Amitriptyline restores nerves. Amitriptyline is a dangerous drug. Special instructions and precautions

Antidepressant: Amitriptyline
Manufacturer: Zentiva Pharma LLC (Russia)
Active substance: Amitriptyline (Amitriptyline)

Pharmacological action of an antidepressant

Amitriptyline belongs to the group of tricyclic antidepressants. Its action is based on blocking the reuptake of dopamine, serotonin and norepinephrine by CNS neurons. In addition, amitriptyline has analgesic effects, as well as antibulimic and antiulcer effects. The drug is also effective in the fight against bedwetting. With regular and sufficiently long-term use, it restores the balance of serotonin and norepinephrine transmission, shaken due to depression.
A pronounced antidepressant effect, as a rule, appears 2-4 weeks after the start of the antidepressant. In depression complicated by anxiety, amitriptyline reduces both depressive manifestations and agitation and anxiety. The antiulcer effect of the drug is due to its ability to block the work of histamine H2 receptors in the cells of the stomach. Thus, effective pain relief is achieved, as well as accelerated healing of gastric and duodenal ulcers.
The high efficacy of amitriptyline in the treatment of bulimia nervosa has not yet been scientifically substantiated. However, it is well known that the drug shows good results in the fight against this disease (at the same time, improvements in patients with bulimia occur regardless of the presence / absence of depressive conditions in them, the antibulimic effect occurs even in the absence of an antidepressant effect).
A domestic study conducted in one of the Samara clinics showed that patients feel a significant decrease in anxiety and agitation, as well as motor restlessness already in the first days of taking amitriptyline. At 2-3 weeks of treatment, patients felt an improvement in mood, an increase in self-esteem, a sharp decrease in the feeling of melancholy, depression and hopelessness. Feelings of guilt and suicidal tendencies disappeared.
In addition, there was a marked improvement in sleep among all patients treated with amitriptyline. Night sleep completely normalized, became strong and uninterrupted.

Indications for use

• treatment of depressions of any origin (endogenous, neurotic, involutional, drug-induced, reactive, with anxiety, sleep disturbances and agitation, depression with alcohol withdrawal, as well as with organic disorders of the brain);
• Treatment of mixed emotional disorders;
• Treatment of schizophrenic psychoses;
• Treatment of bulimia nervosa and psychogenic anorexia;
• Treatment of nocturnal enuresis, including in children (the drug is contraindicated in patients with hypotension of the bladder);
• Treatment of phobic disorders;
• Elimination of behavioral disorders (including activity and attention);
• Peptic ulcer of the stomach and duodenum;
• Prevention of headaches;
• Treatment of patients with chronic pain syndrome (atypical facial pain, migraines, chronic pain in cancer patients, postherpetic neuralgia, rheumatic pain, posttraumatic, peripheral and diabetic neuropathy).

Method of application and dosage

Amitriptyline is taken orally during or after a meal. You should start taking the drug with 50-75 mg / day. The dose should be divided into several doses of 25 mg each. In order to achieve the optimal therapeutic effect, the dose may be gradually increased by 25-50 mg. The maximum allowable dosage is 150-200 mg per day. In this case, most should be taken before bedtime. With extremely severe depressions that are not amenable to therapy, it is possible to increase the dose to 300 mg or even more, depending on the individual tolerance of the drug. In such a situation, it is advisable to start treatment with intravenous / intramuscular administration of the substance.
The therapeutic effect should appear no later than one month after the start of taking amitriptyline. In this case, the dosage is gradually reduced, however, if signs of depression resume, you should return to the previous effective dose. If the drug does not show effectiveness after 3-4 weeks of treatment, it should be discarded.
For elderly patients, the minimum dose is 25 mg / day, which can be increased gradually to 50-100 mg / day. In the prevention of headaches, as well as neurogenic pain, it is recommended to use the drug in an amount of 12.5-25 mg / day with a possible increase in dosage up to 100 mg / day.
In severe depression, intramuscular / intravenous administration of the drug is performed at a dose of 10-20-30 mg, up to 3-4 injections per day. The maximum daily dose can be gradually increased and is 150 mg. After 7-14 days of injections, they switch to oral amitriptyline. Children (mandatory over 12 years old) and elderly people are prescribed the most minimal doses, increasing the dosage should be slower.

Contraindications

Amitriptyline should not be taken by people with heart failure in the stage of decompensation, impaired conduction of the heart muscle, the period of myocardial infarction (including recovery after it), arterial hypertension. It is forbidden to take the drug to patients with prostatic hypertrophy, atony of the bladder, paralytic ileus, as well as in acute violations of the liver and kidneys.
It is forbidden to take amitriptyline to pregnant women, nursing mothers, as well as children under 6 years of age (when taken orally). Patients with hypersensitivity to amitriptyline should also not take this drug.

Side effects

Blurred vision, increased intraocular pressure, dry mouth, constipation, fever. These are the consequences of the body's adaptation to the drug, so they usually disappear soon (sometimes you need to reduce the dose). On the part of the nervous system, the following side effects occur: irritability, headache, tinnitus, sleep disorders, drowsiness, anxiety, etc. In addition, heart rhythm disturbances, heartburn, nausea, vomiting, taste disturbance, enlargement of the mammary glands, as well as allergic reactions: itching, rash, urticaria. (see also Norpramin)

Storage conditions

The drug is stored out of the reach of small children at temperatures from 10 to 25 ° C in a dry, dark place.
Amitriptyline is also available under brand names:

• • Amizol
  • Amirol
  • Amitriptyline

Antidepressant "Amitriptyline": 62 comments and patient reviews:

1. Sergey, 26, St. Petersburg Post author

   I take for depression, almost a month, 50 mg before bed. I woke up, there was some kind of energy, activity. Prior to that, he took Fevarin, to no avail, with emissions into mania. In Amitriptyline, almost everything suits, but the side effects make me healthy: trouble with memory, terrible dryness, I see worse, my hands are shaking. But the antidepressant effect so far pays for this whole bouquet.

2. Belarus Post author

   I take the 4th day from VSD, asthenia, and depression, the doctor said two tablets (50 mg) a day, on the first day I almost went crazy, I lowered the dose to 0.5 twice a day, now I suffer from insomnia, dizziness, I can’t nothing to focus on. I knew that the first days would be hard but not the same ..

3. margarita

   Hello, I have been taking amitriptyline for two weeks and it seems to me that anxiety, fear, fear have become less. That's just vision and memory worse

4. Faith

   I was betrayed by a close person. It was a strong blow for me. She drank amitriptyline for six months, up to 3 tablets a day. Helped. Good drug. I got a little better, but compared to what it was, it's a trifle.

