Amitriptyline 25 helps eliminate signs of depression and other pathological conditions that arise against the background of mental disorders and disorders. The advantages include low price and a relatively small number of contraindications, thereby expanding the scope of action of this remedy. From the designation you can find out the dosage of the drug (25 mg).

Amitriptyline.

ATX

Release forms and composition

You can purchase the medicine in the form of a solution and tablets. Amitriptyline hydrochloride exhibits activity. Its concentration varies, depending on the structure of the substance. 1 tablet contains 25 mg of amitriptyline. Pack of 50 pcs.

The concentration of the active component in 1 ml of liquid substance is 10 mg. The volume of ampoules with solution is 2 ml. This means the total amount of amitriptyline is 20 mg. The drug is produced in this form in packages of 5 and 10 ampoules.

Pharmacological action

The drug is an antidepressant. Its main purpose is to eliminate the symptoms of depressive conditions. Other properties:

• anxiolytic;
• sedative;
• thymoleptic.

Amitriptyline can have a relaxing effect on the body in cases of anxiety, fear, and anxiety. Nervous tension is reduced due to inhibition of the reuptake of neurotransmitters, which include serotonin and norepinephrine. This process develops with the participation of the nerve endings of neurons. Under the influence of amitriptyline, the accumulation of monoamines in the synaptic cleft is accelerated. In addition, this substance enhances the postsynaptic response.

The sedative effect is due to a decrease in sensitivity to external stimuli. At the same time, the patient's daily activity decreases. There is a decrease in nervous excitability. The antidepressant effect occurs due to a decrease in the activity of certain brain receptors.

At the same time, the process of beta-adrenergic and serotonin transmission is restored. The decrease in the intensity of manifestations of depression is also due to the restoration of the equilibrium state of these systems. In addition, the function of M-choline and histamine receptors is inhibited.

Amitriptyline

Is amitriptyline prescribed for life?

A special feature of the drug is the ability to exhibit different properties due to taking different doses. For example, under certain conditions an antidepressant effect is provided. If the dose is adjusted, a stimulating property appears. In this case, the opposite effect of sedation is obtained.

Conversely, after a change in the plasma concentration of amitriptyline, the stimulating properties weaken.

It is difficult to accurately determine the range of doses during which the intensity of the sedative effect decreases and the stabilizing effect increases, since the amount of the drug sufficient for this is determined individually.

Additionally, other properties appear during therapy. They are less pronounced, but due to this, Amitriptyline helps to increase the activity of other drugs, along with which it is used. Thus, this medicine helps to normalize the function of urination, exhibits a weak analgesic property, and suppresses appetite.

Pharmacokinetics

The drug is absorbed quickly. The tablets do not have a negative effect on the gastrointestinal tract, which is due to their antiulcer properties (based on the mechanism of M-anticholinergic and sedative action). The bioavailability of amitriptyline is average: 30-60%. The active metabolite of this substance is characterized by higher bioavailability: 40-70%.

The product begins to work relatively quickly: after 2 hours, the processes that underlie the mechanism of action of Amitriptyline are activated. Despite the high rate of achievement of peak plasma concentrations of the main substance, the drug eliminates the symptoms of depression and other mental disorders after 2-3 weeks.

Amitriptyline is almost completely bound to blood proteins (up to 96%). This substance penetrates into various biological environments, thereby narrowing its scope of application. Transformation of the active component occurs with the participation of the liver. As a result, active and inactive metabolites are released. Some of them exhibit sedative, antidepressant properties along with amitriptyline, while others are superior to this substance in effectiveness (for example, nortriptyline).

The plasma half-life of the drug varies depending on the condition of the kidneys, since this organ is responsible for removing active and inactive components from the body. These substances are eliminated within 10-44 hours. Moreover, the half-life of nortriptyline is longer. The product is completely removed from the body only after 2 weeks.

What is it for?

The main purpose is to treat depression. Moreover, Amitriptyline is effective in the treatment of disorders of various etiologies: caused by functional disorders of the brain, abuse of drugs with characteristic properties (tranquilizers, sedatives and other sedatives), internal causes, neuroses, etc. This drug eliminates the symptoms of not only depression, but also other pathological conditions. It is prescribed as part of complex therapy in a number of cases:

• psychosis due to schizophrenia;
• emotional disorders;
• hangover syndrome due to alcohol abuse;
• decreased attention, increased daytime activity;
• enuresis caused by mental disorders;
• headache;
• migraine prevention;
• bulimia (provoked by non-physiological disorders);
• neuropathy that developed due to trauma;
• neuralgia caused by herpes zoster due to herpes infection;
• diseases of the stomach and duodenum, including ulcerative lesions.

Considering that the drug is characterized by a moderate analgesic effect, it can be used for pain, for example, during an exacerbation of osteochondrosis or cancer. However, in these cases, Amitriptyline is prescribed only as part of complex therapy.

Contraindications

A number of absolute restrictions when using the product:

• intolerance to components in the composition: hypersensitivity to amitriptyline and lactose often develops;
• ethanol poisoning;
• subacute, acute periods of myocardial infarction;
• some pathologies of the visual organs (in particular, angle-closure glaucoma);
• disruption of the heart;
• children under 6 years of age;
• negative reaction to galactose, glucose-galactose malabsorption, lactase deficiency.

With caution

Relative contraindications:

• severe respiratory dysfunction;
• regular alcohol abuse;
• schizophrenia;
• epilepsy accompanied by convulsive conditions;
• disruption of the hematopoietic system;
• bipolar mental disorder;
• ventricular arrhythmia;
• insufficiency of heart function;
• chest pain;
• stroke, myocardial infarction (history);
• hypertension;
• increase in pressure indicators in the organs of vision;
• violation of the contractile function of the stomach and intestines;
• excessive activity of prostate tissue development;
• thyrotoxicosis;
• pathologies of the bladder that contribute to urination problems.

How to take Amitriptyline 25?

The tablets should not be chewed. They are taken after meals.

Amitriptyline dosage regimen for 25 children

The drug is used in the treatment of various disorders, the treatment regimen is different in each case. Instructions for use:

• nocturnal enuresis due to mental disorders: 10-20 mg per day before bedtime for children from 6 to 10 years old, 50 mg per day for patients from 10 to 16 years old;
• therapy of various pathological conditions for mental disorders: children from 6 to 12 years old are prescribed 10-30 mg per day or 1-5 mg/kg of weight, patients over 12 years old - 100 mg per day.

Dosage regimen for adults

• depression: the daily dose at the initial stage is 300 mg, then gradually decreases over 4 weeks, the course of treatment is 3 months;
• mild mental disorders, therapy for the elderly: 25-100 mg per day;
• pain of various etiologies: 100 mg per day.

Taking the drug for diabetes mellitus

How long does it last?

Improvement can be seen a few hours after taking the first dose. Peak effectiveness is achieved after 2-3 weeks. The result obtained lasts for 14 days after discontinuation of the drug.

How to properly cancel Amitriptyline 25?

It is necessary to gradually reduce the dose of the medicine. This may take several weeks. The course of therapy should not be interrupted abruptly. In this case, the risk of symptoms of withdrawal syndrome increases.

Side effects

Arrhythmia and tachycardia develop, which can be caused by dysfunction of the contraction of the heart muscle. Fainting appears, symptoms of insufficiency of cardiac function, and shortness of breath occur.

Gastrointestinal tract

Heartburn, anorexia due to loss of appetite, loss of taste, abdominal pain, loose stools or, conversely, chronic constipation.

Blood-forming organs

Changes in blood composition.

Central nervous system

Headache, general weakness, deterioration of mental state (irritability, nightmares, confusion, hallucinations, increased excitability and disorientation), tremors, loss of sensitivity, and also mental disorders (hypomania, mania).

Metabolism

Hypo-, hyperglycemia.

Allergies

Rash, itching are symptoms accompanying urticaria. Angioedema and signs of a reaction to sunlight are also noted.

