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Amitriptyline (sometimes called Amitryptyline) hydrochloride (popularly sold as Endep, Elavil, Elatrol, Trptanol, Laroxyl, Trepiline, Tryptizol) is a popular antidepressant drug. It is tricyclic in structure. It is a crystalline compound, white in color, without any odor and is completely water soluble in nature. Generally, it is sold in the form of tablets.

Drug Uses

Amitriptyline is usually prescribed for treating involutional melancholia and endogenous depression. The former refers to the depression which occurs in late life and is generally not seen as disease. The dosage is generally 25 to 150 milligrams daily. Another use of Amitriptyline is the treatment of bed wetting which is technically known as nocturnal enuresis. A dosage of 10 to 20 milligrams is prescribed for children from 7 to 10 yrs of age, for older children 25 to 50 milligrams is usually prescribed. The drug’s overall usage should not be more than three months and its intake should be withdrawn towards the end of treatment. In a few European countries, Amitriptyline is also used for the treatment of patients suffering from frequent migraines. The dosage is generally from 25 to 75 milligrams.

Other uses of the Amitriptyline include the treatment of conditions like insomnia, rebound, chronic pain, headaches, postherpetic neuralgia (consistent pain after a shingles attack), vulvodynia, fibromyalgia, irritable bowel syndrome, interstitial cystitis, diabetic peripheral, neurological pain, painful paresthesias in relation to several sclerosis and neuropathy. Amitriptyline is also used in small dosages as a painkiller.

In very lower amount of dosages, Amitriptyline is also prescribed sometimes to help relieve the indications of chronic fatigue syndrome. It is thought that Amitriptyline
helps in combating symptoms related to insomnia.

Side Effects

The following reactions should be considered when Amitriptyline is used.

    * Cardiovascular: Stroke; Myocardial infarction; heart block; irregular ECG changes; alterations in AV conduction; hypotension; palpitation; and others.

    * Neuromuscular and CNS: Coma; hallucinations; seizures; delusions; disorientation; confusional states; ataxia; peripheral neuropathy; tremors; drowsiness; dizziness; fatigue; weakness; headache; tinnitus; and others.

    * Anticholinergic: hyperpyrexia; Paralytic ileus; urinary retention; constipation; blurred vision; greater than before ocular pressure; disturbance in accommodation; dry mouth; mydriasis; and others.

    * Allergic: urticaria; Skin rash; edema of face and tongue; photosensitization.

    * Hematologic: Depression of Bone marrow; agranulocytosis, leukopenia, purpura; thrombocytopenia; eosinophilia.

    * Gastrointestinal: A very rare case of hepatitis (also including jaundice and changed liver function); epigastric distress; nausea; anorexia; vomiting; stomatitis; diarrhea; peculiar taste; black tongue; parotid swelling.

    * Endocrine: in the female, galactorrhea and breast enlargement; in the male, Gynecomastia and Testicular swelling; decreased or increased libido; lowering or elevation of sugar levels of the blood; impotence.

    * Other: edema; Alopecia; weight loss or gain; increased perspiration; urinary frequency.

Thus the drug should always be taken under medical supervision and in case of any
unusual symptoms, the doctor should be consulted immediately.


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