(E)-10-Hydroxy amitriptyline is a metabolite of Amitriptyline (brand name Elavil), a FDA-approved oral medicine for the treatment of major depressive and anxiety disorders, attention deficit hyperactivity disorder (ADHD), bipolar disorder, as well as migraines and neuropathic pain (fibromyalgia & postherpetic neuralgiapain). Amitriptyline acts mainly on the serotonin transporter (SERT) and moderately on the norepinephrine transporter (NET). Amitriptyline is metabolised by cytochrome P450 enzymes (demethylation by CYP2C19 & CYP3A4) in the liver to Nortriptyline, which also acts as a noradrenaline reuptake inhibitor and thereby potentiates the antidepressant effects of amitriptyline. Amitriptyline and Nortriptyline are subject to metabolisation by hydroxylation (by CYP2D6) and n-oxidation.
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Metabolomics research
Biochem/physiol Actions
Metabolite of amitriptyline, tricyclic antidepressant; chromatographic standard.
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Drug metabolism reviews, 36(3-4), 723-746 (2004-11-24)
Amitriptyline (AT), the most widely used tricyclic antidepressant, undergoes oxidative metabolism in the side chain with production of the secondary amine nortriptyline (NT), a primary amine, and the N-oxide amitriptylinoxide (AT-NO); in addition, direct conjugation leads to a quaternary ammonium-linked
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