Impact on the ability to operate machinery

Special instructions

During drug therapy, basic blood parameters are regularly monitored.

Large doses of the drug lower the threshold for seizure activity. This should be taken into account during the period of withdrawal of anticonvulsants.

To reduce the tendency to suicidal thoughts, at the initial stage Amitriptyline is combined with antipsychotics or benzodiazepines.

If you are undergoing surgery, you need to inform the anesthesiologist about the fact that you are taking the medication in question.

Use for renal impairment

The drug is prescribed with caution for developing diseases of this organ. This is due to the fact that the kidneys are involved in the metabolization of amitriptyline.

Use in old age

Use during pregnancy and lactation

The drug is not used during breastfeeding, since amitriptyline passes into mother's milk and can enter the newborn's body.

During pregnancy, the medicine is allowed to be taken, but regular monitoring is required in the 1st trimester.

Use for liver dysfunction

The drug is prescribed with caution for diseases of this organ.

Overdose

Increasing the recommended amount of the drug when treating children is deadly. The drug increases the intensity of negative manifestations in adults. To eliminate side effects, the stomach is washed, and treatment must be interrupted. Fluid is infused into the body.

Interaction with other drugs

Amitriptyline therapy is completed 2 weeks before the start of treatment with MAO inhibitors. The simultaneous use of these drugs is contraindicated.

If, along with Amitriptyline, other drugs with similar properties are prescribed, the effect of this medicine is enhanced.

The drug in question helps to increase the activity of anticholinergic drugs.

Alcohol compatibility

The medicine is not combined with alcohol-containing drinks.

Analogues

Substitutes for the product in question:

• Saroten;
• Doxepin;
• Amitriptyline Nycomed.

Depression, anxiety, saroten...

Treatment of depression: sedatives and antidepressants (Amitriptyline, Melitor)

Conditions for dispensing from a pharmacy

Prescription drug.

Can I buy it without a prescription?

Price for Amitriptyline 25

The cost is 20-60 rubles.

Storage conditions of the drug

Best before date

The properties of the drug are preserved for 3 years from the date of release.

Antidepressant: Amitriptyline
Manufacturer: Zentiva Pharma LLC (Russia)
Active ingredient: Amitriptyline

Pharmacological action of an antidepressant

Amitriptyline belongs to the group of tricyclic antidepressants. Its action is based on blocking the reuptake of dopamine, serotonin and norepinephrine by CNS neurons. In addition, amitriptyline has an analgesic effect, as well as antibulimic and antiulcer effects. The drug is also effective in combating bedwetting. With regular and long-term use, it restores the balance of serotonin and norepinephrine transmission, shaken due to depression.
A pronounced antidepressant effect, as a rule, appears 2-4 weeks after the start of antidepressant use. For depression complicated by anxiety, amitriptyline reduces both depressive symptoms and agitation and anxiety. The antiulcer effect of the drug is due to its ability to block the functioning of histamine H2 receptors in the cells of the stomach. Thus, effective pain relief is achieved, as well as accelerated healing of stomach and duodenal ulcers.
The high effectiveness of amitriptyline in the treatment of bulimia nervosa does not yet have a scientific basis. However, it is well known that the drug shows good results in the fight against this disease (improvement in patients with bulimia occurs regardless of the presence/absence of depressive conditions; the antibulimic effect occurs even in the absence of an antidepressant effect).
A domestic study conducted in one of the Samara clinics showed that patients feel a significant reduction in anxiety and agitation, as well as motor restlessness already in the first days of taking amitriptyline. At 2-3 weeks of treatment, patients felt improved mood, increased self-esteem, and a sharp decrease in feelings of melancholy, depression and hopelessness. The feeling of guilt and suicidal tendencies disappeared.
In addition, a marked improvement in sleep was observed among all patients taking amitriptyline. Night sleep was completely normalized, sound and uninterrupted.

Indications for use

• treatment of depression of any origin (endogenous, neurotic, involutional, medicinal, reactive, with anxiety, sleep disorders and agitation, depression during alcohol withdrawal, as well as organic brain disorders);
• Treatment of mixed emotional disorders;
• Treatment of schizophrenic psychoses;
• Treatment of bulimia nervosa and psychogenic anorexia;
• Treatment of nocturnal enuresis, including in children (the drug is contraindicated in patients with bladder hypotension);
• Treatment of phobic disorders;
• Elimination of behavioral disorders (including activity and attention);
• Peptic ulcer of the stomach and duodenum;
• Prevention of headaches;
• Treatment of patients with chronic pain syndrome (atypical facial pain, migraines, chronic pain in cancer patients, postherpetic neuralgia, rheumatic pain, post-traumatic, peripheral and diabetic neuropathy).

Directions for use and dosage

Amitriptyline is taken orally during or after meals. You should start taking the drug at 50-75 mg/day. The dose should be divided into several doses of 25 mg each. In order to achieve an optimal therapeutic effect, the dose can be gradually increased by 25-50 mg. The maximum permissible dosage is 150-200 mg per day. However, most of it should be taken before bed. For extremely severe depression that cannot be treated, it is possible to increase the dose to 300 mg or even more, depending on individual tolerance to the drug. In such a situation, it is advisable to begin treatment with intravenous/intramuscular administration of the substance.
The therapeutic effect should appear no later than a month after starting to take amitriptyline. In this case, the dosage is gradually reduced, however, if signs of depression recur, you should return to the previous effective dose. If the drug does not show effectiveness after a 3-4 week course of treatment, it should be abandoned.
For elderly patients, the minimum dose is 25 mg/day, which can be increased gradually to 50-100 mg/day. When preventing headaches, as well as neurogenic pain, it is recommended to use the drug in an amount of 12.5-25 mg/day with a possible increase in dosage to 100 mg/day.
For severe depression, the drug is administered intramuscularly/intravenously at a dose of 10-20-30 mg, up to 3-4 injections per day. The maximum daily dose can be gradually increased and is 150 mg. After 7-14 days of injections, they switch to taking amitriptyline orally. Children (necessarily over 12 years of age) and elderly people are prescribed the minimum doses; dosage increases should occur more slowly.

Contraindications

Amitriptyline should not be taken by people with heart failure in the stage of decompensation, cardiac muscle conduction disorders, the period of myocardial infarction (including recovery after it), and arterial hypertension. The drug is prohibited for patients with prostatic hypertrophy, bladder atony, paralytic intestinal obstruction, as well as acute disorders of the liver and kidneys.
Pregnant women, nursing mothers, and children under 6 years of age (if taken orally) are prohibited from taking amitriptyline. Patients with hypersensitivity to amitriptyline should also not take this drug.

Side effects

Blurred vision, increased intraocular pressure, dry mouth, constipation, increased body temperature. These are consequences of the body’s adaptation to the drug, so they usually go away soon (sometimes it is necessary to reduce the dose). The following side effects occur from the nervous system: irritability, headache, tinnitus, sleep disorders, drowsiness, anxiety, etc. In addition, heart rhythm disturbances, heartburn, nausea, vomiting, taste disturbances, enlarged mammary glands, as well as allergic reactions: skin itching, rash, urticaria. (see also Norpramin)

Storage conditions

The drug is stored out of the reach of small children at temperatures from 10 to 25°C in a dry, dark place.
Amitriptyline is also available under the brand names:

• • Amizol
  • Amirol
  • Amitriptyline

Antidepressant "Amitriptyline": 62 comments and patient reviews:

1. Sergey, 26, St. Petersburg Author of the post

   I’ve been taking it for depression for almost a month, 50 mg before bed. I woke up, some energy and activity appeared. Before that, I took Fevarin, to no avail, with bursts of mania. I'm happy with almost everything about Amitriptyline, but the side effects are overwhelming: problems with memory, terrible dryness, worse vision, shaking hands. But the antidepressant effect so far pays for this whole bouquet.

