Unmasking of cerebellar tumours by amitriptyline in depressive patients

Abstract

In three patients receiving antidepressive treatment with 75 to 100 mg amitriptyline per day, a cerebellar syndrome appeared on the fourth or fifth day after the commencement of this treatment. In all three patients the computed tomographic (CT) scan demonstrated an intra-axial mass lesion in the cerebellum. Our impression is that antidepressive tricyclic drugs may play a crucial role in the development of symptoms and signs in the presence of a previously unsuspected posterior fossa tumour. We believe that neurological examination should be meticulously performed before treatment of depression with tricyclic drugs.