Amitriptyline is an antidepressant drug approved in the United States as early as 1961. These medications are generally not approved for use in pediatric patients but offer benefits to adults who are under the care of a doctor for depression or generalized anxiety disorder.
Identification
Amitriptyline is a tricyclic antidepressant (TCA), or noradrenaline re-uptake inhibitor. These chemicals prevent neurons in the brain from reabsorbing noradrenaline, a hormone involved in the stress response. An overactive noradrenaline response has been associated with depression.
Forms
Amitriptyline is available in 10 to 150 mg amitriptyline hydrochloride tablets and taken orally, usually one to four times a day. Doctors generally begin a patient on a low dose, then gradually increase the dose as needed. The full benefit of the medication may not be achieved for several weeks. Some other forms of the medication are available, combining the TCA with a serotonin inhibitor in a single tablet.
Indications
Amitriptyline is usually prescribed to treat depression symptoms, but clinical studies have also shown that amitriptyline is useful against panic disorder, a form of anxiety. The drug also may be prescribed for eating disorders, migraines or post-shingles neuralgia.
Side Effects
Amitriptyline use has been associated with nausea; vomiting; drowsiness; weakness; nightmares; headaches; dry mouth; constipation; difficulty urinating; blurred vision; pain or tingling in the hands and feet; excessive sweating; confusion; unsteadiness; and changes in sex drive, appetite and weight. Alcohol consumption increases the drowsiness associated with the use of this drug. Serious side effects, such as slow or difficult speech, dizziness or fainting, weak or numb extremities, crushing chest pain, rapid or irregular heartbeat, skin rash, yellowing of the skin or eyes, muscle spasms or uncontrollable shaking, unusual bleeding, seizures, or hallucinations should be reported to a doctor and the Food and Drug Administration's MedWatch Adverse Event Reporting program at 1-800-332-1088.
Warnings
Patients who have had a heart attack, are pregnant or nursing, have been diagnosed with schizophrenia or seizures, have diabetes, or have liver or kidney disorders may be directed to take a different medication. In clinical trials of antidepressants like amitriptyline, some children, teens and adults up to 24 years of age were found to have increased suicidal thoughts while taking the medication. Tell your doctor about any changes in your mental health while taking the drug. Patients who stop taking amitriptyline suddenly may experience withdrawal symptoms, including nausea, headache and fatigue. Overdose can be toxic to the heart, so follow the directions on the prescription bottle carefully.