2. Belarus Post author

   I’m on the 4th day for VSD, asthenia, and depression, the doctor said two tablets (50 mg) a day, on the first day I almost went crazy, I reduced the dose to 0.5 twice a day, now I’m suffering from insomnia, dizziness, I can’t nothing to focus on. I knew that the first days would be hard, but not the same...

3. margarita

   Hello, I’ve been taking amitriptyline for two weeks and it seems to me that my anxiety, fear, and fear have decreased. It’s just that my vision and memory have gotten worse

4. Faith

   I was betrayed by a loved one. It was a strong blow for me. I took amitriptyline for six months, up to 3 tablets a day. It helped. Good product. I’ve gained a little weight, but compared to what I had before, it’s a small thing.

5. Julia

   I was prescribed this drug for chronic pain syndrome. Daily headaches, weakness. In general, neurasthenia with chronic tension headaches. Prescribed 10 mg at night. At first I took half a tablet (5 mg). The next day there was no headache. Gradually I switched to a whole tablet at night (10 mg).
   What can I say? I’ve been drinking for three months now, but they told me to drink for at least six months. The drug is strong, in anti-depressant doses it is almost unrealistically heavy. There are many bad side effects, the worst of which is the cardio-toxic effect. Your heart is beating so hard that you can hear your own pulse in your ears.
   And my head doesn't hurt!!!
   On the one hand, it’s scary to live with such tachycardia, but on the other hand, it’s scary to quit, in case the pain returns...
   In addition, it causes constipation and greatly increases appetite, without removing the asthenic component. In general, there is fat, but no vigor. Hence the weight gain...
   Even in such small doses - 10 mg. For a blood pressure effect, the dose should be 150-200 mg.
   Unthinkable!

6. Natalia

   Pensioners are often at a loss after retirement, having become accustomed to a constant work schedule. I was no exception - I lost interest in life, I was pressed by some kind of longing for youth, I had nowhere to put myself. A friend suggested the drug “Biotredin”. So what? For me, it became a real panacea for the blues and thoughts that life is over.

7. Sasha

   When people get sick, it is a very big grief. I myself have recently begun to feel unwell. People need drugs such as Amitriptyline. So, I was in a very bad mood every day. Lived like in a dream. I woke up in the morning and already felt tired. My wife, she is a nurse, bought the drug from me. I want to say that he helped me a lot. Now everything is the same as before. I’m not sad and I want to live every day, and I’m grateful for that!!!

8. Galya

   I’ve been taking it for two weeks, they prescribed it to me after a cystoscopy, 25 mg, I’ve had urinary neuralgia for 13 years, nothing helped, I had severe pain, I constantly went to the toilet. And this medicine apparently cures me. It doesn’t hurt almost anymore.

9. Alex

   Please tell me, I have 10 mg tablets. how many times do you need to drink and for how long to walk during the day and it didn’t matter, excuse my French, and at night to sleep like a log and not stare at the ceiling until the morning...

10. Julia

    The drug is one of the cheapest, which is probably why it has so many side effects. I constantly want to sleep, my memory and vision are deteriorating, I have no strength or desire for anything. In combination with Pantogam Active, the condition improved slightly, some vigor appeared, but still, due to the lack of the desired effect, I switched to other tablets.

11. Vovan

    But it didn’t help me!

12. Tatiana

    Good afternoon The drug was prescribed to my mother. After an ischemic stroke, she began to recover, but hysterics appeared, 4 months ago she buried her dad, she always says that he comes to pick her up. I took hydrozepam, maybe from it? One way or another, after the first amitriptyline tablet at night, he slept for the second day, the nurses could not wake him up. Yesterday the therapist stopped me from taking hydrosepam and amitriptyline and said that she was just sleeping. Today they called an ambulance, they say that she is unconscious, they are waiting for a therapist and a neurologist. I’m in Moscow, I just returned yesterday, my mother is in Ukraine, I don’t know what to do, I don’t trust local doctors anymore, I read somewhere that amitripcilline is generally contraindicated for cardiovascular disorders. If anyone can give some good advice, please help. Thank you! [email protected]

13. Konstantin 31 years old, Moscow

    I tried to take it with a small dose, but I couldn’t, my heart rate increased and there were interruptions in my heart rhythm. I took 1/4 25 mg for 3 days. I had to cancel. Tried to start 3 times, same result.

14. Arthur

    Hello everyone, after the second injection I stopped treatment, the condition was terrible. Can anyone tell me when to completely stop using amitripline?

15. Igor

    I had headaches as if I had a helmet on my head I didn’t sleep well I was irritated by the lamp light especially in rooms and car headlights the doctor diagnosed depression I started taking amitriptyline after 3 weeks my blood pressure started in my sleep I jump up because my heart is racing panic sets in This wasn’t the case earlier Everything that wasn’t there at all appeared It’s a dangerous thing, I don’t know what to do yet.

16. Elvira

    I took amitriptyline 3 months. I started reducing the dose to 1/4 at night. Nothing during the day, and again in the morning alarming symptoms began. I went to the doctor and she prescribed a new drug, fevarin. She said that for older people (I’m 59 years old) this that’s what you need. So I don’t know what’s better?

17. Svetlana

    My mother-in-law was prescribed this drug. She had fears, panic, and an excited state. After the appointment everything improved. Now there are exacerbations, we immediately start giving these pills and she calms down on about the third day. Complains of dry mouth only and memory. And so everything is fine.

18. Alexander

    I used drugs for many years, then started drinking heavily. Now I’m taking amitriptyline, I have anxiety, I’m sleeping soundly (2 tablets in the morning). Got a job, started a family. Amitriptyline is a drug for drug and alcohol addiction. Among the “side effects” are dry mouth, memory and attention have deteriorated.

19. Tatyana, 58 years old

    Three times in my life, amitriptyline helped me out like no other remedy when stress accumulated and a state of complete inability to “take the blows” and the inability to work with people, asthenia, set in. Despite the fact that as a psychotherapist she helped everyone, but she could not “settle” her life. Calm came, anxiety, tearfulness, uncertainty, and fear of circumstances disappeared. Only dry mouth is a side effect. The previous time I started drinking with 25 mg 3 times a day, without increasing the dose, but for a long time (up to 9 months) on the recommendation of a doctor. Now again the same period of life. I started on my own without a doctor. But I know that you need to “go away” by gradually reducing the dose every 5 days by 1/4. Nycomed is a better company. But for some reason, its reserves are “melting” in the city. And there are no 25 mg doses at all now. And dividing halves is inconvenient and troublesome. By the way, tell me, do they let him cross the border?

20. Denis 27, Irkutsk

    The drug is good, for me, at least. I drink it at night. I suffered from sleep disorders, anxiety, panic, “not good” thoughts in the morning, fatigue, etc. I started taking amitriptyline - everything was ok. At first - yes, the next day there was fatigue, lethargy, attention disorder, but this lasted about a week. An adaptation period, as I understand it. Afterwards - performance, vitality, and “bad” thoughts are gone.

21. Vladlena

    I have been taking the drug since the summer in combination with chlorprothixene. At the beginning there was no effect, there were some side effects, mostly very severe dryness, but after a month everything went away, I went to work, everything was great. Now I take 25 mg in the morning, 25 mg in the afternoon and 50 mg at night. The doctor and I tried to reduce the dose, but it didn’t work out yet, he said that it’s 3 months again. We drink, and then taper. The sleep is wonderful, but my attention is very impaired, for attention I was prescribed another medicine, I took a course and it became easier.

22. Pauline

    Prescribed for depression. Of course it helped. I drink for a week, I live calmly for a couple of months, not paying attention to stress. But when the effect ends, it’s just tough, don’t come to me, I destroy everything. The other day I started drinking a quarter again, in addition to all the side effects (dry mouth, weakness, sleep, deterioration of attention) numbness in my hands was added, the right one went away, but the left one is still dangling 🙁 But I can’t give up yet, I’m afraid. I don’t know what to replace it with yet. Tomorrow see the doctor.

