What does Amitriptyline treat? Notes on use

Article written by Pharmacist Duong Thu Huong - Vinmec Times City International General Hospital.

Amitriptyline is not the first choice when initiating depression treatment due to more undesirable side effects than newer generation antidepressants. Drugs are often prescribed in cases of failure to respond to new generation antidepressants.
Amitriptyline can be used for many other indications that are not included in the official product information, such as chronic asthenia due to sleep disturbances, neuropathic pain (such as shingles), indigestion, migraine, syndrome irritable bowel syndrome , polysalivitis syndrome , etc.

Anticholinergic : Due to its anticholinergic properties, amitriptyline can cause constipation, dry mouth, blurred vision, and urinary retention. Caution should be exercised in patients with decreased intestinal motility, glaucoma, or ophthalmic problems when taking amitriptyline. Central nervous system depression: Amitriptyline inhibits the central nervous system, causing drowsiness. Therefore, amitriptyline is often taken at night to reduce side effects. Antidiuretic hormone disorder (SIADH): causes low Na. The risk of hyponatremia is increased in patients who are dehydrated, on diuretics, in female patients, and underweight. Weight gain: Weight gain is a possible side effect of most antidepressants. Patients respond to medications for mental well-being and stimulation to eat, leading to weight gain.

Antidepressants have an increased risk of suicidal thoughts in adolescents (18-24 years old). During the treatment of adolescents with amitriptyline, close monitoring of symptoms is necessary to prevent exacerbation of the disease. People with cardiovascular risk should not use amitriptyline because it can prolong QT and cause dangerous cardiovascular complications Serotonin syndrome: Antidepressants have a risk of causing serotonin syndrome when the body releases too much serotonin. endanger life. Symptoms of serotonin syndrome include: dilated pupils, hot face, excessive sweating, increased body temperature, increased heart rate, and muscle fibrosis. When using amitriptyline and have the above symptoms, contact your doctor immediately.

When treating depression, doctors usually start amitriptyline at a dose of 25mg/day in the evening. Depending on the patient's response, the doctor may increase the dose by 25mg every 3-7 days. The maximum daily dose of amitriptyline is usually 300 mg.
When the dose is appropriate, the drug takes 2-4 weeks to take effect. The drug will be maintained for at least 3 months to prevent recurrence of the disease.
It should be noted that amitriptyline cannot be stopped suddenly. When amitriptyline has been discontinued for more than 3 weeks, the dose should be reduced gradually over 2 to 4 weeks as directed by the physician to reduce withdrawal symptoms and relapse.
Amitriptyline can interact with many different drugs. Before starting amitriptyline, contact your doctor and pharmacist for detailed advice.
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N sources: Update, Medical News Today