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Smythe Pain Clinic, University of Toronto (Drs. Watson and Evans), Clarke Institute of Psychiatry (Dr. Warsh), Queen Street Mental Health Centre, Toronto (Dr. Reed), Toronto General Hospital (Dr. Goldsmith), and London Psychiatric Hospital, London, Ontario, Canada (Dr. Merskey).
To study the effects of amitriptyline in treating postherpetic neuralgia, 24 patients were randomly assigned to either drug or placebo in a double-blind crossover study. We found good to excellent pain relief in 16 of 24 patients (p 
0.001). We did not find an antidepressant effect in most patients (p < 0.05). The median dose of amitriptyline was 75 mg. The median blood level was 65 ng per milliliter, and of nortriptyline 30 ng per milliliter. Good responses were maintained in 12 of 22 patients. Amitriptyline is useful in treating postherpetic neuralgia and may not act as an antidepressant.
Address correspondence and reprint requests to Dr. Watson, 3025 Hurontario Street, #504, Mississauga, Ontario, Canada L5A 2H1.
This study was presented as a paper at the American Academy of Neurology Meeting, Toronto, Canada, April 1981.
Accepted for publication October 28, 1981.
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