23. Anastasia

    I took amitriptyline and it caused dryness and an unpleasant taste in my mouth, and I developed a fear of communication, as well as the skin on my hands began to crack.

24. Marina 36 years old, Almaty

    I was in a psychoneurological clinic, they don’t use ammitriptyline there now. They treated me with expensive, new antidepressants... after discharge I felt bad again, and the evening panics did not leave me alone. I’m currently taking ammitriptyline as an outpatient, and I can’t be happier with how I feel. only for some reason they prescribed half of it in the morning and afternoon. I sleep like a horse day and night...what should I do? Someone tell me if it is possible to drink it in the afternoon. And yet, the course was prescribed for only a month, and then switch to tranquilizers, also for a month. I’m afraid to quit ammitriptyline...and maybe it will somehow help me out of depression in a month of taking it. Thanks a lot

25. yogann

    First you need to think about whether to accept it or you can still do without it, otherwise we grab everything that they advise and whatever comes to hand.

26. Svetlana, 49 years old, St. Petersburg

    Everything is very individual. If you experience side effects that worsen your quality of life, you should inform your doctor. For example, I was given strong side effects from Paxil, fluoxetine, and Lerivon, but I have been living and working on amitriptyline for the 3rd month. I enjoy life. I took 2 months 3 times a day: 1/2 in the morning, 1/2 in the afternoon and at night - a whole tablet, and since November I removed the daily dose. There was only one side effect: I gained 5 kg... But this is nothing.

27. Alevtina

    I took this drug six months ago. Before I started taking it, I suffered from terrible depression, I didn’t want to live: I blamed myself for everything, I was afraid. I started taking amitriptyline 50 mg 3 times a day, I slept from it almost around the clock, dizziness, and tinnitus. But after a week, positive thoughts began to appear, my mood improved. I realized that my fears were greatly exaggerated, and I now consider my mistakes (not so terrible) as experience. After the first improvements, I lowered the dose, although they said it was impossible, not enough time had passed. I stopped taking it much earlier than prescribed. There was no withdrawal syndrome, I haven’t taken amitriptyline since the summer and everything is fine. But you still need to listen to doctors and take it as prescribed. The drug is good, at least it helped me a lot, otherwise I couldn’t get out of bed, I kept crying.
    Thank you to my family for being patient and supporting me)

G.

Yes, I also took it for 3 weeks, with increasing doses. I had secondary depression and didn’t sleep well, so in principle he helped me! But at the beginning of days 2 and 3 the condition was bad, everything was annoying! and after drinking the course that was prescribed to me, it became like I’m sorry, fuck everything.... I take everything that I really like less to heart)))

28. Maria, 35 years old, Moscow

    For those who are afraid to get hooked. I have been drinking in autumn-spring courses for a long time now. It turns out to be a natural break.
    There was a time when I only drank at night. But I noticed that my heart rate was increasing. I divided the dose into two doses: in the morning and in the afternoon. The action is the same, but the feeling is much more pleasant.

29. Natasha 36 years old Saratov

    They prescribed this disgusting thing, I feel like I’m in a comatose state, I’ll stop drinking them, I tried them for only three days, all three days I felt a state of depression, heaviness in my whole body, but I need something completely different - performance and a good mood, but here there’s only some kind of moronic calm, two since taking 1/4 of the tablet caused panic attacks. no, I’d rather do without antidepressants, neurologists and psychiatrists can’t do without prescribing them, let them prescribe them to those who have MDP, not VSD. I only felt better before them, on they ruined everything for you with this amitriptyline.

30. Tanya

    I just started taking 1/6 amitriptyline at night. Guys, a young man left me, these tablets in a small dose help a lot, I forgot about him and now I don’t care who he is or what he is!))))))))))))))))))))))))))) I'm enjoying myself

31. Dmitry

    After taking it, I had very pronounced side symptoms - half of my body went completely numb, especially in the morning (after 2 tablets at night) the dry mouth was terrible. I quit drinking it, walked around for another 2 days, withdrawal started, wow. I started catching glitches in the minibus. I won't touch this crap again.

32. Svetlana

    Good afternoon, I used to take amitriptyline, but then it stopped helping, a year ago I started taking it again, and it helped for the time being. I want to know how long the body should rest after taking amitriptyline...

33. Zhanna

    I’m saved only by it…..I’m already afraid that I won’t sit down on it and become dependent….It helps with headaches when you want to sleep, but the brain doesn’t turn off at all…and in the morning you get up in the most terrible mood and condition….So that’s just it This is how I save myself, I try to drink only at night….

34. Angelica

    what happens if you take 2.5 packs of amitriptyline

35. Larisa
36. okrwkukdh
37. esbswrrre

    Cool + for the post

38. TerryRom

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Amitriptyline is a classic tricyclic antidepressant. Suppresses the reuptake of norepinephrine and serotonin by presynaptic neurons, which leads to an increase in the concentration of these mediators and the development of an antidepressant effect. With regular use, it suppresses the activity of cerebral beta-adrenergic receptors and serotonin receptors, normalizes the propagation of nerve impulses through these receptors, eliminates the imbalance of these systems caused by depression, exhibits an anxiolytic (eliminating anxiety) effect, reduces agitation (emotional overexcitation) and manifestations of depression. It has a mild analgesic effect, which, according to scientists, is due to fluctuations in the level of monoamines (primarily the neurotransmitter serotonin) in the central nervous system and the effect on the body’s own (internal) opiateergic systems. The pronounced ability to bind to m-cholinergic receptors determines the powerful anticholinergic effect of Amitriptyline, and its ability to interact with histamine H1 receptors and block alpha-adrenergic receptors causes a sedative effect. It has an antiulcer effect, reduces the severity of pain in stomach and duodenal ulcers, and ensures rapid scarring of the ulcer. The above-mentioned anticholinergic activity of Amitriptyline, which increases the elasticity of the bladder walls and their ability to stretch, makes it effective in the treatment of enuresis. This property of the drug is reinforced by direct beta-adrenergic stimulation and blocking the uptake of the transmitter serotonin by central neuronal synapses. Amitriptyline reduces bulimia nervosa both with and without comorbid depression. The antidepressant effect of the drug begins to clearly manifest itself 2-3 weeks after the start of drug therapy.

The bioavailability of Amitriptyline is about 50%, the half-life is 30-45 hours. Elimination from the body occurs through urine. The drug is available in tablet and ampoule form. Pharmacotherapy is started with a dose of 25-50 mg, the optimal time of administration is before bedtime. Gradually over the course of a week the dose is increased by 3-4 times. If there is no improvement in the condition in the second week, the daily dose is raised to 300 mg. Elimination of depressive symptoms is not a reason to refuse treatment: in this case, the dose is reduced to daily 50-100 mg and pharmacotherapy is continued for at least another three months. In elderly people with mild depression, the dose of the drug is set in the range from 30 to 100 mg per day, and when positive results are achieved, they move on to a maintenance daily dose of 250-50 mg. During treatment, it is necessary to avoid situations that require sudden standing up from a sitting or lying position. It is not recommended to abruptly interrupt treatment: in this case, withdrawal syndrome may develop. It is necessary to take the necessary precautions when using Amitriptyline in patients suffering from epilepsy, because the drug in a daily dose of over 150 mg reduces the seizure threshold. When planning treatment, one should be aware of possible suicide attempts in patients suffering from severe depression. The combined use of Amitriptyline and electroconvulsive therapy is possible only with constant medical monitoring. In patients with a complicated medical history and the elderly, taking the drug can lead to the occurrence of pharmacological psychoses (after cessation of drug therapy, such phenomena quickly disappear). Long-term use of Amitriptyline can lead to the development of caries. The drug is not compatible with alcohol.

Pharmacology

An antidepressant from the group of tricyclic compounds, a derivative of dibenzocycloheptadine.