5. Julia

   I was prescribed this drug for chronic pain syndrome. Daily headaches, weakness. In general, neurasthenia with chronic tension headaches. Have appointed or nominated 10 mg for the night. At first I drank half a tablet (5 mg). The next day there was no headache. Gradually switched to a whole tablet at night (10 mg).
   What to say? I have been drinking for the third month, and they said to drink at least six months. The drug is strong, in anti-depressive doses it is almost unrealistically heavy. A lot of bad side effects, the worst of which is a cardio-toxic effect. Your heart beats so hard you can hear your own pulse in your ears.
   And my head doesn't hurt!
   On the one hand, it’s scary to live with such tachycardia, and on the other hand, it’s scary to quit, what if the pain returns ...
   In addition, it gives constipation and greatly increases appetite, without removing the asthenic component. In general, there is zhor, but there is no cheerfulness. Hence the weight gain...
   Even in such small doses - 10 mg. For an AD effect, the dose should be 150-200 mg.
   Unthinkable!

6. Natalia

   Retirees often get lost after retirement, getting used to a regular work schedule. I was no exception - I lost interest in life, I was pressed by some kind of longing for youth, there was nowhere to put myself. A friend suggested the drug "Biotredin". And what? For me, it has become a real panacea for the blues and thoughts that life is over.

7. Sasha

   When people get sick, it is a very big grief. Lately, I've been feeling unwell myself. People need drugs like Amitriptyline. So, my mood was very bad every day. Lived like a dream. I woke up in the morning and already felt tired. My wife, she is a nurse who bought the drug from me. I want to say that he helped me a lot. Now everything is as before. I am not sad and I want to live every day, and I am grateful for it!!!

8. Galya

   I take it for two weeks, they prescribed it to me after cystoscopy 25 mg, I have had urinary neuralgia for 13 years, nothing helped, there were sirashny pains, I constantly went to the toilet. And this medicine apparently heals me. It doesn’t hurt almost.

9. Alex

   Please tell me, I have tablets of 10 mg. how many times you need to drink and how much to walk a day and it didn’t matter, excuse my French, but at night to sleep like a log and not look at the ceiling until the morning ...

10. Julia

    The drug is one of the cheapest, which is probably why it gives so many side effects. I constantly want to sleep, my memory and vision are deteriorating, there is no strength and desire for anything. In combination with Pantogam Active, the condition improved slightly, some vigor appeared, but still, due to the lack of the desired effect, she switched to other pills.

11. Vovan

    But it didn't help me!

12. Tatiana

    Good afternoon The drug was prescribed to my mother. After an ischemic stroke, she began to recover, but tantrums appeared, 4 months ago they buried her dad, she always says that he comes to pick her up. She took gidosepam, maybe from him? One way or another, after the first tablet of amitriptyline, at night, he sleeps for the second day, the nurses cannot wake up. Yesterday the therapist canceled both gidosepam and amitriptyline, said that she was just sleeping. Today they called an ambulance, they say that she is unconscious, they are waiting for a therapist and a neuropathologist. I’m in Moscow, I just returned yesterday, my mother is in Ukraine, I don’t know what to do, I no longer trust local doctors, I read somewhere that amitripcilin is generally contraindicated in cardiovascular disorders. If anyone can give some good advice, please help. Thank you! [email protected]

13. Konstantin, 31 years old, Moscow

    I tried to take it from a small dose, I couldn’t, my heart-beat increased and there were interruptions in the heart rhythm. I drank 3 days for 1/4 25 mg. I had to cancel. Tried 3 times to start, the result is the same.

14. Arthur

    Hello everyone, after the second injection I stopped the treatment, the condition was terrible, can anyone tell me when they completely go away from amitriplin?

15. Igor

    There were headaches as if the helmet on the head didn’t get enough sleep, irritated the lamp light, especially in the rooms and the headlights of the cars, the doctor diagnosed depression, started taking amitriptyline, after 3 weeks, blood pressure started in a dream, I jump up from the fact that the heart is running, panic sets in, this didn’t happen, everything that didn’t exist at all It's dangerous and I don't know what to do.

16. Elvira

    I took amitriptyline for 3 months. I started to reduce the dose to 1/4 at night. Nothing happened in the afternoon, and alarming symptoms began again in the morning. what you need. So I don’t know which is better?

17. Svetlana

    My mother-in-law was prescribed this drug. She had fears, panic, an excited state. After taking it, everything went well. Now there are exacerbations, we immediately begin to give these pills and she calms down on the third day approximately. Complains of dry mouth only and for memory. And so all is well.

18. Alexander

    He used drugs for many years, then he began to drink heavily. Now I take amitriptyline, anxiety, I sleep soundly (2 tablets in the morning). I got a job, started a family. Amitriptyline is a remedy for drug and alcohol addiction. Of the "side effects" - dry mouth, worsened memory, attention.

19. Tatyana, 58 years old

    Three times in my life, amitriptyline helped me out like no other remedy, when stress accumulated and a state of complete inability to “take blows” and the inability to work with people, asthenia, set in. Despite the fact that as a psychotherapist she helped everyone, but she could not “rule” her life. Calm set in, anxiety, tearfulness, uncertainty, fear of circumstances disappeared. Only dry mouth is a side effect. The previous time I started drinking with 25 mg 3 times a day, without increasing the dose, but for a long time (up to 9 months) on the recommendation of a doctor. Now again the same period of life. I started on my own without a doctor. But I know that you need to “leave” by gradually reducing the dose every 5 days by 1/4. Better company Nycomed. But for some reason, its reserves "melt" in the city. And 25 mg is not available at all now. And dividing the halves is inconvenient, troublesome. By the way, tell me, are they allowed to cross the borders with him?

20. Denis 27 Irkutsk

    The drug is good, for me, anyway. I drink at night. He suffered from sleep disorders, anxiety, panic, “not good” thoughts, in the morning, fatigue, etc. I started taking amitriptyline - everything is ok. At first - yes, the next day, fatigue, lethargy, attention disorder, but this lasted about a week. Adjustment period as far as I can tell. After - and working capacity, and vital energy, and there are no "not good" thoughts.

21. Vladlena

    I have been taking the drug since the summer in combination with chlorprothixene. At the beginning, there was no effect, there were side effects, mostly dryness was very strong, but after a month everything went away, I went to work, everything is super. Now I take 25 mg in the morning, 25 mg in the afternoon and 50 mg at night, I tried to reduce the doses with the doctor, but so far it has not worked out, he said that again 3 months. drink, and then to decline. The dream is wonderful, only attention is very disturbed, another medicine was prescribed for attention, I drank the course and it became easier.

22. Pauline

    Prescribed for depression. Of course it helped. I drink for a week, I live calmly for a couple of months, not paying attention to stress. But when the effect ends, just tin, do not come up to me, I destroy everything. The other day I started drinking a quarter again, to all the side effects (dry mouth, weakness, sleep, deterioration of attention) numbness of the hands was added, the right one passed, and the left one hangs 🙁 But I can’t refuse yet, I’m afraid. And I don't know what to replace. Tomorrow to the doctor.

23. Anastasia

    She took amitriptyline from him, there was dryness and an unpleasant aftertaste in her mouth, and there was a fear of communication, and the skin on her hands began to crack.

