{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:37:15Z","timestamp":1776868635626,"version":"3.51.2"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T00:00:00Z","timestamp":1549584000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Pharmacologic triggers of autonomic dysreflexia (AD) have rarely been described. This report describes the case of a 31\u2010year\u2010old woman with T3 American Spinal Injury Association Impairment Scale A spinal cord injury who developed recurrent AD while receiving duloxetine and amitriptyline combination therapy for neuropathic pain. After excluding other AD generators, duloxetine was discontinued and the AD episodes resolved. Although secondary hypertension is a known side effect of amitriptyline and duloxetine, neither drug has been previously associated with AD. One potential mechanism for inhibition of duloxetine metabolism is discussed. Unexplained AD in at\u2010risk patients receiving duloxetine and amitriptyline should prompt consideration of an adverse reaction to combination therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>V<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2018.07.010","type":"journal-article","created":{"date-parts":[[2018,7,21]],"date-time":"2018-07-21T05:38:05Z","timestamp":1532151485000},"page":"214-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Autonomic Dysreflexia as a Potential Adverse Effect of Duloxetine and Amitriptyline Combination Therapy: A Case Report"],"prefix":"10.1002","volume":"11","author":[{"given":"Sara C.","family":"Parke","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine University of Washington  Seattle WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Regina","family":"Reyes","sequence":"additional","affiliation":[{"name":"University of Washington, Spinal Cord Injury Service VA Puget Sound Health Care System, 1660 S Columbian Way, S\u2010128\u2010SCI  Seattle WA 98108"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,8]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/mr.2000.3848"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2014.04.007"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2017.58"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1179\/2045772313Y.0000000098"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2016.90"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2015.06.027"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jcp.0000155815.44338.95"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.155.5.450"},{"key":"e_1_2_5_10_1","first-page":"311","volume-title":"Clinical Pharmacology","author":"Bennett PN","year":"2012"},{"key":"e_1_2_5_11_1","volume-title":"Product information: Elavil(R), amitriptyline","author":"Micromedex","year":"1999"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.pmrj.2018.07.010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218303885?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218303885?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.07.010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T07:54:36Z","timestamp":1694678076000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2018.07.010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1016\/j.pmrj.2018.07.010"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2018.07.010","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]},"assertion":[{"value":"2018-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}