The mechanism of antidepressant action is associated with an increase in the concentration of norepinephrine in synapses and/or serotonin in the central nervous system due to inhibition of the reverse neuronal uptake of these mediators. With long-term use, it reduces the functional activity of β-adrenergic receptors and serotonin receptors in the brain, normalizes adrenergic and serotonergic transmission, and restores the balance of these systems, disturbed during depressive states. In anxiety-depressive conditions, it reduces anxiety, agitation and depressive symptoms.

It also has some analgesic effect, which is believed to be associated with changes in the concentrations of monoamines in the central nervous system, especially serotonin, and effects on endogenous opioid systems.

It has a pronounced peripheral and central anticholinergic effect due to its high affinity for m-cholinergic receptors; strong sedative effect associated with affinity for histamine H1 receptors and alpha-adrenergic blocking effect.

It has an antiulcer effect, the mechanism of which is due to the ability to block histamine H2 receptors in the parietal cells of the stomach, as well as to have a sedative and anticholinergic effect (in case of gastric and duodenal ulcers, it reduces pain and helps accelerate the healing of ulcers).

Efficacy for bedwetting appears to be due to anticholinergic activity leading to increased bladder distensibility, direct β-adrenergic stimulation, and α-adrenergic agonist activity accompanied by increased sphincter tone and central blockade of serotonin uptake.

The mechanism of therapeutic action for bulimia nervosa has not been established (possibly similar to that for depression). Amitriptyline has been shown to be clearly effective against bulimia in patients both without and with depression, while a decrease in bulimia can be observed without a concomitant decrease in depression itself.

During general anesthesia, it reduces blood pressure and body temperature. Does not inhibit MAO.

The antidepressant effect develops within 2-3 weeks after the start of use.

Pharmacokinetics

The bioavailability of amitriptyline is 30-60%. Plasma protein binding 82-96%. V d - 5-10 l/kg. Metabolized to form the active metabolite nortriptyline.

T1/2 - 31-46 hours. Excreted mainly by the kidneys.

Release form

10 pcs. - contour cell packaging (5) - cardboard packs.
50 pcs. - polymer jars (1) - cardboard packs.

Dosage

For oral administration, the initial dose is 25-50 mg at night. Then, over 5-6 days, the dose is individually increased to 150-200 mg/day (most of the dose is taken at night). If there is no improvement during the second week, the daily dose is increased to 300 mg. When signs of depression disappear, the dose is reduced to 50-100 mg/day and therapy is continued for at least 3 months. In elderly patients with mild disorders, the dose is 30-100 mg/day, usually 1 time/day at night; after achieving a therapeutic effect, they switch to the minimum effective dose - 25-50 mg/day.

For nocturnal enuresis in children aged 6-10 years - 10-20 mg/day at night, in children aged 11-16 years - 25-50 mg/day.

IM - the initial dose is 50-100 mg/day in 2-4 injections. If necessary, the dose can be gradually increased to 300 mg/day, in exceptional cases - up to 400 mg/day.

Interaction

When used simultaneously with drugs that have a depressant effect on the central nervous system, a significant increase in the inhibitory effect on the central nervous system, hypotensive effect, and respiratory depression is possible.

When used simultaneously with drugs that have anticholinergic activity, the anticholinergic effects may be enhanced.

With simultaneous use, it is possible to enhance the effect of sympathomimetic drugs on the cardiovascular system and increase the risk of developing heart rhythm disturbances, tachycardia, and severe arterial hypertension.

When used simultaneously with antipsychotics (neuroleptics), metabolism is mutually inhibited, and the threshold for convulsive readiness decreases.

When used simultaneously with antihypertensive drugs (with the exception of clonidine, guanethidine and their derivatives), the antihypertensive effect and the risk of developing orthostatic hypotension may be increased.

When used simultaneously with MAO inhibitors, a hypertensive crisis may develop; with clonidine, guanethidine - it is possible to reduce the hypotensive effect of clonidine or guanethidine; with barbiturates, carbamazepine - the effect of amitriptyline may be reduced due to an increase in its metabolism.

A case of the development of serotonin syndrome with simultaneous use with sertraline has been described.

When used simultaneously with sucralfate, the absorption of amitriptyline decreases; with fluvoxamine - the concentration of amitriptyline in the blood plasma and the risk of developing toxic effects increases; with fluoxetine - the concentration of amitriptyline in the blood plasma increases and toxic reactions develop due to inhibition of the CYP2D6 isoenzyme under the influence of fluoxetine; with quinidine - the metabolism of amitriptyline may be slowed down; with cimetidine - it is possible to slow down the metabolism of amitriptyline, increase its concentration in the blood plasma and develop toxic effects.

When used simultaneously with ethanol, the effect of ethanol is enhanced, especially during the first few days of therapy.

Side effects

From the central nervous system and peripheral nervous system: drowsiness, asthenia, fainting, anxiety, disorientation, agitation, hallucinations (especially in elderly patients and patients with Parkinson's disease), anxiety, motor restlessness, manic state, hypomanic state, aggressiveness, disturbance memory, depersonalization, increased depression, decreased ability to concentrate, insomnia, nightmares, yawning, activation of symptoms of psychosis, headache, myoclonus, dysarthria, tremor (especially of the hands, head, tongue), peripheral neuropathy (paresthesia), myasthenia gravis, myoclonus , ataxia, extrapyramidal syndrome, increased frequency and intensification of epileptic seizures, changes in the EEG.

From the cardiovascular system: orthostatic hypotension, tachycardia, conduction disturbances, dizziness, nonspecific changes on the ECG (ST interval or T wave), arrhythmia, blood pressure lability, intraventricular conduction disturbances (widening of the QRS complex, changes in the PQ interval, bundle branch block ).

From the digestive system: nausea, heartburn, vomiting, gastralgia, increased or decreased appetite (increased or decreased body weight), stomatitis, change in taste, diarrhea, darkening of the tongue; rarely - impaired liver function, cholestatic jaundice, hepatitis.

From the endocrine system: testicular swelling, gynecomastia, breast enlargement, galactorrhea, changes in libido, decreased potency, hypo- or hyperglycemia, hyponatremia (decreased vasopressin production), syndrome of inadequate ADH secretion.

From the hematopoietic system: agranulocytosis, leukopenia, thrombocytopenia, purpura, eosinophilia.

Allergic reactions: skin rash, itching, urticaria, photosensitivity, swelling of the face and tongue.

Effects due to anticholinergic activity: dry mouth, tachycardia, accommodation disturbances, blurred vision, mydriasis, increased intraocular pressure (only in individuals with a narrow anterior chamber angle), constipation, paralytic ileus, urinary retention, decreased sweating, confusion, delirium or hallucinations.

Other: hair loss, tinnitus, edema, hyperpyrexia, swollen lymph nodes, pollakiuria, hypoproteinemia.

Indications

Depression (especially with anxiety, agitation and sleep disorders, including in childhood, endogenous, involutional, reactive, neurotic, drug-induced, with organic brain damage, alcohol withdrawal), schizophrenic psychoses, mixed emotional disorders, behavioral (activity) disorders and attention), nocturnal enuresis (except for patients with bladder hypotension), bulimia nervosa, chronic pain syndrome (chronic pain in cancer patients, migraine, rheumatic pain, atypical pain in the face, post-herpetic neuralgia, post-traumatic neuropathy, diabetic neuropathy, peripheral neuropathy), migraine prevention, peptic ulcer of the stomach and duodenum.

Contraindications

Acute period and early recovery period after myocardial infarction, acute alcohol intoxication, acute intoxication with hypnotics, analgesics and psychotropic drugs, closed-angle glaucoma, severe disturbances of AV and intraventricular conduction (bundle branch block, AV block of the second degree), lactation period, children up to 6 years of age (for oral administration), children up to 12 years of age (for intramuscular and intravenous administration), simultaneous treatment with MAO inhibitors and a period of 2 weeks before the start of their use, hypersensitivity to amitriptyline.