24. Marina 36 years old, Almaty

    I was in a psycho-neurological dispensary, where ammitriptyline is not practiced now. They were treated with expensive, new antidepressants .... after discharge, it became bad again, evening panics were not left alone. Now I drink ambulatory ammitriptyline, I can not get enough of my well-being. only for some reason they appointed half in the morning and in the afternoon. I sleep like a horse day and night ... what should I do? Can anyone tell me if I can drink it in the afternoon. and yet, the course was prescribed only for a month, and then switch to tranquilizers, also for a month. I'm afraid to quit ammitriptyline, .. and maybe he can somehow get out of depression in a month of taking it. Thanks a lot

25. yogann

    first you need to think, accept it, or you can still do without it, otherwise we eat everything that is advised and that it comes to hand.

26. Svetlana, 49 years old, St. Petersburg

    Everything is very individual. If there are side effects that worsen the quality of life, then you need to inform the doctor. For example, they gave me strong side effects and paxil, and fluoxetine, and lerivon, but I have been living on amitriptyline for the 3rd month and working. Enjoying the life. I drank 2 months 3 times a day: in the morning 1/2, in the afternoon 1/2 and at night - a whole pill, and from November I removed the daily dose. One single side effect: I recovered by 5 kg ... But this is nothing.

27. Alevtina

    I took this drug six months ago. Before I started taking it, I suffered from a terrible depression, I didn’t want to live: I blamed myself for everything, I was afraid. I began to drink amitriptyline 50 mg 3 times a day, slept from them almost around the clock, dizziness, tinnitus. But after a week, positive thoughts began to appear, the mood improved. I realized that my fears were greatly exaggerated, and now I consider my mistakes (not so terrible) as an experience. After the first improvements, I reduced the dose, although they said it was impossible, little time had passed. Stopped taking much earlier than prescribed. There was no withdrawal syndrome, since the summer I have not taken amitriptyline and everything is in order. But doctors still need to be obeyed and taken as prescribed. The drug is good, at least it helped me a lot, otherwise I didn’t get out of bed, I kept crying.
    Thank you family for being patient and supporting me.

G.

Yes, I also drank it for 3 weeks, with an increase in the dose. I had secondary depression and didn’t sleep well, so in principle he helped me! But at the beginning of day 2.3, the state was bad, everything was annoying! and after drinking the course that I was prescribed, it became somehow for everything, forgive me FSUs .... less to heart I accept everything that I really like)))

28. Maria, 35 years old, Moscow

    For those who are afraid to sit down. I have long been drinking courses autumn-spring. There is a natural break.
    There was a time when I only drank at night. But I noticed that my heart rate increased. I divided the dose into two doses: in the morning and in the afternoon. The action is the same, but the feeling is much more pleasant.

29. Natasha 36 years old Saratov

    they prescribed this muck, the state is like a coma, I’ll quit drinking, I tried it for only three days, all three days of the state of depression, heaviness in the whole body, but I need something completely different - working capacity and a good mood, and here only some kind of debilitating calmness, two once taking 1/4 tablet caused panic attacks. no, I’d better get along without antidepressants, it’s neurologists and psychiatrists who can’t do without their appointment, let them prescribe them to those who have MDP, and not VSD. I only feel better before them, on you - they ruined everything with this amitriptyline.

30. Tanya

    I just started drinking amitriptyline 1/6 at night. Guys, a young man left me, these pills in a small dose help a lot, I forgot about him and now I don't care who he is and what he is!))))))))))))))))))))) I get high

31. Dmitriy

    After taking it, side symptoms were very pronounced - half of the body was generally numb, especially the next morning (after 2 tablets at night), dry mouth was terrible, I quit drinking it, nafig, it looked like withdrawal for another 2 days, PPC. glitches began to catch in the minibus. I won't touch this crap anymore.

32. Svetlana

    Good afternoon, I used to take amitriptyline, but then it stopped helping, a year ago I started taking it again, and it helped for the time being. I want to know how long the body should rest after taking amitriptyline ...

33. Jeanne

    I’m saved only by him ... .. I’m already afraid that I won’t sit on it and become addicted .... It helps with headaches when you want to sleep, but the brain doesn’t turn off at all ... and in the morning you get up in a terrible mood and condition .... So that's just I am saved by them, I try to drink only at night ....

34. Angelica

    what happens if you drink 2.5 packs of amitriptyline

35. Larisa
36. okrwkukdh
37. esbswrrre

    Cool + for the post

38. TerryRom

    People, I can suggest an excellent group for finding sponsors and kept women in Krasnodar.

Amitriptyline is a drug from the group of antidepressants prescribed for depression, psychosis, emotional and phobic disorders. It has a pronounced sedative and thymoanaleptic effect - the treatment leads to the activation of the psyche and an improvement in mood. Refers to the antidepressants of the "old" generation.

Despite the rapid therapeutic effect, the opinions of doctors about this remedy in the first line of treatment are divided. Consider how amitriptyline works and is used, what is the danger of uncontrolled intake and overdose of the drug.

Description of instructions for use of amitriptyline

Amitriptyline is a drug from the group of tricyclic antidepressants. In addition to the main effects, it has an analgesic effect, helps in the treatment of bedwetting.

Amitriptyline is produced by several manufacturers - domestic Veropharm, ALSI Pharma, as well as foreign ones - Grindex, Nycomed, under different trade names:

• "Amizol";
• "Amirol";
• "Saroten retard";
• "Triptizol";
• "Elivel".

Amitriptyline belongs to the pharmacological group of antidepressants. Its gross formula is C20H23N. International non-proprietary name (INN) - amitriptyline.

Forms of release and composition

Amitriptyline is available in two dosage forms - tablets and solution.

1. Tablets of 10 and 25 mg for internal use. Packed in contour packs of 50 and 100 pieces.
2. Solution 10 mg/ml, 2 ml ampoules for intravenous and intramuscular administration. There are 10 pieces in a package.

The tablets contain 10 or 25 mg of the active substance - amitriptyline hydrochloride. Additional (inactive) substances - microcrystalline cellulose, talc, lactose monohydrate, silicon dioxide, magnesium stearate, pregelatinized starch.

The composition of the drug "Amitriptyline" in the form of a solution includes 10 mg of the active substance and additionally - hydrochloric (hydrochloric) acid, benzethonium and sodium chloride, dextrose monohydrate, water for infusion.

pharmachologic effect

The drug belongs to strong antidepressants. The mechanism of action of amitriptyline on the body is an increase in the concentration of norepinephrine in the synapses and serotonin in the nervous system (their reabsorption decreases). With long-term treatment, the functional activity of beta-2 adrenergic and serotonin receptors in the brain decreases. It has a pronounced anticholinergic effect (central and peripheral).

How does amitriptyline work for depression? - improves mood, reduces psychomotor agitation, anxiety, normalizes sleep. The antidepressant effect of the drug appears 2-3 weeks after the start of the intake.

In addition to the pronounced antidepressant effect, the drug has a number of other actions.

1. Antiulcer, associated with blocking histamine receptors in the digestive organs.
2. Decreased appetite.
3. An increase in the ability of the bladder to stretch and an increase in the tone of its sphincter, based on a decrease in the activity of serotonin and acetylcholine receptors.
4. If general anesthesia is planned, then it is necessary to warn the doctor about taking this medication, as it lowers blood pressure and body temperature.
5. Eliminates pain syndrome. When does amitriptyline start to help with pain? - according to patients, already for 2-3 days of treatment.
6. Eliminates nighttime urinary incontinence.

