouse astrocytes in primary cultures. In clinically relevant concentrations, acute administration of either antidepressant drug had a direct inhibitory effect on the binding of the beta-adrenergic ligand dihydroalprenolol and on the isoproterenol-induced accumulation of cyclic AMP. However, in the absence of isoproterenol, these drugs enhanced the formation of cyclic AMP in the astrocytes. Chronic exposure to amitriptyline or tranylcypromine led to a decrease in isoproterenol-induced accumulation of cyclic AMP, and the time course for the development of this phenomenon was similar to that reported for whole brain in vivo. These findings suggest that these antidepressant drugs act as a partial agonists at beta-adrenergic receptors on astrocytes, and that the down-regulation of beta-adrenergic activity that occurs in vivo after chronic administration of antidepressant drugs may, to a large extent, take place in astrocytes and may result from the partial beta-agonist nature of the drugs., Astrocytes play important roles in guiding the construction of the nervous system, controlling extracellular ions and neurotransmitters, and regulating CNS synaptogenesis. Egr-1 is a transcription factor involved in neuronal differentiation and astrocyte cell proliferation. In this study, we investigated whether the tricyclic antidepressant (TCA) amitriptyline induces Egr-1 expression in astrocytes using rat C6 glioma cells as a model. We found that amitriptyline increased the expression of Egr-1 in a dose- and time-dependent manner. The amitriptyline-induced Egr-1 expression was mediated through serum response elements (SREs) in the Egr-1 promoter. SREs were activated by the Ets-domain transcription factor Elk-1 through the ERK and JNK mitogen-activated protein (MAP) kinase pathways. The inhibition of the ERK and JNK MAP kinase signals attenuated amitriptyline-induced transactivation of Gal4-Elk-1 and Egr-1 promoter activity. Our findings suggest that the induction of Egr-1 expression in astrocytes may be required to attain the therapeutic effects of antidepressant drugs., Antidepressants such as serotonin-noradrenaline reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs) are frequently used for the management of neuropathic pain. Noradrenaline (NA) and serotonin (5-HT) increase in the spinal cord by reuptake inhibition is considered to be main mechanism of the therapeutic effect of antidepressants in neuropathic pain. In the present study, we examined the analgesic effects of duloxetine (SNRI) and amitriptyline (TCA) in a rat model of neuropathic pain induced by spinal nerve ligation (SNL). Intraperitoneal administration of duloxetine and amitriptyline dose-dependently (3,10 and 30 mg/kg) suppressed hyperalgesia induced by SNL. In vivo microdialysis in the lumbar spinal dorsal horn revealed that NA and 5-HT concentrations increased after intraperitoneal administration of duloxetine and amitriptyline (10 mg/kg, respectively). We further determined NA and 5-HT contents in homogenized samples from the ipsilateral dorsal spinal cord after SNL. Although the NA content in SNL rats 2 weeks after ligation was higher than that in SNL rats 4 weeks after ligation, the analgesic efficacy of duloxetine and amitriptyline was similar between two groups. The present study suggests that NA/5-HT increase in the spinal cord is crucial in the antihyperalgesic effect of duloxetine and amitriptyline. The plastic change of the descending noradrenergic system does not obviously affect the analgesic efficacy of duloxetine and amitriptyline., Recent studies show that neuronal and glial plasticity are important for the therapeutic action of antidepressants. Here, we demonstrated that amitriptyline, a tricyclic antidepressant, significantly increased GDNF mRNA and GDNF release in C6 cells. Furthermore, different classes of antidepressants increased GDNF release, but non-antidepressant psychotropic drugs did not. The amitriptyline-induced GDNF release was completely inhibited by U0126, a mitogen-activated protein kinase (MAPK)-extracellular signal-regulated kinase (ERK) kinase (MEK) inhibitor, but was not inhibited by H-89, a protein kinase A inhibitor or calphostin C, a protein kinase C inhibitor. These results suggest that the amitriptyline-induced GDNF release may be regulated through a MEK/MAPK pathway. Next, we examined the effects of monoamines on GDNF release, because antidepressants are known to increase monoamines. 5-HT increased GDNF mRNA and GDNF release, but noradrenaline and dopamine did not. The 5-HT-induced GDNF release was partially, but significantly, blocked by ketanserin, a 5-HT2A receptor antagonist. The 5-HT-induced GDNF release was completely inhibited by U0126, but was not inhibited by H-89 or calphostin C. These results suggest that the 5-HT-induced GDNF release was mediated through a MEK/MAPK pathway and, at least, 5-HT2A receptors. GDNF, as well as other neurotrophic factors, may contribute to explain the therapeutic action of antidepressants and suggest a novel strategy of pharmacological intervention., For more Mechanism of Action (Complete) data for AMITRIPTYLINE (13 total), please visit the HSDB record page.
Record name Amitriptyline
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Color/Form

Crystals

CAS No.