Features of application

Use during pregnancy and breastfeeding

Amitriptyline should not be used during pregnancy, especially in the first and third trimesters, unless absolutely necessary. Adequate and strictly controlled clinical studies of the safety of amitriptyline during pregnancy have not been conducted.

Amitriptyline should be gradually discontinued at least 7 weeks before the expected birth to avoid withdrawal syndrome in the newborn.

In experimental studies, amitriptyline had a teratogenic effect.

Contraindicated during lactation. Excreted in breast milk and may cause drowsiness in nursing infants.

Use in children

Contraindication: children under 6 years of age (for oral administration), children under 12 years of age (for intramuscular and intravenous administration).

Special instructions

Use with caution for ischemic heart disease, arrhythmia, heart block, heart failure, myocardial infarction, arterial hypertension, stroke, chronic alcoholism, thyrotoxicosis, and during therapy with thyroid drugs.

During amitriptyline therapy, caution is required when suddenly moving to a vertical position from a lying or sitting position.

If you stop taking it abruptly, withdrawal syndrome may develop.

Amitriptyline in doses of more than 150 mg/day reduces the seizure threshold; the risk of developing epileptic seizures in predisposed patients should be taken into account, as well as in the presence of other factors that increase the risk of developing a convulsive syndrome (including brain damage of any etiology, simultaneous use of antipsychotic drugs, during the period of ethanol withdrawal or drug withdrawal, having anticonvulsant activity).

It should be taken into account that patients with depression may experience suicide attempts.

Should only be used in combination with electroconvulsive therapy under close medical supervision.

In predisposed patients and elderly patients, it can provoke the development of drug-induced psychoses, mainly at night (after discontinuation of the drug, they disappear within a few days).

May cause paralytic ileus, primarily in patients with chronic constipation, the elderly, or those forced to bed rest.

Before performing general or local anesthesia, the anesthesiologist should be warned that the patient is taking amitriptyline.

With long-term use, an increase in the incidence of caries is observed. The need for riboflavin may increase.

Amitriptyline can be used no earlier than 14 days after discontinuation of MAO inhibitors.

Should not be used simultaneously with adrenergic and sympathomimetics, incl. with epinephrine, ephedrine, isoprenaline, norepinephrine, phenylephrine, phenylpropanolamine.

Use with caution simultaneously with other drugs that have anticholinergic effects.

Avoid drinking alcohol while taking amitriptyline.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, you should refrain from potentially hazardous activities that require increased attention and rapid psychomotor reactions.

Detailed instructions for use are published on this page. Amitriptyline. The available dosage forms of the drug are listed (tablets and dragees 10 mg and 25 mg, injections in ampoules), as well as its analogues. Information is provided on the side effects that Amitriptyline can cause and on interactions with other medications. In addition to information about the diseases for the treatment and prevention of which the drug is prescribed (depression, anxiety, psychosis, migraine), administration algorithms, possible dosages for adults and children are described in detail, and the possibility of use during pregnancy and breastfeeding is clarified. The abstract for Amitriptyline is supplemented with reviews from patients and doctors. Interaction of the drug with alcohol.

Instructions for use and dosage

Administered orally, without chewing, immediately after meals (to reduce irritation of the gastric mucosa).

Adults

For adults with depression, the initial dose is 25-50 mg at night, then the dose can be gradually increased, taking into account the effectiveness and tolerability of the drug, to a maximum of 300 mg per day in 3 divided doses (the largest part of the dose is taken at night). When a therapeutic effect is achieved, the dose can be gradually reduced to the minimum effective, depending on the patient's condition. The duration of the course of treatment is determined by the patient’s condition, the effectiveness and tolerability of the therapy and can range from several months to 1 year, and if necessary, more. In old age with mild disorders, as well as with bulimia nervosa, as part of complex therapy for mixed emotional disorders and behavioral disorders, psychoses in schizophrenia and alcohol withdrawal, a dose of 25-100 mg per day (at night) is prescribed, after achieving a therapeutic effect, switch for the minimum effective dose - 10-50 mg per day.

For the prevention of migraines, with chronic pain syndrome of a neurogenic nature (including prolonged headaches), as well as in the complex therapy of gastric and duodenal ulcers - from 10-12.5-25 to 100 mg per day (maximum part of the dose taken at night).

Children

For children as an antidepressant: from 6 to 12 years old - 10-30 mg per day or 1-5 mg/kg per day in fractions, in adolescence - up to 100 mg per day.

For nocturnal enuresis in children 6-10 years old - 10-20 mg per day at night, 11-16 years old - up to 50 mg per day.

Release forms

Tablets 10 mg and 25 mg.

Dragee 25 mg.

Solution for intravenous and intramuscular administration (injections in injection ampoules).

Amitriptyline- antidepressant (tricyclic antidepressant). It also has some analgesic (of central origin), antiserotonin effect, helps eliminate bedwetting and reduces appetite.

It has a strong peripheral and central anticholinergic effect due to its high affinity for m-cholinergic receptors; strong sedative effect associated with affinity for H1-histamine receptors and alpha-adrenergic blocking effect.

It has the properties of a class IA antiarrhythmic drug; like quinidine in therapeutic doses, it slows down ventricular conduction (in overdose it can cause severe intraventricular block).

The mechanism of antidepressant action is associated with an increase in the concentration of norepinephrine and/or serotonin in the central nervous system (CNS) (decreasing their reabsorption).

The accumulation of these neurotransmitters occurs as a result of inhibition of their reuptake by the membranes of presynaptic neurons. With long-term use, it reduces the functional activity of beta-adrenergic and serotonin receptors in the brain, normalizes adrenergic and serotonergic transmission, and restores the balance of these systems, disturbed during depressive states. In anxiety-depressive conditions, it reduces anxiety, agitation and depressive symptoms.

The mechanism of antiulcer action is due to the ability to have a sedative and m-anticholinergic effect. Effectiveness for bedwetting appears to be due to anticholinergic activity leading to increased bladder distensibility, direct beta-adrenergic stimulation, alpha-adrenergic agonist activity leading to increased sphincter tone, and central blockade of serotonin uptake. It has a central analgesic effect, which is believed to be associated with changes in the concentration of monoamines in the central nervous system, especially serotonin, and an effect on endogenous opioid systems.

The mechanism of action in bulimia nervosa is unclear (may be similar to that in depression). A clear effect of the drug on bulimia has been shown in patients both without depression and in its presence, while a decrease in bulimia can be observed without a concomitant weakening of depression itself.

During general anesthesia, it reduces blood pressure and body temperature. Does not inhibit monoamine oxidase (MAO).

The antidepressant effect develops within 2-3 weeks after the start of use.

Pharmacokinetics

Absorption is high. Passes (including nortriptyline, a metabolite of amitriptyline) through histohematic barriers, including the blood-brain barrier, placental barrier, and penetrates into breast milk. Excreted by the kidneys (mainly in the form of metabolites) - 80% in 2 weeks, partially with bile.

Indications

• depression (especially with anxiety, agitation and sleep disorders, including in childhood, endogenous, involutional, reactive, neurotic, medicinal, with organic brain damage);
• as part of complex therapy it is used for mixed emotional disorders, psychoses in schizophrenia, alcohol withdrawal, behavioral disorders (activity and attention), nocturnal enuresis (except for patients with bladder hypotension), bulimia nervosa, chronic pain syndrome (chronic pain in cancer patients, migraine, rheumatic diseases, atypical pain in the face, postherpetic neuralgia, post-traumatic neuropathy, diabetic or other peripheral neuropathy), headaches, migraines (prevention), gastric and duodenal ulcers.

Contraindications

• hypersensitivity;
• use together with MAO inhibitors and 2 weeks before starting treatment;
• myocardial infarction (acute and subacute periods);
• acute alcohol intoxication;
• acute intoxication with sleeping pills, analgesics and psychoactive drugs;
• angle-closure glaucoma;
• severe disturbances of AV and intraventricular conduction (bundle branch block, AV block 2 degrees);
• lactation period;
• children under 6 years of age;
• galactose intolerance;
• lactase deficiency;
• glucose-galactose malabsorption.