Indications for use

The list of indications is extensive, but the main reason for prescribing amitriptyline is depressive states of various origins.

What helps amitriptyline?

1. Depression - involutional, endogenous, neurotic, reactive, drug, on the background of alcohol withdrawal, organic brain damage. Especially flowing with anxiety, sleep disorders.
2. Emotional disorders of mixed nature. Amitriptyline may be prescribed for panic attacks.
3. Psychosis on the background of schizophrenia, alcohol withdrawal.
4. Behavioral disorders (changes in attention and activity).
5. Nocturnal enuresis.
6. Chronic pain syndrome - oncological, rheumatic diseases, postherpetic neuralgia, post-traumatic pain.
7. Nervous bulimia.
8. Prevention of migraine.
9. Ulcerative lesions of the digestive system.

Indications for the use of tablets and Amitriptyline solution are similar.

Dosage and administration

The therapeutic dose and duration of treatment are prescribed privately. How long can you take amitriptyline? - a course of no more than 8 months.

The use of tablets

Should I take amitriptyline before or after meals? Tablets are taken after meals, without chewing, to reduce the irritating effect on the stomach.

The instructions for use of Amitriptyline tablets indicate the following recommended dosages.

1. Treatment of depressive states. The initial dose is 25–50 mg at night. Then increase gradually, within 5 days to 200 mg per day, divided into 3 doses. If the therapeutic effect does not occur within 2 weeks, the daily dose is increased to the maximum possible - 300 mg.
2. Treatment of headaches, migraine, chronic pain syndrome. The therapeutic dose is 12.5-100 mg per day, the average is 25 mg. How to take amitriptyline for headaches and other types of pain? - once, at night.
3. The dosage of Amitriptyline tablets in other conditions is selected individually.

How to take amitriptyline at night for insomnia? If there is a sleep disturbance against the background of depression, then this does not require a change in the standard scheme, the drug is taken as described above.

Solution application

The solution is administered intravenously or intramuscularly, slowly. The daily dose is 20-40 mg, divided into 4 injections. Gradually switch to the oral form, that is, to tablets.

Use during pregnancy and lactation

The drug belongs to the C category of action on the fetus according to the FDA classification (negative effects were found in animal studies). Therefore, the appointment of amitriptyline during pregnancy is highly undesirable. It is used only if the intended benefit to the mother outweighs the risk to the fetus.

When the drug is prescribed during lactation, breastfeeding should be stopped for the entire course of treatment.

Application in childhood

Amitriptyline is prescribed for children to treat bedwetting:

• tablets - from the age of six;
• solution - from twelve.

It is rarely prescribed in childhood for the treatment of depressive states. In this case, the dose, frequency rate and duration of treatment are selected individually.

children's enuresis

How is amitriptyline taken in children with depression? - dosage as follows:

• at the age of 6 to 12 years - 10-30 mg per day or 1-5 mg / kg;
• adolescents from 12 years old - up to 100 mg.

For nocturnal enuresis:

• children from 6 to 10 years old, 10-20 mg per day at night;
• adolescents 11-16 years old - up to 50 mg per day.

Use in the elderly

In old age, it is mainly prescribed for mild depressive disorders, bulimia nervosa, mixed emotional disorders, psychosis on the background of schizophrenia and alcohol dependence.

How to take amitriptyline in the elderly? At a dose of 25-100 mg at night, once. After achieving a therapeutic effect, reduce the dose to 10-50 mg per day.

Side effects and complications

Side effects of amitriptyline develop very often and can be so pronounced that they exceed the therapeutic effect of the treatment. In this regard, the decision on the appointment is always made carefully, and patients and their loved ones should evaluate their condition during treatment.

dilated pupils

Side effects associated with anticholinergic action:

• blurred vision, dilated pupils, accommodation paralysis, increased intraocular pressure in people with a narrow angle of the anterior chamber of the eye;
• dry mouth;
• confusion;
• constipation, paralytic ileus;
• difficulty urinating.

Side effects from the central nervous system:

For the cardiovascular system:

• tachycardia;
• arrhythmia;
• orthostatic hypotension;
• ECG changes in patients who do not have heart disease;
• jumps in blood pressure;
• violation of intraventricular conduction.

From the gastrointestinal tract:

From the endocrine system:

• swelling of the testicles;
• an increase in the mammary glands in men;
• decrease or increase in libido;
• problems with potency;
• increase or decrease in blood sugar;
• decreased production of vasopressin.

Allergic reactions:

• skin rash, urticaria;
• angioedema (Quincke);
• photosensitivity.

Other side effects:

• noise in ears;
• hair loss;
• edema;
• increase in body temperature;
• enlarged lymph nodes;
• urinary retention.

special instructions

Take precautions seriously and balance the risk of adverse reactions with the benefits of treatment.

Based on possible reactions, the following categories of people should use this medicine with extreme caution:

• suffering from alcoholism;
• children and adolescents under 14 years of age;
• elderly patients;
• with diseases such as schizophrenia, bronchial asthma, bipolar disorder, epilepsy, inhibition of bone marrow hematopoiesis, heart and vascular diseases, intraocular hypertension, stroke, decreased motor function of the stomach and intestines, liver, kidney failure, thyrotoxicosis, prostate enlargement, urinary retention, bladder hypotension.

Contraindications

All of the following contraindications to the use of amitriptyline are absolute! Therefore, when prescribing a drug, the doctor always studies the patient's history.

When is amitriptyline contraindicated? - under the following conditions:

• hypersensitivity to the drug;
• acute and subacute periods of myocardial infarction;
• in combination with MAO inhibitors, as well as 2 weeks before the start of their intake;
• alcohol intoxication;
• poisoning with sleeping pills, psychoactive, analgesic drugs;
• angle-closure glaucoma;
• violation of atrioventricular and intraventricular conduction of a severe degree;
• lactation period;
• galactose intolerance;
• glucose-galactose malabsorption;
• lactase deficiency;
• tablets are contraindicated in children under 6 years of age, and the solution is up to 12;
• pregnancy, especially in the first trimester.

Storage conditions and shelf life

"Amitriptyline" in tablets and solution should be stored in a dry, dark place, at a temperature not exceeding 25 ° C. Children and people with mental illness, alcoholism and drug addiction should not have access to medicine!

The shelf life of the drug is 3 years.

Amitriptyline and alcohol

Mixing this medicine with alcohol is strictly prohibited! In some cases, amitriptyline is prescribed for the relief of withdrawal symptoms in alcoholics after hard drinking, but only strictly in a hospital.

Why is the combination of amitriptyline with alcohol dangerous?

