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Comparison of effects of amitriptyline and venlafaxine on cognitive and psychomotor functions in healthy volunteers: A randomized parallel group study

Rima B Shah, Sumit Patel, Vipul Chaudhary.




Abstract

Background: Antidepressant drugs cause various degree of psychomotor and cognitive function impairment.

Aim and Objective: The objective of the study was to compare effects of amitriptyline and venlafaxine on cognitive and psychomotor functions in healthy volunteer.

Materials and Methods: A prospective double-blind parallel group study involving 28 participants was carried in the clinical pharmacology laboratory. Participants were divided in two groups of 14 each and given single oral doses of amitriptyline 100 mg and venlafaxine 75 mg. Participants undergone battery of cognitive-psychomotor function tests at baseline and 2, 6-, and 24-h post-drug administration and analyzed.

Results: Mean age of the participants was 21.93 ± 0.47 years with no significant difference at baseline for psychomotor functions (P > 0.05). Both amitriptyline and venlafaxine affect psychomotor and cognitive function significantly (P < 0.05). On comparing the effects of two drugs on psychomotor functions, at 2 h only statistically significant difference found in memory test score (7.50 ± 1.51 with amitriptyline vs. 9.14 ± 1.10 with venlafaxine, P = 0.003). At 6 h, only statistically significant difference found in six letter cancellation test (SLCT) net score (116.21 ± 36.25 with amitriptyline vs. 145.43 ± 28.12 with venlafaxine, P = 0.025). Memory score improves at 2 h with venlafaxine as compared to amitriptyline while SLCT improves at 6 h with venlafaxine. Twenty-two participants (12 from Group A vs. 10 from Group B, P < 0.05) developed adverse drug event. Sedation and dry mouth were common among amitriptyline group while nausea, vomiting, and muscular pain were common among venlafaxine group.

Conclusions: Both amitriptyline and venlafaxine affect psychomotor functions but deterioration is more in amitriptyline group. Venlafaxine can be better therapeutic option with less deteriorating effect on psychomotor functions and less adverse drug reactions.

Key words: Amitriptyline; Venlafaxine; Psychomotor and Cognitive Function; Critical Flicker Frequency; Choice Reaction Time; Six Letter Cancellation Test; Digit Symbol Substitution Test; Arithmetic Ability Test; Zigzag Test; Leeds Sleep Evaluation Questionnaire






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