Special instructions

Before starting treatment, blood pressure monitoring is necessary (in patients with low or labile blood pressure, it may decrease even more); during the treatment period - control of peripheral blood (in some cases, agranulocytosis may develop, and therefore it is recommended to monitor the blood picture, especially with an increase in body temperature, development of flu-like symptoms and sore throat), during long-term therapy - control of the functions of the cardiovascular system and liver. In the elderly and patients with cardiovascular diseases, monitoring of heart rate, blood pressure, and ECG is indicated. Clinically insignificant changes may appear on the ECG (smoothing of the T wave, depression of the S-T segment, widening of the QRS complex).

Caution is required when suddenly moving to a vertical position from a lying or sitting position.

During the treatment period, the use of ethanol should be avoided.

Prescribed no earlier than 14 days after discontinuation of MAO inhibitors, starting with small doses.

If you suddenly stop taking it after long-term treatment, withdrawal syndrome may develop.

Amitriptyline in doses above 150 mg per day reduces the threshold of convulsive activity (the risk of epileptic seizures in predisposed patients should be taken into account, as well as in the presence of other factors predisposing to the occurrence of convulsive syndrome, for example, brain damage of any etiology, simultaneous use of antipsychotic drugs (neuroleptics) ), during the period of withdrawal from ethanol or withdrawal of medications with anticonvulsant properties, for example, benzodiazepines). Severe depression is characterized by a risk of suicidal actions, which can persist until significant remission is achieved. In this regard, at the beginning of treatment, a combination with drugs from the group of benzodiazepines or antipsychotic drugs and constant medical supervision (entrust trusted persons with the storage and dispensing of drugs) may be indicated. In children, adolescents and young adults (under 24 years of age) with depression and other mental disorders, antidepressants, compared with placebo, increase the risk of suicidal thoughts and suicidal behavior. Therefore, when prescribing amitriptyline or any other antidepressants in this category of patients, the risk of suicide should be weighed against the benefits of their use. In short-term studies, the risk of suicide did not increase in people over 24 years of age, but it decreased slightly in people over 65 years of age. During treatment with antidepressants, all patients should be monitored for early detection of suicidal tendencies.

In patients with cyclic affective disorders during the depressive phase, manic or hypomanic states may develop during therapy (reducing the dose or discontinuing the drug and prescribing an antipsychotic drug is necessary). After relief of these conditions, if indicated, treatment in low doses can be resumed.

Due to possible cardiotoxic effects, caution is required when treating patients with thyrotoxicosis or patients receiving thyroid hormone preparations.

In combination with electroconvulsive therapy, it is prescribed only under the condition of careful medical supervision.

In predisposed patients and elderly patients, it can provoke the development of drug-induced psychoses, mainly at night (after discontinuation of the drug, they disappear within a few days).

May cause paralytic ileus, primarily in patients with chronic constipation, the elderly, or those forced to bed rest.

Before performing general or local anesthesia, the anesthesiologist should be warned that the patient is taking amitriptyline.

Due to the anticholinergic effect, there may be a decrease in tear production and a relative increase in the amount of mucus in the tear fluid, which can lead to damage to the corneal epithelium in patients using contact lenses.

With long-term use, an increase in the incidence of dental caries is observed. The need for riboflavin may be increased.

Animal reproduction studies have shown adverse effects on the fetus, and there are no adequate and well-controlled studies in pregnant women. In pregnant women, the drug should be used only if the expected benefit to the mother outweighs the potential risk to the fetus.

Children are more sensitive to acute overdose, which should be considered dangerous and potentially fatal to them.

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Side effect

• blurred vision;
• mydriasis;
• increased intraocular pressure (only in persons with a local anatomical predisposition - a narrow angle of the anterior chamber);
• drowsiness;
• fainting conditions;
• fatigue;
• irritability;
• anxiety;
• disorientation;
• hallucinations (especially in elderly patients and patients with Parkinson's disease);
• anxiety;
• mania;
• memory impairment;
• decreased ability to concentrate;
• insomnia;
• "nightmare" dreams;
• asthenia;
• headache;
• ataxia;
• increased frequency and intensification of epileptic seizures;
• changes in the electroencephalogram (EEG);
• tachycardia;
• feeling of heartbeat;
• dizziness;
• orthostatic hypotension;
• arrhythmia;
• lability of blood pressure (decrease or increase in blood pressure);
• dry mouth;
• constipation;
• nausea, vomiting;
• heartburn;
• gastralgia;
• increased appetite and body weight or decreased appetite and body weight;
• stomatitis;
• change in taste;
• diarrhea;
• darkening of the tongue;
• increase in size (swelling) of the testicles;
• gynecomastia;
• increase in the size of the mammary glands;
• galactorrhea;
• decreased or increased libido;
• decreased potency;
• skin rash;
• photosensitivity;
• angioedema;
• hives;
• hair loss;
• tinnitus;
• swelling;
• hyperpyrexia;
• swollen lymph nodes;
• urinary retention.

Drug interactions

When ethanol (alcohol) is used together with drugs that depress the central nervous system (including other antidepressants, barbiturates, benzodiazepines and general anesthetics), a significant increase in the depressant effect on the central nervous system, respiratory depression and hypotensive effect is possible. Increases sensitivity to drinks containing ethanol (alcohol).

Increases the anticholinergic effect of drugs with anticholinergic activity (for example, phenothiazine derivatives, antiparkinsonian drugs, amantadine, atropine, biperiden, antihistamines), which increases the risk of side effects (from the central nervous system, vision, intestines and bladder). When used together with anticholinergic blockers, phenothiazine derivatives and benzodiazepines, there is a mutual enhancement of the sedative and central anticholinergic effects and an increased risk of epileptic seizures (lowering the threshold of convulsive activity); Phenothiazine derivatives may also increase the risk of neuroleptic malignant syndrome.

When used together with anticonvulsants, it is possible to enhance the inhibitory effect on the central nervous system, reduce the threshold of convulsive activity (when used in high doses) and reduce the effectiveness of the latter.

When used together with antihistamines, clonidine - increased inhibitory effect on the central nervous system; with atropine - increases the risk of paralytic intestinal obstruction; with drugs that cause extrapyramidal reactions - an increase in the severity and frequency of extrapyramidal effects.

With the simultaneous use of amitriptyline and indirect anticoagulants (coumarin or indadione derivatives), the anticoagulant activity of the latter may increase. Amitriptyline may enhance depression caused by glucocorticosteroids (GCS). Medicines used to treat thyrotoxicosis increase the risk of developing agranulocytosis. Reduces the effectiveness of phenytoin and alpha-blockers.

Inhibitors of microsomal oxidation (cimetidine) prolong T1/2, increase the risk of developing toxic effects of amitriptyline (a dose reduction of 20-30% may be required), inducers of microsomal liver enzymes (barbiturates, carbamazepine, phenytoin, nicotine and oral contraceptives) reduce plasma concentrations and reduce the effectiveness of amitriptyline.

Combined use with disulfiram and other acetaldehydrogenase inhibitors provokes delirium.

Fluoxetine and fluvoxamine increase plasma concentrations of amitriptyline (a 50% reduction in amitriptyline dose may be required).

With the simultaneous use of amitriptyline with clonidine, guanethidine, betanidine, reserpine and methyldopa - a decrease in the hypotensive effect of the latter; with cocaine - the risk of developing cardiac arrhythmias.

Antiarrhythmic drugs (such as quinidine) increase the risk of developing rhythm disturbances (possibly slowing down the metabolism of amitriptyline).

Pimozide and probucol may increase cardiac arrhythmias, which is manifested by prolongation of the QT interval on the ECG.