1. A person from their joint intake falls asleep soundly - the hypnotic effect of the drug is enhanced several times. Exceeding the dose of amitriptyline in this case is the cause of a violation of the respiratory system, which can lead to cardiac arrest.
2. The effect of alcohol intensifies - the effect of drinking a glass of beer can be like that of the same amount of vodka.
3. A dangerous combination is used by many people to enhance the hypnotic effect of amitriptyline (deliberate but slight overdose). Very quickly develops addiction, similar to a drug. A person ceases to think sensibly, assess the danger of the situation, accurately dose the drug, so every pill taken can be fatal. With severe poisoning with amitriptyline with alcohol, the chances of survival tend to be zero.
4. The consequence of the regular combination of amitriptyline with a small amount of alcohol is an irreversible change in the human psyche - intelligence decreases, memory deteriorates, everyday and professional skills are lost. All organs and systems suffer, especially the liver, kidneys, heart, blood vessels, brain. All side effects of amitriptyline are fully manifested.
5. Between taking alcohol and amitriptyline should withstand the time. You can't take it with a hangover. Even if consumed a day after taking the tablets, symptoms of poisoning may appear - nausea, vomiting, decreased visual acuity. When can I take amitriptyline after alcohol? - not earlier than in two days!

It is impossible to combine amitriptyline and alcohol under any circumstances, as it is deadly!

Dependence on amitriptyline

The drug does not belong to narcotic drugs, since it does not have an intoxicating or intoxicating effect, it does not cause classical physiological addiction, like opiates. Dependence on amitriptyline is only psychological and has nothing to do with physical craving for the drug. To understand the nature of addiction, you need to know the principle of the drug - natural neurotransmitters do not decay in the body at a normal rate, so they remain unchanged for a long time. The effect of taking amitriptyline is achieved by maintaining a constant concentration of serotonin and other neurotransmitters at a high level.

Is amitriptyline addictive? Like all antidepressants, it is able to form a certain dependence - with a sharp withdrawal, the symptoms return again. Only in this sense can amitriptyline be considered as a drug, since while the drug is taken, the person is well, and when the course is completed, the state returns. It happens that patients switch from antidepressants to real drugs. Therefore, in order to exclude possible harm from amitriptyline, its reception is canceled gradually, within a month.

withdrawal syndrome

With a sharp refusal of the drug, especially if it was taken in high doses, the development of amitriptyline withdrawal syndrome is possible. What are the symptoms of this?

• nausea;
• vomit;
• headache;
• diarrhea;
• sleep disorders;
• malaise;
• nightmares.

Even with a gradual refusal, motor restlessness, irritability, sleep disturbances, and difficult dreams develop.

How long does amitriptyline withdrawal last? - the condition is observed during the time until the entire drug is excreted from the body, that is, 8-14 days. Further manifestations are already more psychological in nature.

The scheme for reducing the intake of amitriptyline is a gradual decrease in the therapeutic dose over a month, starting from ¼ and until completely canceled.

Overdose

An overdose of a drug is not uncommon, therefore, in most cases, the drug is prescribed only to inpatients, under the supervision of a doctor.

Amitriptyline poisoning according to ICD-10 class

sified - T43.

Reasons for an overdose

Exceeding the dose for a single dose of the drug most often occurs in the following cases:

• non-compliance with the dose prescribed by the doctor (deliberate or accidental excess);
• self-administration of the drug without a doctor's prescription;
• combination of the drug in a therapeutic dose with alcoholic beverages.

Overdose symptoms

Depending on the amount of amitriptyline taken, there are 3 degrees of overdose - mild, moderate and severe, which, without resuscitation, ends in death in 100% of cases.

Children are most sensitive to acute overdose, up to death.

A mild overdose of amitriptyline is expressed by the following symptoms:

• dry mouth;
• constipation;
• lack of urination;
• dyspepsia.

Moderate to severe overdose symptoms are always serious and require immediate medical attention.

1. From the side of the central nervous system - increased drowsiness, hallucinations, causeless anxiety, epileptic seizures, increased reflexes, impaired pronunciation, muscle rigidity, confusion, loss of orientation in space, impaired concentration, psychomotor agitation, ataxia, stupor, coma.
2. From the side of the heart and blood vessels - arrhythmia, tachycardia, impaired intracardiac conduction, heart failure, a sharp decrease in blood pressure, shock, cardiac arrest (rarely).
3. Other manifestations are a decrease in the amount of urine, up to its complete absence, hyperthermia, increased sweating, vomiting, shortness of breath, respiratory depression, cyanosis, kidney and liver dysfunction.
4. At the terminal stages, blood pressure drops, pupils do not react to light, reflexes fade, liver and heart failure and respiratory arrest develop.

The lethal dose is 1.5 grams of amitriptyline taken at a time. However, smaller amounts are enough for children.

Treatment of poisoning

At the first signs of an overdose, the following pre-medical measures should be taken.

1. Call an ambulance.
2. Give the patient a liter of water to drink and provoke him to vomit. Repeat this procedure until clean wash water appears.
3. Take enterosorbents to reduce the absorption of the drug into the blood - "Enterosgel", activated carbon, "Atoxil", "Polysorb MP" and others.
4. If a person has lost consciousness, he must be turned to the side.

Treatment of poisoning with amitriptyline is carried out in intensive care and includes the following therapeutic measures.

1. Emergency gastric lavage.
2. The introduction of saline solutions to maintain the level of blood pressure, correction of acidosis, water and electrolyte balance.
3. Taking cholinesterase inhibitors to eliminate anticholinergic manifestations.
4. The introduction of glucocorticoids with a sharp drop in blood pressure.
5. Prescribing antiarrhythmic drugs for the heart.
6. Round-the-clock monitoring of the patient with monitoring of blood pressure and heart rate.
7. In severe cases - resuscitation, anticonvulsant measures, blood transfusion.

Hemodialysis and forced diuresis have not proven effective in amitriptyline overdose.

There is no specific antidote for amitriptyline poisoning.

Consequences of poisoning

A severe overdose is fatal, even if medical care was provided on time. The cause of death is cardiac arrest, respiratory arrest, severe arrhythmia.

The consequences of an overdose of amitriptyline remain, even if the person managed to survive:

• mental changes, severe depression;
• chronic renal and hepatic insufficiency;
• violation of the heart rhythm.

Residual effects are observed throughout life and require constant drug therapy.

Analogues

The structural analogue of amitriptyline is the imported drug "Saroten retard", which is manufactured by H. LUNDBECK A/S (Denmark).

What else can replace amitriptyline? Group analogues are "Anafranil", "Doxepin", "Melipramine", "Novo-Triptin" - the drugs have the same effect, but differ in composition. These drugs are modern analogues of amitriptyline without the presence of side effects characteristic of taking an antidepressant.

Interaction with other drugs

Before you start treatment with amitriptyline, you need to tell your doctor about all the medicines that you take constantly.

