Amitriptyline detailed information

Jump to: navigation, search
Amitriptyline detailed information
Amitriptyline-2D-skeletal.png
Clinical data
Pregnancy
category
  • US: D (Evidence of risk)
Routes of
administration
Oral
ATC code
Legal status
Legal status
  • AU: Unscheduled
  • UK: POM (Prescription only)
Pharmacokinetic data
Bioavailability40%
MetabolismHepatic
Elimination half-life12-24 hours
ExcretionRenal
Identifiers
CAS Number
PubChem CID
DrugBank
E number{{#property:P628}}
ECHA InfoCard{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
FormulaC20H23N
Molar mass277.403 g/mol

Overview

Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. It is a white, odorless (but tastes like licorice), crystalline compound which is freely soluble in water; it is usually dispensed in tablet form. In terms of its mechanism of action, amitriptyline inhibits serotonin and noradrenaline reuptake almost equally.

Uses

Approved

Amitriptyline is approved for the treatment of endogenous depression and 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 It should be gradually withdrawn at the end of the course, which overall should be of no more than 3 months.[1]

In some European countries it is also approved as prophylaxis for patients with frequent migraines (usually 25 to 75 mg).

Unapproved/Off-Label/Investigational

Amitriptyline may be prescribed for other conditions such as insomnia, migraine, rebound headache, chronic pain, postherpetic neuralgia (persistent pain following a shingles attack), fibromyalgia, vulvodynia, interstitial cystitis, irritable bowel syndrome, diabetic peripheral neuropathy, neurological pain, and painful paresthesias related to multiple sclerosis and as a preventative (prophylaxis) for patients with frequent migraines. It is also used in small (10 mg) doses to act as a painkiller and ease the effects of Carpal Tunnel Syndrome. Typically lower dosages are required for pain modification of 10 to 50 mg daily.[1]

Amitriptyline in very small doses (5 mg a day) 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 refractory to famotidine and mosapride combination therapy.[2]

Side effects

Common side effects of using amitriptyline are extreme weight gain, drowsiness, nervousness, dizziness, and insomnia. Some rare side effects include tinnitus, hypotension, mania, psychosis, anticholinergic effects, heart block, arrhythmias, extrapyramidal symptoms, depression, and hepatic toxicity.

Overdose: The symptoms and the treatment of an overdose are largely the same as for the other tricyclic antidepressants.

Footnotes

  1. 1.0 1.1 British National Formulary 45 March 2003
  2. Otaka M, Jin M, Odashima M, Matsuhashi T, Wada I, Horikawa Y, Komatsu K, Ohba R, Oyake J, Hatakeyama N, Watanabe S. "New strategy of therapy for functional dyspepsia using famotidine, mosapride and amitriptyline." Alimentary Pharmacology & Therapeutics. 2005 Jun;21 Suppl 2:42-6. PMID 15943846 Fulltext

References

de:Amitriptylin it:Amitriptilina sv:Amitryptylin



Linked-in.jpg