Other Brands/Names

Amitriptyline Hydrochloride, Trilin.

How It Works

Amitriptyline is part of a medications class known as tricyclic antidepressants. These drugs are commonly prescribed to help manage conditions such as depression, anxiety, eating disorders, and other related issues. It works by enhancing the levels of certain natural chemicals in the brain that are essential for maintaining mental stability.

Indications

Amitriptyline is used to treat various medical conditions, including:

• Depression

• Anxiety

• Nocturnal enuresis (bedwetting during sleep, commonly in children)

• Neuropathic pain (nerve-related pain)

• Prevention of migraine headaches, and more.

Contraindications

• A history of allergic reactions to amitriptyline

• Recently experienced a heart attack, particularly with arrhythmia (irregular heart rhythms)

• Taken antidepressants like monoamine oxidase inhibitors (MAOIs) or cisapride (a drug for improving gastrointestinal motility) in the past 14 days

• Severe liver damage

• Are a child under 6 years old or over 65 years old

Side Effects

Some common side effects include drowsiness, dizziness, dry mouth, blurred vision, constipation, weight gain, or urinating difficulty. If these effects persist or worsen, it’s important to inform your doctor.

Serious side effects can occur, such as:

• Black stools or feces

• Vomit resembling coffee grounds

• Severe dizziness or fainting

• Convulsions (seizures)

• Eye pain, swelling, or redness

• Distorted vision, such as seeing rainbows around lights at night

• Severe chest pain or rapid heartbeat

• Red skin rashes that may be accompanied by swelling of the face or tongue

Types

This medication is available in in the form of  a 25 mg tablet.

Dosage

For nocturnal enuresis (bedwetting)

• Children aged 6-10 years: 10-20 mg daily

• Children aged 11-16 years: 25-50 mg at bedtime

• The treatment duration should not exceed 3 months

For depression

• Adults:

  • Start with 25 mg twice daily, then increase gradually by 25 mg daily up to 150 mg daily, divided into doses.

  • Alternatively, start with 50-100 mg at bedtime, increasing by 25-50 mg if needed up to 150 mg daily.

  • Treatment duration: 2-4 weeks, up to 6 months after recovery to prevent relapse.

• Elderly:

  • 10-25 mg daily, preferably taken at night.

  • May be increased gradually to 100-150 mg daily based on patient tolerance.

  • Doses over 100 mg should be used with caution.

For pain from nerve disorders or migraine prevention

• Adults:

  • Initial dose: 10-25 mg taken at night. The recommended dose is 25-75 mg per day.

  • Doses over 75 mg may be split into multiple doses.

  • Doses over 100 mg should be used with caution.

• Elderly:

  • Initial dose: 10-25 mg at night.

  • Doses over 75 mg should be used cautiously.

Safety

Amitriptyline may cause dizziness, drowsiness, or blurred vision. Avoid activities requiring alertness or clear vision, such as driving or operating machinery, until you can do so safely. It’s also important to refrain from drinking alcohol while on this medication.

Amitriptyline can make you more sensitive to the sun, so use sunscreen and wear protective clothing when you are outdoors. If you have diabetes, make sure to monitor your blood sugar levels regularly. Never stop taking this medication on your own without consulting your doctor.

If you’re planning to become pregnant or think you might be, discuss the benefits and risks of using this medication during pregnancy with your healthcare provider. Amitryptiline is also excreted in breast milk, and the effects on a nursing infant while you are on this medication are not fully known, so consult your doctor before breastfeeding.

Drug Interactions

MAOI Antidepressants

Taking amitriptyline with MAOI antidepressants, such as isocarboxazid, linezolid, metaxalone, procarbazine, sanifamide, or selegiline, can result in a life-threatening drug interaction. These medications should not be taken within 2 weeks before or after using amitriptyline. Always consult your doctor before using these drugs together.

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