RT Journal
A1 King SA
T1 ACupuncture and amitriptyline for hiv-related peripheral neuropathic pain
JF JAMA
JO JAMA
YR 1999
FD April 14
VO 281
IS 14
SP 1270
OP 1272
DO 10-1001/pubs.JAMA-ISSN-0098-7484-281-14-jac90002
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-281-14-jac90002
AB 
The first is that the maximum dose of amitriptyline used was only 75
mg/d. The authors cite 2 articles supporting this
decision.2- 3 However, neither of these articles appear to
do so. In fact, in their study of diabetic neuropathy, Sindrup et
al3 used a dosage range of imipramine from 125 to 350 mg/d
and stated "it is important to not discontinue treatment because of
an inadequate response on a standard dose of for example 100 mg
imipramine per day."3(p514) As amitriptyline and
imipramine are usually considered to be of roughly equal potency and
because many other studies supporting the use of antidepressants for
analgesia have used doses higher than 75 mg/d of amitriptyline or the
equivalent,4 including at least 1 coauthored by 1 of the
current authors, Dr Max,5 it is difficult to understand why
the dose was limited. It is quite possible that the poor medication
response resulted from a subtherapeutic dose.