Amitriptyline

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Amitriptyline hydrochloride (sold as Elavil®, Tryptanol®, Endep®, Elatrol®, Tryptizol®) is a tricyclic antidepressant drug. It is a white, odorless, crystalline compound which is freely soluble in water and usually dispensed in tablet form. The empirical formula of its hydrochloride salt is C₂₀H₂₃N·HCl.

Contents

1 Mechanism of Action
2 Uses

2.1 Approved
2.2 Unapproved/Off-Label/Investigational

3 See also
4 References

Mechanism of Action

Amitriptyline affects serotonin and noradrenaline reuptake almost equally.

Uses

Approved

Amitriptyline is approved for the treatment of endogenous depression and involutional melancholia (depression of late life, which is no longer seen as a disease in its own right),Weissman MM. "The myth of involutional melancholia." Journal of the American Medical Association. 1979 Aug 24-31;242(8):742-4. PMID 459064 and reactive depression and for depression secondary to alcoholism and schizophrenia. Adult typical dosages are 75 to 200mg daily, with half this initially for elderly or adolescents.

It may also be used to treat nocturnal enuresis (bed wetting). Children between the ages of 7 to 10 years having a dose of 10 to 20 mg, older children 25 to 50mg at night. It should be gradually withdrawn at the end of the course, which overall should be of no more than 3 months.British National Formulary 45 March 2003

Unapproved/Off-Label/Investigational

Amitriptyline may be prescribed for other conditions such insomnia, chronic pain, postherpetic neuralgia (persistent pain following a shingles attack), fibromyalgia, vulvodynia, interstitial cystitis, irritable bowel syndrome and as a preventative (prophylaxis) for patients with frequent migraines. Typically lower dosages are required for pain modification of 10 to 50mg daily.2

A randomized controlled trial published in June of 2005 found that amitriptyline was effective in functional dyspepsia to famotidine and mosapride combination therapy. Otaka M, Jin M, Odashima M, Matsuhashi T, Wada I, Horikawa Y, Komatsu K, Ohba R, Oyake J, Hatakeyama N, Watanabe S. "New strategy of therapy for functional dyspepsia using famotidine, mosapride and amitriptyline." Alimentary Pharmacology & Therapeutics. 2005 Jun;21 Suppl 2:42-6. PMID 15943846 [Fulltext]

References

[PubChem Substance Summary: Amitriptyline] National Center for Biotechnology Information.
[TREPILINE®-10 TABLETS; TREPILINE®-25 TABLETS] South African Electronic Package Inserts. 12 May 1978. Revised February 2004.
[SAROTEN® RETARD 25 mg Capsules; SAROTEN® RETARD 50 mg Capsules] South African Electronic Package Inserts. December 1987. Updated May 2000.


Monoamine oxidase inhibitors (MAOI): Reversible Inhibitor of Monoamine oxidase A (RIMA): Dopamine Reuptake Inhibitor (DARI): Norepinephrine-dopamine reuptake inhibitors: Norepinephrine Reuptake Inhibitor (NRI) or (NARI): Serotonin-Norepinephrine Reuptake Inhibitor (SNRI): Selective Serotonin Reuptake Inhibitor (SSRI): Selective Serotonin Reuptake Enhancer (SSRE): Tricyclic antidepressants (TCA): Tetracyclic antidepressants: Noradrenergic and Specific Serotonergic Antidepressant (NaSSA):

Monoamine oxidase inhibitors (MAOI):

Reversible Inhibitor of Monoamine oxidase A (RIMA):

Dopamine Reuptake Inhibitor (DARI):

Norepinephrine-dopamine reuptake inhibitors:

Norepinephrine Reuptake Inhibitor (NRI) or (NARI):

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI):

Selective Serotonin Reuptake Inhibitor (SSRI):

Selective Serotonin Reuptake Enhancer (SSRE):

Tricyclic antidepressants (TCA):

Tetracyclic antidepressants:

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA):

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