Oral treatment with amitriptyline induces coenzyme Q deficiency and oxidative stress in psychiatric patients

• Published in: Journal of psychiatric research Vol. 46; no. 3; pp. 341 - 345
• Main Authors: Moreno-Fernández, Ana M, Cordero, Mario D, Garrido-Maraver, Juan, Alcocer-Gómez, Elísabet, Casas-Barquero, Nieves, Carmona-López, María I, Sánchez-Alcázar, José Antonio, de Miguel, Manuel
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-03-2012; Elsevier
• Subjects: Adenosine Triphosphate - metabolism; Administration, Oral; Adult; Amitriptylene; Amitriptyline; Amitriptyline - administration & dosage; Amitriptyline - adverse effects; Antidepressive Agents, Tricyclic - administration & dosage; Antidepressive Agents, Tricyclic - adverse effects; Antioxidants - metabolism; Avitaminosis - chemically induced; Biological and medical sciences; Biomarkers; Coenzyme Q; Depression; Depressive Disorder - drug therapy; Depressive Disorder - metabolism; Dietary Supplements; Dysfunction; Female; Humans; Lipid peroxidation; Lipids; Male; Medical sciences; Mentally ill people; Mitochondria - drug effects; Mitochondria - metabolism; Mitochondrial Diseases - chemically induced; Neuropharmacology; Oxidative stress; Oxidative Stress - drug effects; Pharmacology. Drug treatments; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Ubiquinone - analogs & derivatives; Ubiquinone - deficiency; Ubiquinone - metabolism; Ubiquinone - therapeutic use; Lipid peroxidation; Oxidative stress; Coenzyme Q; Amitriptyline; Human; Serotonin; Psychotropic; Oral administration; Lipids; Catecholamine; Tricyclic compound; Reuptake inhibitor; Coenzyme; Treatment; Neurotransmitter; Mental disorder; Antidepressant agent; Norepinephrine; Peroxidation
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2011.11.002

Abstract Amitriptyline is a commonly prescribed tricyclic antidepressant, which has been shown to impair mitochondrial function and increase oxidative stress in a variety of in vitro assays. Coenzyme Q10 (CoQ10 ), an essential component of the mitochondrial respiratory chain and a potent antioxidant, has been proposed as a mitochondrial dysfunction marker. In order to evaluate the putative mitochondrial toxicity of amitriptyline, we have analyzed CoQ10 and ATP levels, oxidative damage and mitochondrial mass in peripheral blood cells from control healthy volunteers and psychiatric patients with depressive episodes treated or non-treated with amitriptyline. In patients not following amitriptyline treatment, CoQ10 and ATP levels and mitochondrial mass were reduced when compared to normal individuals while lipid peroxidation was clearly increased. All these alterations were aggravated in patients following oral amitriptyline therapy. These results suggest that mitochondrial dysfunction could be involved in the pathophysiology of depression and may be worsened by amitriptyline treatment. CoQ10 supplementation is postulated to counteract the adverse effects of amitriptyline treatment in psychiatric patients.