Amitriptyline
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DRUG STATUS
Approvals
US(FDA), UK(BNF)
Essential Medicine
YES
Teratogenicity
Unlisted
Pharmaceutical Class
Tricyclic Antidepressant
Amitriptyline
Know More About This Medicine -
Click HereSummary
Amitriptyline is primarily used to treat depression. It's also used for anxiety and certain types of chronic pain, such as neuropathic pain or migraines. It can also help manage insomnia associated with depression and anxiety.
Amitriptyline works by increasing the levels of neurotransmitters, specifically serotonin and norepinephrine, in the brain. This helps improve mood, alleviate pain, and improve communication between neurons.
The usual starting dosage for adults is 25 to 50 mg per day, taken at bedtime. The dose can be gradually increased based on individual response, up to a maximum of 150 mg per day. It's taken orally, usually in the evening or before sleep due to its sedative effects.
Common side effects of Amitriptyline include dry mouth and dizziness. Rare but severe side effects can include hallucinations and heart arrhythmias. Abruptly stopping the medication can lead to withdrawal symptoms like dizziness, nausea, headache, irritability, and flu-like symptoms.
Amitriptyline should be used with caution in patients with a history of heart disease or seizures. It can also increase the risk of suicidal thoughts or behavior, especially in young adults. It's excreted in breast milk and can cause adverse effects in nursing infants, so breastfeeding mothers should be cautious. Pregnant women should discuss the risks and benefits with their healthcare provider.
Indications and Purpose
What is Amitriptyline used for?
Amitriptyline is primarily indicated for the relief of symptoms of depression, particularly endogenous depression. It may also be used for other psychiatric disorders, although its use in children and adolescents is not recommended due to potential risks. Always consult a healthcare provider for specific indications and usage.
How does Amitriptyline work?
Amitriptyline works by inhibiting the reuptake of norepinephrine and serotonin, which are neurotransmitters involved in mood regulation. This action increases the levels of these neurotransmitters in the brain, helping to improve mood and alleviate symptoms of depression. It also has sedative effects, which can aid in sleep.
Is Amitriptyline effective?
Amitriptyline is an antidepressant that works by inhibiting the reuptake of norepinephrine and serotonin, which are neurotransmitters involved in mood regulation. Clinical studies have shown its effectiveness in alleviating symptoms of depression, particularly endogenous depression. It is also used for other psychiatric disorders, although its exact mechanism of action is not fully understood.
How does one know if Amitriptyline is working?
The benefit of amitriptyline is evaluated by monitoring the patient's symptoms and overall mental health. Healthcare providers assess improvements in mood, reduction in depressive symptoms, and any side effects experienced. Regular follow-ups and communication with the healthcare provider are essential to ensure the medication is working effectively and safely.
Directions for Use
What is the usual dose of Amitriptyline?
The usual daily dose of amitriptyline for adults typically ranges from 25 mg to 150 mg, depending on the severity of the condition and the patient's response to the medication. Amitriptyline is not recommended for use in children under 12 years of age due to a lack of experience and potential risks.
How do I take Amitriptyline?
Amitriptyline can be taken with or without food, but it is important to follow the healthcare provider's instructions regarding dosage and timing. There are no specific food restrictions, but patients should avoid alcohol as it can enhance the sedative effects of the medication. Always consult a healthcare provider for personalized advice.
For how long do I take Amitriptyline?
The duration of amitriptyline use varies based on the condition being treated and the patient's response. It is often used for several months to manage symptoms of depression effectively. The exact duration should be determined by a healthcare provider, who will monitor the patient's progress and adjust the treatment plan as needed.
How long does it take for Amitriptyline to start working?
Amitriptyline may take several weeks to show its full effects in alleviating symptoms of depression. Patients may notice some improvement in symptoms within the first week, but it can take 4 to 6 weeks to experience the full therapeutic benefits. Consistent use as prescribed is important for effectiveness.
How should I store Amitriptyline?
From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.
Warnings and Precautions
Who should avoid taking Amitriptyline?
Amitriptyline is contraindicated in patients with hypersensitivity to the drug, those taking monoamine oxidase inhibitors, and during the acute recovery phase following a myocardial infarction. It may worsen depression or induce suicidality, especially in young adults. Patients should be monitored for clinical worsening, and the drug should be used cautiously in those with cardiovascular disorders, glaucoma, or a history of seizures.
Can I take Amitriptyline with other prescription drugs?
Amitriptyline can interact with several drugs, including monoamine oxidase inhibitors, which can cause severe reactions. It may also interact with SSRIs, leading to increased plasma levels and potential toxicity. Caution is advised when used with CNS depressants, anticholinergic agents, and drugs that inhibit cytochrome P450 2D6, as these can alter amitriptyline's effects and increase side effects.
Can I take Amitriptyline with vitamins or supplements?
From all available and reliable information, there is no confirmed data on this. Please consult a doctor for personalized advice.
Can Amitriptyline be taken safely while pregnant?
Amitriptyline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. There is limited evidence from human studies, but some reports suggest possible adverse effects on the fetus, such as developmental delays. Pregnant women should consult their healthcare provider to weigh the risks and benefits before using amitriptyline.
Can Amitriptyline be taken safely while breastfeeding?
Amitriptyline is excreted into breast milk, and while no trace of the drug was detected in the infant's serum in one report, there is potential for serious adverse reactions in nursing infants. A decision should be made to either discontinue nursing or the drug, considering the importance of the medication to the mother.
Is Amitriptyline safe for the elderly?
Elderly patients are more sensitive to the side effects of amitriptyline, particularly its anticholinergic effects, which can include confusion, sedation, and an increased risk of falls. It is recommended to start elderly patients on lower doses and monitor them closely. Adjustments should be made based on their response and any side effects experienced.
Is it safe to exercise while taking Amitriptyline?
Amitriptyline may cause drowsiness, dizziness, or fatigue, which can affect physical performance and exercise capacity. Individuals taking amitriptyline should be cautious when engaging in physical activities and consult their healthcare provider if they experience significant limitations or concerns related to exercise.
Is it safe to drink alcohol while taking Amitriptyline?
Drinking alcohol while taking amitriptyline can enhance the sedative effects of the medication, increasing the risk of drowsiness and impairing mental and physical abilities. This combination can be dangerous, especially when performing tasks that require alertness, such as driving. It is generally advised to avoid alcohol while taking amitriptyline.
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