Amitriptyline is a tricyclic antidepressant that is used to increase the natural substances in the brain which are required to achieve healthy mental balance. In most cases this is used to help treat depression, but Amitriptyline is also used to treat the symptoms of eating disorders, neuralgia, and to help prevent migraines. It is important to follow dosing instructions for this medication carefully. If you stop taking your medication suddenly you can experience withdrawal effects which can be very unpleasant and in some cases dangerous. Your doctor will give you all the information you need to help avoid these conditions.
Indications and Usage
Amitriptyline is sold under the brand names Elavil, Endep and Vanatrip. It is also featured as a key ingredient in Duo-Vil, Etrafon, Limbitrol and Triavil. These medications are prescribed to help treat the symptoms of depression. Amitriptyline is available as a tablet that is to be taken orally up to four times a day as necessary. Your prescription instructions will be personalized based on the nature of your condition and the severity of your case. In most cases you will be started on a low dose of Amitriptyline that will be increased based on your need and tolerance.
It may take a few weeks before you begin to experience the full effects of Amitriptyline. Do not adjust your medication without your doctor's knowledge and consent if you feel as though it is not working properly. This includes stpping your prescription if you feel as though your symptoms are under control. If your doctor determines you do not need to take Amitriptyline on a regular basis, they will design a step down program to help your body eliminate this drug from your system safely.
Amitriptyline Dosage
There are two regular dosing schedules that your doctor may recommend. In most cases, patients will be started on 75 mg per day in divided doses. This can be increased to 150 mg per day as necessary. A second dosing schedule will start the patient on 50-100 mg right before bed and two to three additional 25-50 mg doses throughout the day. Patients using Amitriptyline long term are given doses averaging 100 mg per day. Those receiving an Amitriptyline dose injection can be given up to four 20-30 mg doses per day. Patients which are hospitalized may require 200-300 mg per day in divided doses, though doses this large are not intended for long term use.
Elderly patients and adolescents have a stronger risk of reacting negatively to Amitriptyline. Doses should be limited to 20 mg and should not be given more than three times a day. Some elderly patients may be able to increase these doses, but doctors should check your plasma levels before increasing your doses to help ensure that a negative reaction will not occur. Children under 12 should not use Amitriptyline.
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Indications |
Usual Dosage |
Special Dosage |
|---|---|---|
|
Initial Dosing |
75 mg in divided doses. This may be increased to 150 mg per day as necessary. Alternative initial doses include 50-100 mg at bedtime and 25-50 mg in two or three doses throughout the day. Hospitalized patients may require up to 200 mg per day. |
Adolescents and Elderly patients should be limited to 20 mg three times a day. |
|
Maintaining Doses |
100 mg per day in divided doses. Hospitalized patients may require up to 300 mg per day. |
Elderly patients may increase their dosing as their bodies will allow. |
|
Intramuscular Dosing |
20-30 mg four times a day |
Children who have never used this drug before should consult with their doctor about an appropriate dose. Patients under 12 may not be able to use this medication. |
Amitriptyline Side Effects
Common side effects of Amitriptyline include dizziness, drowsiness, confusion, constipation, dry mouth, hair loss, weight gain, weight loss, erectile dysfunction, changes in blood sugar and increased sweating. The incidence of these side effects is not known. In most cases these side effects are not dangerous and get better as your body becomes used to your medication. Contact your doctor if your side effects do not stop or become worse over the course of your treatment.
If you begin to develop seizures, confusion, changes in breasts, swelling testicles, jaundice, suicidal thought, attempted suicide, anxiety or panic attacks while using this medication, contact your doctor right away. These side effects are a sign that you are reacting negatively to the mediation or another, more serious medical condition has developed.
Signs of an allergic reaction to Amitriptyline include unexplained rash, hives, unexplained swelling, itching, wheezing and difficulty breathing. If you begin to experience these side effects after taking your dose, stop taking your medication and contact emergency medical services immediately to get assistance. Confirm with your doctor whether or not it is safe to continue using your medication before you take another dose.
It is necessary to use a step down program when it is time for you to stop using Amitriptyline. Otherwise you run the risk of developing withdrawal effects. Withdrawal symptoms include nausea, headache, irritability, restlessness, and sleep problems. If you begin to suffer from these side effects, contact your doctor and determine how best to adjust your medication to help your body react to this dosing change more smoothly.
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Types of Side Effects |
Symptoms |
|---|---|
|
Common Side Effects |
Dizziness, drowsiness, confusion, constipation, dry mouth, hair loss, weight gain, weight loss, erectile dysfunction, changes in blood sugar and increased sweating. |
|
Serious Side Effects |
Seizures, confusion, changes in breasts, swelling testicles, jaundice, suicidal thought, attempted suicide, anxiety or panic attacks. |
|
Signs of Allergic Reaction |
Unexplained rash, hives, unexplained swelling, itching, wheezing and difficulty breathing. |
|
Withdrawal Side Effects |
Nausea, headache, irritability, restlessness, and sleep problems. |
Interactions
Medications known to negatively interact with Amitriptyline include cimetidine, isoniazid, methimazole, nicardipine, ropinirole, ticlopidine, antibiotics, anti-malaria mediation, HIV or AIDS mediation, medications which treat psychiatric disorders, and heart rhythm medication. You should let your doctor know if you are taking these or any other medications regularly to help avoid a negative reaction to Amitriptyline.
Talk to your doctor before taking sedatives, sleeping pills, muscle relaxers or seizure medications while using Amitriptyline. These, and any other medications that are known for making you drowsy, could increase your risk of developing side effects to your medication.
If you have used any other antidepressants or SSRI medications in the last five weeks let your doctor know before you start using Amitriptyline. These medications may still be in your system and could cause a negative reaction when combined with heavy doses of your new medication.
Amitriptyline may make you dizzy or drowsy. Until you know how this medication will affect you, avoid driving or doing any other tasks that will require you to be fully alert. Drinking alcohol may increase your risk of developing these side effects.
This medication may also make you more sensitive to UV rays. Avoid using tanning beds, and wear SPF 30 or higher sunblock and protective clothing when you are outdoors to avoid burning.