50-48-6
Record name Amitriptyline
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Melting Point

196-197, 196 - 197 °C
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Synthesis routes and methods I

Procedure details

6-Carboxyfluorescein (1.00 g, 2.66 mmol) was dissolved in 8 mL DMF, 306 mg (2.66 mmol) of N-hydroxysuccinimide (HOSu) was added, 549 mg (2.66 mmol) of 1,3-dicyclohexylcarbodiimide (DCC) was added, and the reaction stirred for 17 hours, under N2, in the dark. The reaction was then vacuum filtered, filtrate combined with 784 mg (2.65 mmol) of 2-aminoimipramine (26c), 0.56 mL (4.0 mmol) of triethylamine, and 4.0 mL DMF, and reaction allowed to stir 4 days under N2, in the dark. Reaction solvents were removed in vacuo and residue purified on reverse phase C18 preparative (1 mm) TLC plates, eluting with H2O/THF/HOAc (40/60/0.4) followed by preparative HPLC on a Waters mbondapak C18 column (19 mm×150 mm), eluting with H2O/THF/HOAc (35/65/0.4) at a flow rate of 7.0 mL/minute to yield 410 mg (24%) of the desired tracer (27) as an orange powder; mass spec (FAB) (M+H)+ 654.
Quantity
1 g
Type
reactant
Reaction Step One
Name
Quantity
8 mL
Type
solvent
Reaction Step One
Quantity
306 mg
Type
reactant
Reaction Step Two
Quantity
549 mg
Type
reactant
Reaction Step Three
[Compound]
Name
( 26c )
Quantity
0 (± 1) mol
Type
reactant
Reaction Step Four
Quantity
0.56 mL
Type
reactant
Reaction Step Four
Name
Quantity
4 mL
Type
solvent
Reaction Step Four

Synthesis routes and methods II

Procedure details

0.750 gm amitriptyline hydrochloride USP, is wetted with 1.5 ml of ethoxy diglycol reagent, and stirred into 75 gm of the base cream prepared as per example 3 and triple milled. A cream-type preparation results which contains amitriptyline hydrochloride @ 10 mg/ml
Quantity
0.75 g
Type
reactant
Reaction Step One
Quantity
1.5 mL
Type
reactant
Reaction Step Two
[Compound]
Name
base
Quantity
75 g
Type
reactant
Reaction Step Three
Quantity
0 (± 1) mol
Type
reactant
Reaction Step Four

Synthesis routes and methods III

Procedure details

1-Chloro-amitriptyline (196 mg) in 3 ml. absolute ethanol was added to an ethanolic solution of 1.1 eq. d-tartaric acid and warmed for 5-10 mins. The title compound was precipitated with ethyl ether as a white powder. After purity and identification checks, the overall yield from amitriptyline base was 32%.
Quantity
196 mg
Type
reactant
Reaction Step One
Quantity
0 (± 1) mol
Type
reactant
Reaction Step Two
Quantity
0 (± 1) mol
Type
solvent
Reaction Step Two

Retrosynthesis Analysis

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Feasible Synthetic Routes

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Amitriptyline
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Amitriptyline

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Please be aware that all articles and product information presented on BenchChem are intended solely for informational purposes. The products available for purchase on BenchChem are specifically designed for in-vitro studies, which are conducted outside of living organisms. In-vitro studies, derived from the Latin term "in glass," involve experiments performed in controlled laboratory settings using cells or tissues. It is important to note that these products are not categorized as medicines or drugs, and they have not received approval from the FDA for the prevention, treatment, or cure of any medical condition, ailment, or disease. We must emphasize that any form of bodily introduction of these products into humans or animals is strictly prohibited by law. It is essential to adhere to these guidelines to ensure compliance with legal and ethical standards in research and experimentation.