Amitriptyline is a drug classified as an antidepressant drug.. Specifically, it belongs to the group of tricyclic antidepressants. They get this name from their chemical structure which comprises a chain of three links.
However, although many people are unaware of it, the truth is that this substance can be used for many other purposes than depression. For example, to treat insomnia or migraine. In this article, we explain everything you need to know about amitriptyline and when it is used.
What is Amitriptyline? How does it work?
As we have noted, amitriptyline is a tricyclic antidepressant drug. It is a substance that acts in the brain by inducing certain neurotransmitters to increase their concentration in the nerve endings. Specific, increases the availability of norepinephrine and serotonin.
Both norepinephrine and serotonin have essential functions on the nervous system. Your concentration is related to your motivation, mood, feeling of stress and anxiety.
serotonin, As explained by the Association of Prevention and Occupational Medicine Specialists, is known as the particle of happiness. However, in addition to being related to the feeling of well-being, it is also involved in intestinal function.
Amitriptyline inhibits the reuptake of both neurotransmitters. In this way, by bringing them to a greater concentration, their action on the brain and medulla is enhanced.
This medicine is usually given orally. It is rapidly absorbed, which allows its blood level to peak between 2 and 12 hours after ingestion. It is mainly eliminated in the urine.
For whatever purpose amitriptyline is used, treatment should start at low doses. Likewise, when removing it it should be done gradually. If it is stopped abruptly, side effects usually appear.
What is needed?
One of the primary uses of amitriptyline is the treatment of depression. However, as explained by Mayo Clinic specialiststhey are no longer the first line of approach due to their side effects. Selective serotonin reuptake inhibitors are currently preferred.
Another indication for this drug is insomnia. He Center for Disease Control and Prevention (CDC) estimates that nearly 35% of Americans are not getting enough sleep. The problem is that any medication prescribed for insomnia has to be for a short period of time.
Second Explain Cochrane, amitriptyline is also used to treat neuropathic pain. This is what happens after a nerve injury. For example, in diabetic neuropathy or postherpetic neuralgia.
In the case of children, as explained by the Spanish Association of Pediatrics, amitriptyline may be indicated to treat enuresis nocturnal, which is urinary incontinence that occurs during the night. It may also be useful for treating childhood depression, but only in people over the age of 12.
Amitriptyline side effects
The main reason amitriptyline is no longer the first choice for treating depression is that it often has side effects. These reactions can be more or less serious and vary according to the person and the dose.
It is important to note that this drug is contraindicated in many situations. For example, in people with certain heart problems, epilepsy, kidney problems or glaucoma. Likewise, its use in diabetics is not recommended.
The most frequently occurring side effects are dry mouth, constipation and drowsiness. Also, there may be a headache or difficulty urinating. Among the serious adverse reactions is the fact that it can increase the heart rate or produce arrhythmias.
What is the recommended dosage?
The recommended dose of amitriptyline depends on the purpose for which it will be used. Second explain inside National Institute of Health (NHS), can be administered in tablet or liquid form. The tablets can be 10, 25 or 50 milligrams.
As we have pointed out before, the ideal is to always start with the lowest dose. That is, 10 milligrams per day is recommended. Also, it’s best to do it before going to sleep, as it can cause drowsiness, especially in the beginning.
The dose may be increased based on weight or disease. However, you shouldn’t exceed 75 milligrams per day due to the risk of side effects.
If a dose has been missed, it is recommended to take it as soon as possible, but not to combine several. Amitriptyline can be taken with food or on an empty stomach. It should not be chewed, as it can produce an unpleasant taste in the mouth.
Interactions of amitriptyline with other drugs
Another of the big problems with amitriptyline is that it has a high risk of interactions with other drugs. First of all with substances that are used for cardiovascular pathologies. For example, antiarrhythmics such as quinidine.
It can also cause cardiac damage if amitriptyline is combined with epinephrine, phenylephrine, or other catecholamines. The same goes for methadone. All of these can cause dysregulation of the heart’s electrical activity.
Other antidepressants can interact with this drug, even after you’ve been off it for a while. Opioid substances, such as morphine and oxycodone, which are also used for pain, can cause breathing problems and lethargy when combined with amitriptyline.
Amitriptyline requires a prescription
One of the most important aspects to highlight about this drug is that it its effect may take some time to appear. When used to relieve neuropathic pain, it takes 5 to 7 days to work.
In case of depression, months of treatment are needed to be truly effective. Also, it is important to note again that it should be phased out.
The administration of amitriptyline is not recommended during pregnancy. At this stage, it is ideal to use other drugs, as they could cause negative effects on the fetus.
This drug has many benefits, however it is not without side effects. No antidepressant drug should be used without medical indication. Likewise, it is essential to understand that some problems cannot be treated with medication alone.
If your doctor prescribes a treatment with amitriptyline, it is essential that you follow the instructions for use. The doses must be those indicated and the time between them must be respected correctly.
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