1. It cannot be combined with MAO inhibitors.
2. Amitriptyline enhances the inhibitory effect on the brain of sedatives, hypnotics, analgesics, drugs for anesthesia, antipsychotics and ethanol-containing drugs.
3. Reduces the effectiveness of anticonvulsants.
4. May be given in combination with sleeping pills (for example, Sonapax is taken with amitriptyline). But in this combination, it increases the anticholinergic activity of Sonapax - that is, it reduces the ability of brain cells to transmit nerve signals.
5. In combination with other antidepressants, the effects of both drugs are enhanced.
6. When combined with antipsychotics and anticholinergic drugs, body temperature may increase and paralytic ileus may develop.
7. Amitriptyline enhances the hypertensive effects of catecholamines and adrenostimulants, increasing the risk of tachycardia, cardiac arrhythmias, and severe hypertension.
8. May reduce the antihypertensive effect of guanethidine and related drugs.
9. In combination with coumarin or indandione derivatives, the anticoagulant activity of the latter may increase.
10. In combination with cimetidine, the concentration of amitriptyline in the blood plasma increases, which increases the likelihood of developing toxic effects.
11. Inducers of microsomal liver enzymes (carbamazepine and other barbiturates) reduce the concentration of amitriptyline.
12. Quinidine reduces the metabolism of amitriptyline.
13. Estrogen-containing hormonal agents increase the bioavailability of amitriptyline.
14. In combination with disulfiram and acetaldehyde dehydrogenase inhibitors, delirium may develop.
15. Amitriptyline is able to increase depression, which appeared on the background of taking glucocorticoids.
16. In combination with drugs for the treatment of thyrotoxicosis, the risk of developing agranulocytosis increases.
17. Combinations with nootropics lead to a weakening of the effect of these drugs and increase the likelihood of side effects.
18. With caution, you need to combine with digitalis preparations and baclofen.
19. Good compatibility of amitriptyline with antibiotics, antiviral drugs (for example, Acyclovir). Can be combined as prescribed by a doctor.

FAQ

Niche we will answer popular questions based on search queries that relate to the features of the use of amitriptyline and its combination with other drugs that are not listed in the official instructions.

1. Is amitriptyline available by prescription or not? Terms of sale in pharmacies - only by prescription.
2. What is the compatibility of amitriptyline and Donormil, can these drugs be combined? This combination is practiced by doctors - amitriptyline will enhance the effect of Donormil. But drugs are taken at different times of the day and strictly in a hospital under the supervision of a doctor.
3. What is the compatibility of amitriptyline and Phenibut? Since "Fenibut" refers to nootropics, in combination with amitriptyline, the therapeutic effect of both drugs is reduced, and the likelihood of side effects increases. This combination should be discussed with your doctor.
4. Is amitriptyline compatible with Corvalol? The drugs do not have antagonism, but Corvalol contains phenobarbital, which can enhance the effect of amitriptyline.
5. Is carbamazepine (Zeptol, Carbalepsin retard, Tegretol, Finlepsin) compatible with amitriptyline? The drugs can be administered together, but it should be remembered that there may be an increase in the inhibitory effect on the central nervous system, a decrease in the anticonvulsant efficacy of carbamazepine and a decrease in the concentration of amitriptyline in the blood.
6. Can amitriptyline be taken with phenazepam? Such drugs can be prescribed in parallel only in short courses, to speed up the relief of symptoms and reduce the side effects of the antidepressant.
7. Is there compatibility between amitriptyline and cinnarizine? Appointment, perhaps, but under the supervision of a doctor, since in this combination the effect of the antidepressant will be enhanced.
8. What is the compatibility of fluoxetine and amitriptyline, can they be combined? Fluoxetine is also an antidepressant, but from a different group and with a different mechanism of action. The combination is possible using the minimum therapeutic doses of drugs and only as prescribed by a doctor, but it is dangerous for the development of side effects.
9. Is Velafax compatible with amitriptyline? It is also an antidepressant, the mechanism of action of which is different. Their combination is possible, but taking the drugs is divided by time - "Velafax" in the morning, and amitriptyline in the evening at a lower dose and be sure to monitor the reaction of the body in order to exclude a depressant effect on the central nervous system.
10. Is amitriptyline compatible with piracetam? Nootropics are not recommended to be combined with antidepressants due to the difference in their action - stimulating versus calming. The effectiveness of the two drugs may decrease and the risk of side effects may increase. If such a combination is prescribed by a doctor, then it is advisable to divide the intake of tablets by time.
11. Is it possible to drink amitriptyline and Paxil at the same time? These are two antidepressants from different groups. This combination is used, but cannot be taken on its own, as there is a risk of enhancing the effects of both of them.
12. What is the compatibility between amitriptyline and Eglonil? It is an antipsychotic with an antipsychotic effect, therefore, when used together, there is a risk of increasing the inhibitory effect on the central nervous system. If such a combination is practiced, then the drugs are prescribed at different times.
13. Can I take escitalopram with amitriptyline? Combining two antidepressants is not always appropriate. Sometimes this combination is practiced for severe depression, but the best therapeutic effect develops with a combination of an antidepressant and a tranquilizer.
14. Is it possible to take Afobazol and amitriptyline together? The drugs are compatible since "Afobazol" refers to tranquilizers and is often prescribed in combination with antidepressants. But against the background of a stronger amitriptyline, the effect of Afobazole may be lost, therefore, only a doctor should deal with the selection of therapeutic doses.
15. Can amitriptyline and Atarax be taken together? This is a drug from the group of tranquilizers, so it is likely to be combined with amitriptyline in depressive states. But they must be taken at different times.
16. Are there drugs similar to amitriptyline that can be bought without a prescription? There are light over-the-counter drugs, the effect of which can be attributed to antidepressants - Persen, Novo-Passit, Deprim, Azafen and others. But selling medicines without a prescription does not mean that you can prescribe the treatment yourself!
17. Can amitriptyline and Finlepsin be taken together? The drug is used to treat epilepsy, as well as neuralgia and pain syndrome, therefore, it is likely that amitriptyline will increase the inhibitory effect on the central nervous system or decrease its concentration in the blood.
18. Can amitriptyline be taken as a sleeping pill? When insomnia is not associated with depression, the drug is not indicated.
19. If you take amitriptyline frequently, what are the consequences? Long-term continuous treatment is always associated with a high risk of side effects. Therapy with such a serious drug should be carried out only under the supervision of a physician and in adequate doses.
20. Can you give amitriptyline to a drunk person? No, it is absolutely incompatible with alcohol!
21. Does amitriptyline have a cumulative effect? Yes, the therapeutic effect of this medicine is cumulative and fully occurs in 2-3 weeks.
22. Why get fat from amitriptyline? One of its side effects is increased appetite. Sometimes this leads to weight gain.
23. Does amitriptyline raise or lower blood pressure? The drug is able to both reduce and increase it. Jumps in indicators can be observed during the day.
24. How to get rid of weakness after taking amitriptyline? Addiction to the drug lasts for 7-14 days. If the condition does not improve, you should reconsider the dose or change the medicine to another one.
25. How long does amitriptyline last? The active substance enters the bloodstream within 30 minutes after ingestion and remains there for about 7-10 hours (maximum 28 hours). Approximately so much one accepted dose of the drug acts.
26. How long does it take for amitriptyline to be cleared from the body? Its complete elimination occurs 7-14 days after the end of the intake.
27. Which doctor prescribes amitriptyline? - psychiatrist.
28. How long can I take amitriptyline without a break? The course of treatment is a maximum of 8 months.

