The efficacy and tolerability of amitriptyline on the pathologic crying and other pseudobulbar signs were investigated in 22 consecutive patients diagnosed mostly as ALS. The occurrence and intensity of pathologic crying, dysarthria, dysphagia, jaw reflex and primitive reflexes (snout, palmo-mental and oral), were assessed before and after 3 and 6 weeks of amitriptyline treatment. The drug administered in low dose (30-100 mg, mean 64 +/- 17.6 mg) significantly decreased the frequency of pathologic crying in 17 patients after 3 weeks and in 20 patients after 6 weeks of treatment. There were no changes in the intensity of the other pseudobulbar signs. Only few mild and transient side effects were observed. The authors conclude, that amitriptyline is an effective treatment of pathologic crying in ALS patients.