It enhances the effect of epinephrine, norepinephrine, isoprenaline, ephedrine and phenylephrine on the cardiovascular system (including when these drugs are part of local anesthetics) and increases the risk of developing heart rhythm disturbances, tachycardia, and severe arterial hypertension.

When co-administered with alpha-adrenergic agonists for intranasal administration or for use in ophthalmology (with significant systemic absorption), the vasoconstrictor effect of the latter may be enhanced.

When taken together with thyroid hormones, there is a mutual enhancement of the therapeutic effect and toxic effects (including cardiac arrhythmias and a stimulating effect on the central nervous system).

M-anticholinergic drugs and antipsychotic drugs (neuroleptics) increase the risk of developing hyperpyrexia (especially in hot weather).

When co-administered with other hematotoxic drugs, increased hematotoxicity is possible.

Incompatible with MAO inhibitors (increased frequency of periods of hyperpyrexia, severe convulsions, hypertensive crises and patient death are possible).

Analogues of the drug Amitriptyline

Structural analogues of the active substance:

• Amizol;
• Amirol;
• Amitriptyline Nycomed;
• Amitriptyline AKOS;
• Amitriptyline Ferein;
• Amitriptyline hydrochloride;
• Apo Amitriptyline;
• Vero Amitriptyline;
• Saroten retard;
• Tryptisol;
• Elivel.

Use in children

Contraindicated in children under 6 years of age.

In children, adolescents and young adults (under 24 years of age) with depression and other mental disorders, antidepressants, compared with placebo, increase the risk of suicidal thoughts and suicidal behavior. Therefore, when prescribing amitriptyline or any other antidepressants in this category of patients, the risk of suicide should be weighed against the benefits of their use

Use during pregnancy and breastfeeding

In pregnant women, the drug should be used only if the expected benefit to the mother outweighs the potential risk to the fetus.

Passes into breast milk and may cause drowsiness in nursing infants. To avoid the development of withdrawal syndrome in newborns (manifested by shortness of breath, drowsiness, intestinal colic, increased nervous excitability, increased or decreased blood pressure, tremor or spastic phenomena), amitriptyline is gradually discontinued at least 7 weeks before the expected birth.

Amitriptyline instructions for use are classified as tricyclic antidepressants. These are some of the strongest drugs at a fairly reasonable price. But today, experts are divided on the possibility of recommending this drug in the first line of therapy.

Due to the presence of a large number of side effects of tricyclic antidepressants, their poor tolerability profile, and violation of the rules for taking medications by patients, which leads to an increase in morbidity and sometimes death, many experts, including international ones, pay more attention to the drugs new generation. They are comparable in effect to Amitriptyline, but have fewer side effects. Nevertheless, Amitriptyline is used quite successfully in psychiatric practice.

What is Amitriptyline?

Amitriptyline is an antidepressant, one of the most common. In addition to depression, it fights anxiety and has a pronounced hypnotic and calming (sedative) effect. In certain doses it can act as a psychoenergetic and stimulant. For each patient, the interval in which the drug has such an effect is individual.

When it is exceeded, the calming properties of the drug come to the fore, and the stimulating and depression-reducing properties recede into the background. Of its group of drugs, Amitriptyline is considered the most reliable, effective and cheapest. You can find Amitriptyline tablets starting at 26 rubles for 10 tablets.

Very often, for depressive disorders, treatment begins not with this group of drugs, but, for example, with monoamine oxidase inhibitors. If you are taking any thymoanaleptics (antidepressants) or anxiolytics (drugs that reduce anxiety), you need to warn your doctor.

Because some drugs are very dangerous to use together. For example, MAO inhibitors should never be taken together with tricyclic antidepressants. This threatens death. If you need to change one drug to another, there should be a pause of at least 2 weeks between taking MAO inhibitors and tricyclic antidepressants.

Before taking the drug Amitriptyline, the instructions for use must be read carefully and strictly follow the indicated dosages. This product is produced both in ampoules and tablets. For outpatient use, Amitriptyline tablets are usually prescribed.

Amitriptyline: instructions for use (official)

Range of application of the drug

What can amitriptyline help with? Amitriptyline - therefore, its main purpose is to fight depression. It is applicable for any type of depression, but most often Amitriptyline tablets are indicated for use in depressive states of an endogenous nature (that is, arising for internal reasons).

What does Amitriptyline help with, besides depression? Amitriptyline tablets are indicated for use in migraines and are prescribed as a preventive measure. It is given to children with enuresis, if the cause of the pathology does not lie in the bladder with weak tone. Amitriptyline is a medicine that works well:

• with anxiety;
• various pathological fears (phobias);
• eating disorders (bulimia and anorexia) of a neurogenic nature.

Unlike many other drugs of its group, it does not cause hallucinations, at least in most cases. In some cases, this antidepressant is also used by somatic medicine in very small dosages to reduce the manifestations of neurotic conditions.

Rules for taking Amitriptyline

How is the drug taken? Strictly as prescribed by a doctor, as it interacts when taken orally with drugs for the treatment of other serious pathologies. The instructions for use recommend taking amitriptyline after meals and according to the schedule, starting with minimal doses and increasing the dosage by 25 mg every day until the working dose is reached.

The minimum dose is considered to be 50 mg per day per dose; 150 mg/day, 200/250/300 mg per day can be prescribed as a working dose. The size of this dose is determined by the severity of the pathological process. The daily dose is recommended to be divided into several doses (2-4). The last dose should be taken before bedtime. The instructions for the antidepressant Amitriptyline also prescribe slowly stopping taking it, gradually reducing the dose.

Consequences of abrupt refusal

If you abruptly stop taking the drug, the patient may experience the so-called “withdrawal syndrome”:

1. discomfort;
2. headache;
3. nervousness;
4. sleep disorders.

These are not signs of dependence on the drug, but the consequences of its abrupt withdrawal. For children and elderly people, the medicine is prescribed in reduced doses. In the case of severe forms of depression, complicated by suicidal thoughts or actions, treatment of the patient with Amitriptyline in large doses is possible only in a hospital. Since in some cases there is a suicidal effect of the drug, including a delayed one.

Side effects and contraindications

Usually this drug is well tolerated, but, nevertheless, it can cause effects on the active substance or auxiliary chemicals in the composition. Visual symptoms (accommodation disorder), intestinal dysfunction (constipation, diarrhea, and paresis) are noted.

Impaired urinary function (urinary retention, atony of the bladder), vestibulopathy, lethargy, apathy, increased drowsiness (especially with too intense dose increases), decreased libido. When used in large doses or too quickly administered intravenously, convulsive epileptiform seizures may occur. In some cases, there are disturbances in sensitivity (temperature, pain, etc.), spontaneous and pathological leakage of milk from the mammary glands, gynecomastia, weight gain, liver dysfunction, changes in the blood count.

This remedy is not prescribed to children under 12 years of age, women during pregnancy, especially in the first and last trimester (except in extreme cases) and nursing mothers. During the experiments, the teratogenic effect of the drug was revealed. If the medicine could not be discontinued while the child is pregnant, then at least a week before birth you need to reduce the dosage and stop taking it before birth so that the child does not develop withdrawal syndrome.

While taking this medication, you should not engage in activities that require attention and quick reaction, including driving a car.

Drugs with similar effects

Amitriptyline – INN (that is, international nonproprietary name). Patented products containing Amitriptyline as an active ingredient include:

• Saroten Retard,
• Elivel,
• Damile Maleinat,
• Amitriptyline-Grindeks,
• Vero-Amitriptyline,
• Amitriptyline Nycomend.

The latter is quite common. For Amitriptyline Nycomed 25 mg, the instructions for use are similar to those for regular domestic Amitriptyline; it costs approximately 53 rubles per package. Prescription drug. Prescriptions for such drugs are written using Latin. For Amitriptyline, the recipe in Latin will look like this:

Amitriptyline

Rp.: Tab. Amitriptylini 0.025 No. 20

D.S. 2 tablets each 4 times a day after meals for depression.

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