Hypertriglyceridemia associated with the treatment of amitriptyline and maprotiline

✍ Scribed by Yutaka Masuda; Takaubu Takemura; Toshihiro Sugiyama

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 61 KB
• Volume: 13
• Category: Article
• ISSN: 0885-6222
• DOI: 10.1002/(sici)1099-1077(1998100)13:7<527::aid-hup24>3.0.co;2-t

✦ Synopsis

Hypertriglyceridemia associated with the treatment of amitriptyline and maprotiline

We have experienced a depression case with hypertriglyceridemia induced by amitriptyline and maprotiline. This case is very interesting in the view of eects of antidepressants on lipid-metabolism.

The case was a 26-year-old man diagnosed `adjustment disorder' according to DSM-IV. His height was 178 cm and his weight 64 kg. He did not take alcohol, and did not have any genetic metabolic abnormalities containing familial hyperlipidemia. The initial laboratory data on 14 February 1997 were the following: aspartate aminotransferase (AST) 8 U/l (normal 6±31 U/l), alanine aminotransferase (ALT) 8 U/l (normal 5±31 U/l), gamma-glutamyl transpeptidase (G-GT) 18 U/l (normal 8±51 U/l), total cholesterols (T.Cho) 150 mg/dl (normal 120± 230 mg/dl), free cholesterols (F.Cho) 67 mg/dl (normal 35±72 mg/dl), triglycerides (TG) 161 mg/ dl (normal 35±212 mg/dl), lipase (LP) 57 U/l (normal 29±202 U/l), and in lipoprotein electrophoresis, high density lipoprotein (HDL) 30% (normal 29±50%), low density lipoprotein (LDL) 43% (normal 30±50%), very low density lipoprotein (VLDL) 27% (normal 8±29%). Drug treatment was started with amitriptyline (50 mg/day) at the same day. On 12 May, his general condition was good and his weight was 68 kg, but the laboratory data were the following: AST 31/U/l, ALT 42 U/l, G-GT 88 U/l, T.Cho 247 mg/dl, F.Cho 67 mg/dl, TG 456 mg/dl, LP 55 U/l, HDL 24%, LDL 32%, VLDL 44%. As it was thought that the abnormal data were due to amitriptyline, the drug was omitted from the treatments. On 22 July, the laboratory data were the following: AST 7 U/l, ALT 13 U/l, G-GT 19 U/l, T.Cho 190 mg/dl, F.Cho 66 mg/dl, TG141 mg/dl, LP 59 U/l, HDL 29%, LDL 43%, VLDL 28%. He fell into depressive state again, and his weight was