Amitriptyline refers to drugs from the group of psychoanaleptics and antidepressants. This tool is widely used in psychiatric and psychotherapeutic practice. It allows you to remove the manifestations of depression, insomnia, anxiety and causeless fears. But it must be borne in mind that the medicine only helps relieve symptoms, but does not eliminate the disease itself. In addition, this is a rather powerful tool, and before proceeding with treatment, it is worthwhile to study the indications for the use of Amitriptyline, as well as to know under what conditions it is prohibited.

General description and composition of the drug

Amitriptyline is a tricyclic antidepressant. There are several forms of release of this pharmaceutical product: tablets, dragees and solution.

 

The first two types of medicine contain the main active ingredient amitriptyline hydrochloride in a volume of 0.001 or 0.025 g. As an auxiliary agent that does not have a therapeutic effect, when creating tablets, microcrystals of cellulose, lactose monohydrate, colloidal silicon dioxide, starch, talc and magnesium stearate are used.

Tablets are packed in blisters and laid out in cardboard boxes. Dragee is sold in polymer cans, also packed in packs of cardboard. Medicines are white or slightly yellowish in color.

The solution for intramuscular or intravenous injection is presented in glass ampoules, where the content of the active ingredient is 10 mg in 1 ml of liquid.As additional compounds, hydrochloric acid, dextrose monohydrate, sodium chloride, and purified water are used.

The medicinal product remains suitable for 3 years from the date of release. Use it after this period is not recommended. Store the medicine box in a dark place at a relatively normal humidity and temperature not exceeding 25 degrees.

Attention! The antidepressant Amitriptyline is not available for sale: to obtain it, a prescription certified by your doctor is required.

pharmachologic effect

The main purpose of Amitriptyline is the elimination of mental and emotional problems. Such conditions are accompanied by depression, agitation, sleep disturbances, as well as lethargy. Due to the fact that Amitriptyline acts on the central nervous system and restores the balance of serotonin in the body, the patient's condition returns to normal after a few weeks.

In addition, the drug is able to exert the following effects, due to interaction with other receptors and systems:

  • sedative;
  • moderate analgesic;
  • antidiuretic, when it allows you to control urination;
  • antiulcer, because it affects receptors that are in the mucous membranes of the digestive tract.

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In addition, due to the impact on certain parts of the brain, Amitriptyline helps fight appetite disorders. And also with its help, blood pressure indicators in hypertensive patients are reduced.

Like many drugs in this group, amitriptyline is not completely absorbed. Its bioavailability is equal to 30-60%, depending on how the composition got into the body, by oral or injection route. The substance reaches its maximum concentration in the period from 2 to 12 hours. Healed compounds with urine.

Indications for the use of antidepressant

Amitriptyline solution, dragees or tablets can eliminate or reduce the severity of symptoms in the following painful conditions:

  • emotional disorders;
  • psychoses and schizophrenic diseases;
  • alcohol withdrawal;
  • behavioral problems associated with impaired attention and activity;
  • enuresis in childhood or in elderly patients;
  • bulimia nervosa;
  • pain syndromes with neuralgia, oncology and other problems;
  • ulcerative lesions of the digestive tract.

Attention! This drug is very strong, therefore, in order to avoid unpleasant consequences and drug intoxication, it is worth observing the dosage regimen and treatment regimen Amitriptyline prescribed by the doctor.

Amitriptyline Dosage

As the instructions for use say, the medicine can be taken with food or after meals. But at the same time, tablets or dragees must be washed down with a large amount of liquid, otherwise it will cause irritation of the mucous membranes of the stomach and intestines.

Dosage is prescribed depending on the age category and type of disease.

The doctor determines it individually in each case, but there are also such standard schemes:

  1. Children from 6 to 12 years old. In case of psychoemotional disorders, from half a tablet to 4 pieces per day. With enuresis, the minimum dose is the same, and the maximum is 2 pills.
  2. Adults In depressive conditions, take one or two pills per day in the evening. In some cases, this volume can be increased and divided into three stages. Moreover, most of the drug should be drunk at night. In the treatment of pain syndromes, they drink from half to 4 tablets per day, depending on the severity of the symptoms.
  3. Elderly patients. Such patients need to take from 1 to 4 pills a day, gradually reducing this amount until it is equal to half the pill.

Solutions for intravenous and intramuscular administration are used in a volume of 20 to 40 mg 4 times a day. They are used at the initial stage of treatment, and then the patient is gradually transferred to tablets or dragees.

On a note. The duration of therapy in each case is determined individually. Sometimes a month is enough for the patient to feel tangible relief. And in some cases, the treatment lasts for a year or more.

Use during pregnancy and lactation

Oral administration or injections of Amitriptyline are prescribed to women during pregnancy only if the expected benefit significantly exceeds the possible harm to the child. In this case, treatment is carried out under strict medical supervision, and the dosage and regimen are determined individually and are constantly adjusted.

