Amitriptyline
It blocks the neuronal uptake of noradrenaline and exert anticholinergic activity. Drug has marked sedative effect in comparision to Imipramine & is more suitable for depressed patients showing anxiety and agitation.Depressive illness accompanied by anxiety, agitation, retlessness & disturbances of sleep. Masked depression, dysphoria & depression in alcoholics. Childhood bed wetting.
10-25 mg initially 3 times a day, increased by 10-25 mg every 2nd or 3rd day till desired results are achieved. Max 150-225 mg daily. Patients over 60 yrs: 10 mg thrice daily initially. Alcoholics : 25 mg 3-4 times daily. Maint. dose : 10-15 mg thrice daily.
Ischaemic heart disease. Epilepsy. Narrow angle glaucoma. Cardiovascular insufficiency. Pregnancy, retention of urine, severe liver dysfunction.
Hyperthyroidism, suicidal tendency in seriously depressed patients. Renal, hepatic or cardiac disease. May activate latent schizophrenia. Ability to drive or operate heavy machinery may be impaired. Paediatrics: Not recommended below 6 years. Pregnancy & Lactation: Contraindicated. Elderly: Reduced dose necessary.
Dry mouth, constipation, epigastric distress, urinary retention, blurred vision, palpitation, sedation & mental confusion, fine tremors, seizure threshold is lowered, Postural hypotension.
Potentiates sedative effect of alcohol, antiparkinson agents,antipsychotic drugs, increase risk of anticholinergic effects.Reduce effect of antihypertensives, marked hyperpyrexia, convulsions & coma with MAOIs.Potentiates hypertensive effects of sympathomimetics. Reduced serum levels with barbiturates.Neuroleptics inhibit metabolism.
