Amitriptyline

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Sandoz Amitriptyline, Trepiline

Drug type:

Tricyclic antidepressant drug

Prescription needed:

Yes

What does it do?

 Amitriptyline can be used to treat various conditions:

• Depression: usually as 2^nd line treatment as it is poorly tolerated and dangerous in overdose
• Depression with anxiety or insomnia: due to its sedative side effects
• Nocturnal enuresis (bedwetting) in children
• Neuropathic pain: such as postherpetic neuralgia after shingles
• Prevention of migraine

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

• Adult dose 10–200mg daily, usually as a single dose at night

OVERDOSE ACTION

In overdose, amitriptyline may cause abnormal heart rhythms, seizures, and coma.

Seek immediate medical advice in all cases.

How quickly will it start to work?

Sedation: a few hours, full antidepressant effect: 2-4 weeks
         

How long will the effects last?

Up to 6 weeks

When should I stop using it?

Do not stop taking the drug abruptly, your doctor will gradually reduce the dose over 4 weeks to avoid withdrawal effects.
                     

Is it safe for prolonged use?

No problems expected.

What are the possible side effects?

The following have been reported:

• More common: drowsiness, sweating, dry mouth, constipation, blurred vision
• Less common: difficulty passing urine
• Report to your doctor before taking your next dose if you experience: dizziness, fainting, confusion, palpitations

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart problems, epilepsy, glaucoma, prostate problems, thyroid disease, psychotic illnesses
• Other medicines: Monoamine oxidase inhibitors (MAOIs), anti-epileptics, sedatives, anti-arrhythmic drugs
• Pregnancy and breast-feeding: Avoid if possible in pregnancy, passes into the breast milk but at normal doses adverse effects are unlikely.
• Children: Not recommended under 16 years for depression, or under 6 years for enuresis.
• Over 60: lower dose may be necessary to avoid side effects
• Alcohol: Avoid, enhanced sedative effect
• Driving and hazardous work: caution, may cause blurred vision and reduced alertness
• Surgery and general anaesthetics: Amitriptyline treatment may need to be stopped before you have a general anaesthetic