Since the active substances of the drug can penetrate into breast milk, due to which babies develop constant drowsiness, Amitriptyline is not prescribed for lactation. This also threatens the newborn with symptoms such as shortness of breath, intestinal colic, irritability, trembling of the extremities, spastic phenomena and jumps in blood pressure. If a woman was treated with this drug during pregnancy, it should be canceled at least 7 weeks before the expected birth.

With impaired renal function

Impaired functioning of the kidneys and liver are often an absolute contraindication to the use of many drugs. In the case of Amitriptyline, this drug can be prescribed, but it should be used with caution.

In addition, treatment should be carried out under the strict supervision of a specialist. If there is any deterioration in the condition of these organs, the drug is canceled or the dose is adjusted.

Contraindications, side effects, overdose

The drug should not be prescribed to patients who have suffered myocardial infarction, patients with angle-closure glaucoma, intoxication with drugs or alcohol, as well as with violations of the ventricles of the heart. In addition, contraindications for use are breastfeeding and intolerance of the dominant component.

The grounds for special caution and or for drug withdrawal in the event of a worsening condition are:

  • pathology of the heart and blood vessels;
  • circulatory disorders;
  • bone marrow lesions;
  • psychoses of a manic-depressive nature;
  • bronchial asthma;
  • chronic alcohol dependence;
  • digestive disorders;
  • strokes
  • liver and kidney dysfunction;
  • urinary retention;
  • jumps in intraocular pressure;
  • diseases of the prostate and bladder;
  • epilepsy;
  • period of carrying a baby.

Amitriptyline has a strong effect on the body, and side effects can affect various organs and systems, manifesting negative symptoms:

  1. CNS - fainting, sleep disturbances, overexcitation or lethargy, muscle cramps, headaches and epileptic seizures can occur.
  2. Heart and blood vessels - side effects are expressed in instability of blood pressure indicators, dizziness, heart rhythm failures.
  3. Gastrointestinal tract - the onset of diarrhea, vomiting, heartburn, as well as a change in taste and darkening of the tongue are not ruled out.
  4. Endocrine system - manifestations of hyperglycemia, a decrease or increase in libido, and swelling of the mammary glands in women are not uncommon.
  5. Other manifestations are jumps in intraocular pressure, visual disturbances, dry mouth, malfunctioning of the intestines, disturbances in sweat gland activity, confusion and tachycardia.

Side effects are observed quite often, in addition, addiction is not excluded. And the withdrawal of the drug can lead to nausea, diarrhea, sleep disorders, headaches, increased irritability and the appearance of unusual dreams.

An overdose manifests itself as severe symptoms from the nervous system, heart and blood vessels. Their nature depends on the amount of substance taken and the individual characteristics of the patient.

In addition, this condition declares itself and other signs, for example:

  • respiratory failure;
  • vomiting
  • increased sweating;
  • hyperthermia;
  • in especially severe cases, cardiac arrest is possible.

If a drug overdose is suspected, the patient needs immediate hospitalization. Specialists will carry out the necessary measures, namely: they will wash the stomach, prescribe enterosorbents and drugs for treatment according to the symptoms.

Interaction with other medicines

If you take Amitriptyline together with alpha-adrenergic blockers and phenytoin, the effectiveness of the latter decreases. And compounds with fluoxetine and fluvoxamine can lead to the appearance of symptoms of an overdose, since the content of the active substance in the blood increases.

When the drug in question is combined with antipsychotics or m-anticholinergic drugs, the risk of developing hyperpyrexia is high. And when taken together with phenylephrine, epinephrine, isoprenaline and norepinephrine, the cardiovascular system will suffer.

Severe epileptic seizures are not ruled out if people suffering from this disease combine amitriptyline with benzodiazepines, anticholinergics, and phenothiazines.

If the drug is combined with other drugs that affect the functioning of the nervous system, respiratory depression is possible. When taking antihistamines, antiparkinsonian drugs, the anticholinergic effect of amitriptyline is enhanced. In addition, the toxicity of anticoagulant drugs increases if taken together with the drug in question.

The effect of drug therapy will be reduced when combined with formulations containing reserpine, betanidine, clonidine, and guanethidine.

Advice! Given these factors, it is worthwhile to warn the attending physician who prescribed Amitriptyline if the patient is taking any other drugs.

Preparations of a similar action

Structural analogues of amitriptyline are considered drugs containing the same substance in the composition.

Among them, doctors often prefer such drugs:

  • Amixid;
  • Amitriptyline Grindeks;
  • Amitriptyline to Nycomed;
  • Amitriptyline to Akos;
  • To Saroten Retard.

If the patient did not fit these drugs for any reason, they can also be replaced with Anafranil, Doxepin or Melipramine. In any case, it is up to the specialist to decide.

It is important to realize that amitriptyline can bring significant relief in a number of painful conditions. But you can drink it only with the permission of the doctor, subject to strict adherence to the treatment regimen and dosages. Otherwise, uncontrolled reactions of the body are possible, which will entail serious violations, including death.

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