Amitriptyline is a medication which belongs to a class of medications known as tricyclic antidepressants. These drugs are able to affect the levels of different chemicals in the brain, known as neurotransmitters. By altering neurotransmitter levels, tricyclic antidepressants are able to treat depression and certain other medical conditions. Long-term use of amitriptyline can cause certain side effects, however.
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Some of the long-term side effects of amitriptyline have to do with its effects on the nervous system. For example, amitriptyline can cause nervousness, insomnia, and anxiety in some patients because it can stimulate the nervous system. In addition, amitriptyline can also block the effects of a chemical known as acetylcholine, which is used by nerves to control muscles, eMedTV reports. This can result in constipation, urinary retention and increased eye pressure. Other side effects are due to the drug's ability to affect the body's hormonal balance, resulting in swelling and tenderness of the breast tissue as well as testicular swelling for men. These side effects are generally temporary and will go away if the medication is no longer used. In some cases, however, amitriptyline can cause permanent liver and heart damage.
In an effort to minimize the risk of long-term side effects caused by amitriptyline, doctor's will often begin a patient at a low dose of the medication, PubMed Health states. Both the therapeutic and adverse effects of this dose will be monitored, after which the prescribing doctor may opt to up the dose. This will continue until the medication has the desired effect or the side effects become intolerable. In the event of the latter scenario, the dose will be reduced back to an acceptable level.
In order to prevent dangerous side effects from amitriptyline, it is important to take the drug exactly according to the physician's instructions. Ideally the pills should be taken at the same time or times each day which will help prevent fluctuating levels in the body. This will also help prevent missing or taking an extra dose. In the event that a dose is missed, it should be taken as soon as possible unless it is almost time for the next dose, in which case the missed dose should be skipped, Drugs.com notes. Under no circumstances should a patient take extra doses of the medication or stop taking it without contacting his physician, as this can cause dangerous side effects such as mania or organ damage.
Patients may need to have their liver and heart health assessed periodically while taking amitriptyline, particularly if they have a history of heart or liver problems. Liver function can usually be assessed using a series of blood tests, whereas an EKG or cardiac stress test can be performed to ensure that amitriptyline is not causing any long-term health issues.
Amitriptyline can interact with some medications, including cimetidine, which is used for acid reflux, and another class of antidepressants known as selective serotonin reuptake inhibitors, RxList explains. Patients should also avoid taking a class of drugs known as monoamine oxidase inhibitors while taking amitriptyline and should avoid grapefruit. Taking amitriptyline concurrently with drugs which interact with this medication can cause dangerous long-term side effects, so it is important that patients discuss all currently taken medications with their physicians upon starting amitriptyline. Patients should also inform their doctors about any changes in the medications that they take.