(sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl, Saroten) is a tricyclic antidepressant drug
. It is a white, odorless (but tastes like licorice
compound which is freely soluble in water; it is usually dispensed in tablet form. In terms of its mechanism of action
, amitriptyline inhibits serotonin
reuptake almost equally.
Amitriptyline is approved most commonly for the treatment of depression (clinical/endogenous depression
, also involutional melancholia
'depression of late life', which is no longer seen as a disease in its own right). Adult typical dosages are 25 to 150 mg daily, with half this initially for elderly or adolescents.
It may also be used to treat nocturnal enuresis (bed wetting). Children between the ages of 7 to 10 years having a dose of 10 to 20 mg, older children 25 to 50 mg at night. It should be gradually withdrawn at the end of the course, which overall should be of no more than 3 months.
In some European countries it is also officially approved as a preventive (prophylaxis) for patients with frequent/chronic migraines, usually 25 to 75 mg.
Amitriptyline may be prescribed for other conditions such as insomnia
, rebound headache
, chronic pain
, chronic cough
, postherpetic neuralgia
(persistent pain following a shingles
attack), carpal tunnel syndrome
, interstitial cystitis
, male chronic pelvic pain syndrome
, irritable bowel syndrome
, diabetic peripheral neuropathy
pain, and painful paresthesias
related to multiple sclerosis
and at low doses as a preventive (prophylaxis) for patients with frequent migraines
Typically lower dosages are required for pain modification of 10 to 50 mg daily.
Amitriptyline in low doses is also sometimes prescribed to help ease the symptoms of chronic fatigue syndrome. It is thought to help combat symptoms of insomnia primarily, in addition to other selected symptoms of the affliction.
A randomized controlled trial published in June 2005 found that amitriptyline was effective in functional dyspepsia that did not respond to a first-line treatment (famotidine or mosapride).
Common side effects
of using amitriptyline are dry mouth, extreme weight gain, drowsiness, muscle stiffness, nausea, constipation, nervousness, dizziness, blurred vision and insomnia
. Some rare side effects include tinnitus
effects, heart block
, lip and mouth ulcers, extrapyramidal symptoms
, and hepatic toxicity
The symptoms and the treatment of an overdose are largely the same as for the other tricyclic antidepressants.