GENERIC NAME: amitriptyline

BRAND NAME: Elavil, Endep

DRUG CLASS AND MECHANISM: Amitriptyline is an antidepressant medication. Depression is an all-pervasive sense of sadness and gloom. In some patients with depression, abnormal levels of brain chemicals called neurotransmitters may relate to their depression. Amitriptyline elevates mood by raising the level of neurotransmitters in brain tissue.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Tablets: 10mg, 25mg, 50mg, 75mg, 100mg, 150mg.

STORAGE: Amitriptyline should be stored at room temperature in a tight, light resistant container.

PRESCRIBED FOR: Amitriptyline is used to elevate the mood of patients with depression. Amitriptyline is also a sedative, and is useful in depressed patients with insomnia, restlessness, and nervousness. It has also been found to be helpful for treating fibromyalgia and symptoms related to chronic pain.

DOSING: Amitriptyline may be taken with or without food. Amitriptyline is metabolized by the liver and should be used with caution in patients with liver dysfunction.

DRUG INTERACTIONS: Amitriptyline should not be used with monoamine oxidase inhibiting drugs. High fever, convulsions and even death can occur when these two drugs are used together. Epinephrine should not be used with amitriptyline, since together they can cause severe high blood pressure. Amitriptyline is used with caution in patients with seizures, since it can increase the risk of seizures. Amitriptyline is used with caution in patients with prostate enlargement because of risk of urine retention. Amitriptyline can cause elevated pressure in the eyes of certain patients with glaucoma . Alcohol blocks the antidepressant action of amitriptyline but increases its sedative effect. Amitriptyline can aggravate paranoid symptoms in patients with schizophrenia , and increase symptoms of mania in patients with manic-depressive disease. Cimetidine (Tagamet) can increase blood levels of amitriptyline and its side effects. Overdose with amitriptyline can cause life threatening abnormal heart rhythms. The sedative effect of the medication can possibly impair the mental and physical abilities required for driving or operating machinery.

PREGNANCY: Safety in pregnancy and children is not established.

NURSING MOTHERS: Amitriptyline is secreted in human milk, and potentially can adversely affect the nursing infant.

SIDE EFFECTS: Sometimes troublesome side effects include fast heart rate, blurred vision, urinary retention, dry mouth, constipation , weight gain or loss, and low blood pressure on standing. Rash, hives , seizures, and hepatitis are rare side effects.

"If antidepressants are discontinued abruptly, symptoms may occur such as dizziness , headache, nausea, changes in mood, or changes in the sense of smell, taste, etc. (Such symptoms even may occur when even a few doses of antidepressant are missed.) Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued."

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