Amitriptyline is a potent drug that belongs to the "old" generation of antidepressants. Its severe side effects sometimes outweigh the benefits of treatment. Therefore, the decision to take it should be made only by a doctor. Self-prescription of such a medicine is life-threatening!

The name in Latin is amitriptyline.
The active substance is amitriptyline.
Pharmacological properties - an antidepressant, a non-selective inhibitor of the reuptake of norepinephrine and serotonin.
Manufacturers - Moscow Endocrine Plant, ALSI Pharma, Ozone, Dalchimpharm, ZiO-Health, Moskhimfarmpreparaty im. N. A. Semashko, Grindeks (Latvia), Zentiva (Czech Republic), Takeda (Japan), Sintez, Bryntsalov-A, Apotex Inc. (Canada), Veropharm, H. Lundbeck A/O (Denmark).

Amitriptyline is a classic tricyclic antidepressant. The drug was synthesized one of the first, it is called the "old antidepressant". However, even today, the drug occupies a leading position in the treatment of severe depression and chronic pain syndromes. The advantage of amitriptyline is a pronounced dual effect on serotonin and norepinephrine. This provides a high efficacy of the drug both in the case of depression and chronic pain. However, the drug has a number of contraindications and side effects. Therefore, it is impossible to talk about the universality of drugs in this group.

pharmachologic effect

Remedy for depression. Reduces anxiety, marked emotional arousal, depressive manifestations. The principle of action against depression is due to an increase in the amount of noradrenaline in the synapses and / or serotonin in the central nervous system (decrease in their reabsorption). The accumulation of these neurotransmitters is observed due to the suppression of their reuptake by the membranes of presynaptic neurons.

The action of the antidepressant occurs two to three weeks after the start of the drug administration.
Amitriptyline has a sedative, M-anticholinergic, antihistamine, antiserotonin, thymoleptic, anxiolytic and analgesic, antiulcer effect.

During general anesthesia, it lowers blood pressure and body temperature.
Does not inhibit monoamine oxidase.

Dosage forms of the drug

Amitriptyline is manufactured by many manufacturers. The main forms of the drug are tablets, injection solution:

• solution for injection - ampoules 20 mg / 2 ml, vials 10 mg / ml;
• tablets 0.025 g;
• sugar-coated tablets 10 mg, 25 mg;
• tablets, film-coated 10 mg, 25 mg, 50 mg, 75 mg;
• dragee 25 mg;
• capsules of the prolonged action of 50 mg.

The quantitative composition of the drug, as well as the specific gravity of the active substance, may be different.

Compound

The composition of the solution for injection:

• active agent - amitriptyline hydrochloride;
• excipients - glucose (dextrose), water for injection.

Composition of film-coated tablets:

• excipients - magnesium stearate, talc, povidone, potato starch, microcrystalline cellulose, lactose monohydrate.

Shell composition: propylene glycol, hypromellose, titanium dioxide, talc.
The composition of the tablets:

• active substance - amitriptyline;
• excipients - lactose, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, polyethylene glycol 6000, talc, polysorbate 80, colloidal silicon dioxide, hypromellose, titanium dioxide (E 171), carmoisin (E 122).

The composition of the capsules of prolonged action:

• active substance - amitriptyline hydrochloride;
• excipients - stearic acid, sugar spheres, shellac (unwaxed shellac), talc, povidone.

The composition of the empty capsule is gelatin, iron dye red oxide (E 172), titanium dioxide (E 171).

Indications

• severe forms of depression, especially with typical symptoms of anxiety, emotional arousal, sleep disturbances: recurrent (repeating), reactive (after mental trauma), neurotic, drug, with alcohol withdrawal, organic brain damage, including in childhood;
• schizophrenic disorders of mental activity, depressive states in patients with schizophrenia;
• mixed disorders of the emotional state;
• disturbances of attention, vigorous activity;
• nocturnal enuresis (except for patients with reduced tone of the bladder walls);
• nervous;
• chronic pain syndrome - pain in cancer patients, rheumatic diseases, atypical pain in the face, postherpetic neuralgia, neuropathies of various origins (diabetic, post-traumatic, other peripheral neuropathy);
• migraine prevention;
• peptic ulcer of the stomach and duodenum.

Tricyclic antidepressants are becoming first-line drugs for severe disorders.

Contraindications

Individual hypersensitivity to amitriptyline, excipients that make up the drug.
Use simultaneously with drugs that inhibit monoamine oxidase and two weeks before the start of treatment.
in the acute and subacute period.
Acute alcohol intoxication.
Acute intoxication with hypnotics, analgesics and psychoactive drugs.
Angle-closure glaucoma.
Severe disorders of the heart - atrioventricular block II degree, violations of intraventricular conduction (blockade of the legs of the bundle of His).
Children's age up to 6 years when taken orally, age up to 12 years when administered by injection.
Amitriptyline is used with caution in arrhythmias, coronary heart disease, heart failure, thyroid diseases, a history of convulsions, pheochromocytoma, porphyria, anesthesia.
Amitriptyline is not prescribed during pregnancy (primarily in the I and III trimesters), except in cases of emergency. Controlled clinical studies of the safety of the use of amitriptyline during pregnancy have not been conducted.
During therapy, breastfeeding is contraindicated.

Method of administration and dosage

Amitriptyline is taken orally without chewing immediately after a meal to reduce irritation of the gastric mucosa.
The initial dose for adults is 25-50 mg at bedtime, then the dosage increases over 5-6 days to 150-200 mg per day in three doses, the largest part of the dose is prescribed. If after 14 days there is no improvement, the daily dose is increased to 300 mg.

With the disappearance of signs of depression, the dose is reduced to 50-100 mg per day and therapy is continued for at least three months.
In old age, with mild disorders, it is prescribed at a dose of 30-100 mg per day at night, after achieving a therapeutic effect, they switch to the minimum effective dose - 25-50 mg per day.

Injections should be administered slowly at a dose of 20-40 mg four times a day, gradually replacing ingestion. Duration of treatment - no more than 6 - 8 months.
For nocturnal enuresis:

• in children 6-10 years old - 10-20 mg per day at night;
• in children 11-16 years old - 25-50 mg / day.

Children as an antidepressant:

• from 6 to 12 years - 10 - 30 mg or 1 - 5 mg per kilogram of body weight per day fractionally;
• adolescents - 10 mg three times a day, if necessary - up to 100 mg per day.

For the prevention of migraine, with chronic neurogenic pain, prolonged headaches - from 12.5 - 25 to 100 mg per day. The maximum portion of the dose is taken at night.

Side effect

In addition to the effect on neuronal processes, amitriptyline has many secondary neurochemical effects that cause their side effects:

• antagonism against M1-cholinergic receptors determines the development of anticholinergic syndrome - tachycardia, dry mouth, disturbance of accommodation, constipation, urinary retention, confusion (delirium or hallucinations), paralytic ileus;
• blockade of alpha1-adrenergic receptors causes orthostatic circulatory disorders (dizziness, weakness, blackout, fainting), reflex tachycardia;
• blockade of H1-histamine receptors - sedation, weight gain;
• a change in ion metabolism in the tissue of the brain and heart reduces the threshold for convulsive readiness and contributes to the manifestation of a cardiotoxic effect - the rhythm of contractions and conduction of impulses to the myocardium is disturbed.

