Amitriptyline/chlordiazepoxide
Combination drug
From Wikipedia, the free encyclopedia
Amitriptyline/chlordiazepoxide, sold under the brand names Limbitrol and Limbitrol DS, is a combination of amitriptyline (Elavil), a tricyclic antidepressant, and chlordiazepoxide (Librium), a benzodiazepine, which is approved for the treatment of depression associated with anxiety in the United States.[2][3] It is taken orally and contains 12.5 to 25 mg amitriptyline and 5 to 10 mg chlordiazepoxide per tablet.[1][2][3]
| |
 Amitriptyline (top) and chlordiazepoxide (bottom) | |
| Combination of | |
|---|---|
| Amitriptyline | Tricyclic antidepressant |
| Chlordiazepoxide | Benzodiazepine |
| Clinical data | |
| Pronunciation | /ˌklɔːr.daɪəz.ɪˈpɒksaɪd/ /ˌæmɪˈtrɪptɪliːn/[1] |
| Trade names | Limbitrol, Limbitrol DS |
| Routes of administration | Oral |
| Legal status | |
| Legal status |
|
Medical uses
Amitriptyline/chlordiazepoxide is used for the treatment of moderate to severe depression associated with moderate to severe anxiety.[1][3] It has shown to be more effective in treating symptoms of anxiety, irritability, and hostility in patients with comorbid depression and anxiety than amitriptyline alone.[4]: 174 It also has a quicker onset time than either amitriptyline or chlordiazepoxide on their own.[1][4]: 174
Contraindications and precautions
Amitriptyline/chlordiazepoxide should not be taken if the patient has recently had a heart attack.[1][5] It may induce a mixed-manic episode in patients with a history of bipolar disorder or who have had manic or hypomanic episodes in the past.[1] Amitriptyline/chlordiazepoxide may worsen seizures in patients with a previous history of them.[1][5] Patients older than 65 years of age may be more sensitive to amitriptyline/chlordiazepoxide.[6] It may also have stronger effects on patients with kidney or liver disease due to slowed filtering from the bloodstream.[1][5] It may also cause adverse effects in patients with a thyroid condition such as hyperthyroidism.[1][5][6] Use of amitriptyline/chlordiazepoxide later in pregnancy can cause sedation or symptoms of withdrawl in the infant after delivery.[1][5][6] The safety of amitriptyline/chlordiazepoxide for breastfeeding or pediatric patients is unknown.[5]
Drug interactions
Amitriptyline/chlordiazepoxide should not be taken concomitantly with MAOIs, as doing so may cause high blood pressure and seizures .[1][5] Like other benzodiazepines, concomitant use of amitriptyline/chlordiazepoxide with opioids increases the risk of drug-related mortality by way of profound sedation and respiratory depression.[1]