The severity of side effects often provokes doctors to use inadequately low dosages, and also significantly reduces patient adherence to therapy, which sharply reduces the effectiveness of treatment.

Due to the risk of severe poisoning with tricyclic antidepressants, they are chosen by patients with suicidal tendencies to realize their aspirations. Therefore, drugs are prescribed so that the patient could not accumulate enough of them to commit suicide.

Interaction with other drugs

Amitriptyline analogs

Drugs, the main active ingredient of which is amitriptil, are Amizol, Elivel, Saroten retard. Conditionally analogues of the drug can be called drugs belonging to the group of tricyclic antidepressants: imipramine, clomipramine, desipramine, doxepin, pipofezin, tianeptine. However, their pharmacological activity differs.

In general, the effect of the treatment of any antidepressant, especially with long-term use, is realized through a complex effect on most neurotransmitter and receptor systems of the brain. Therefore, the individual spectrum of psychotropic, neurotropic and somatotropic action of drugs against depression depends on the ratio of the primacy and strength of these effects. Their cumulative accounting allows you to choose the only correct drug in each case, which ultimately determines the clinical success of therapy.

Attention! The description of the drug is a simplified and supplemented version of the official instructions for use. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication.

"Amitriptyline" is widely used by medical psychotherapists and psychiatrists to eliminate the symptoms of depression, insomnia, anxiety and fear.
The drug amitriptyline, in addition to antidepressant effects (unlike antidepressants SSRIs - Selective serotonin reuptake inhibitors) is a non-selective monoamine uptake inhibitor (serotonin, dopamine, norepinephrine ...), and additionally has a calming, anti-anxiety and hypnotic effects.

Thus, amitriptyline tablets will not bad help you relieve some depressive, neurotic symptoms, but they are unlikely to cure the disease itself, its source.
To learn more, including about the analogues of this drug, read the article to the end.

Amitriptyline tablets - indications for use

Indications for the use of Amitriptyline, in addition to depression, neurotic manifestations, fears and phobias, insomnia and anxiety, are neurotic personality disorders such as anorexia, bulimia, neurogenic pain, migraine and even enuresis in children.
Only your doctor can prescribe the drug and doses. Do not experiment on your health, do not play a psychotherapist - consult a specialist on Skype.

Amitriptyline - side effects, contraindications and complications

Side effects of amitriptyline are wide and ambiguous. This antidepressant drug has many contraindications and complications, especially if the medication is taken incorrectly and uncontrolled by the doctor.

Side effects when taking amitriptyline are more pronounced and more dangerous than with other tricyclic antidepressants. Unlike selective antidepressants (SSRIs), this medicine is much worse tolerated by patients.

The main side effects and effects of amitriptyline:
dry mouth, blurred vision, constipation, up to intestinal obstruction, difficulty urinating, hand tremor, drowsiness, lethargy, dizziness, apathy and passivity, weakness, lowering blood pressure, tachycardia, fainting, convulsions, decreased libido and potency, etc.

Complications associated with taking amitriptyline:
At high doses, there is a possibility of death. In severely depressed patients, amitriptyline may induce suicidal thoughts, possibly with actual behavior. Also, some neurotic disorders may develop: hypochondria, depersonalization, asthenia…

Amitriptyline contraindications:
Amitriptyline should not be used while intoxicated, with coronary heart disease, with myocardial infarction, arrhythmias, with atony of the bladder, intestinal obstruction, diseases of the prostate, thyroid gland, during pregnancy.

When taking this medicine, in no case should you drive a car and other mechanisms, as well as go to work, where increased attention and reactions are required.

Amitriptyline - reviews of patients and psychotherapists

Reviews of patients taking amitriptyline suffering from depression and other psychological and emotional personality disorders are almost unambiguous - the drug helps to relieve some symptoms, improve the overall psycho-emotional state, but only while the patient is drinking these pills. Because amitriptyline does not cure the disease itself, therefore, with a decrease in doses or a complete withdrawal, which, by the way, cannot be done abruptly, the symptoms return.

Reviews of amitriptyline by medical psychotherapists are mixed, but many of them prescribe this drug, especially in free clinics.
Non-medical psychotherapists, for the most part, have a negative attitude towards the long-term use of this antidepressant. They suggest taking amitriptyline tablets in crisis situations, but in the future they prefer to treat the disease itself with various psychotherapeutic methods and techniques, without drugs.

Amitriptyline is an antidepressant drug from the group of tricyclic compounds. It has a calming, analgesic, antihistamine, hypnotic, antiulcer effect. Most often, this drug is prescribed for depression of various origins, neurosis, psychosis and some other pathological conditions.

Amitriptyline tablets are a fairly powerful tool that produces a systemic effect on the body. In addition to the positive therapeutic effect of this drug, which is achieved fairly quickly, many patients note the appearance of various side effects when using it. In most cases, side effects occur already 1 to 2 days after the start of drug therapy. Consider what are the side effects of Amitriptyline, why they occur, and to whom treatment with this remedy is prohibited.

Side effects of amitriptyline

Most often, the appearance of side effects of Amitriptyline is associated with its overdose (the maximum dose of the drug is individual for each person). They may also be due to the fact that when using the drug, a person abruptly changes the lying position to sitting and standing (all movements should be smooth). A negative effect is also manifested when Amitriptyline interacts with other drugs. Among these are:

• monoamine oxidase inhibitors;
• neuroleptics;
• anticoagulants;
• glucocorticoids, etc.

Among the side effects of Amitriptyline, we note the following:

1. From the digestive system:

• stomach ache;
• nausea;
• vomit;
• jaundice due to congestion in the bile ducts;
• stool disorders;
• changes in taste perception;
• liver dysfunction.

2. From the side of the cardiovascular system and the hematopoietic system:

• heart rhythm failures;
• lowering blood pressure;
• dizziness;
• disorders of the conduction system of the heart;
• changes in the percentage of red blood cells, white blood cells and platelets;
• changes in the electrocardiogram.

3. From the side of the nervous system:

• hallucinations;
• lethargy;
• fainting;
• drowsiness or insomnia;
• the occurrence of uncontrolled movements of the arms and legs;
• confusion;
• trembling of the head and limbs;
• headache;
• convulsions;
• yawn;
• epileptic seizures;
• decrease and increase of nervous excitability.

4. From the endocrine system:

• changes in sexual desire;
• change in glucose content;
• decrease in the content of sodium ions;
• breast enlargement.

5. Other side effects, including those associated with the therapeutic effect of the drug:

• various allergic manifestations (angioedema, urticaria, itching, etc.);
• increased intraocular pressure;
• visual disturbances;
• dry mouth;
• hair loss;
• fever;
• frequent urination, etc.

In no case should you drink alcohol-containing drinks during the treatment with this drug. The interaction of Amitriptyline and alcohol has a depressing effect on the central nervous system, and if the respiratory center is depressed, it can cause suffocation and death.