Dosage ; Initially 30-40mg in divided doses or a single dose nocte.
Normal dose ranges 30-90mg daily.
| Mode Of Action | The mechanism of action of amitriptylinne is not fully known but may be due to its increasing the synaptic concentration of norepinephrine and/or serotonin in the central nervous system (CNS). These neurotransmitters are thought to be increased through inhibition of their reuptake by the presynaptic neuronal membrane. |
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| Drug Indication | Depressive illness; useful in depression associated with anxiety and sleep disturbances; chronic neurogenic pain; and bulimia nervosa; temporary treatment of nocturnal enuresis in children 6 years of age or older. |
| Precautions | Blood monitoring; history of epilepsy; pregnancy and lactation; history of mania; close angle glaucoma; concurrent electroconvulsive therapy; anaesthesia; elderly; hepatic impairment; psychosis; withdraw gradually. |
| Contra-Indications | Severe hepatic disorders; acute recovery phase following myocardial infarction; hypersensitivity to tricyclic drugs; MAOIs. |
| Side Effects | Antimuscarinic actions namely: drowsiness; urinary retention; dry mouth; constipation; blurred vision; sweating; hypotensive effect, which may lead to dizziness and syncope. Arrhythmias and heart block; convulsions; haematological and hepatic reactions |
| Dosage | Initially 30-40mg in divided doses or a single dose nocte. Normal dose ranges 30-90mg daily. |
| Special Information | Exceptions from amitriptylline are that it has less muscarinic and cardiovascular side effects, causes more haematological side effects e.g. leucopenia, agranulocytosis, and aplastic anaemia. |
| Pregnancy Category | Category C |
| Pregnancy Category Description | Drugs which, owing to their pharmacological effects, or may be suspected of causing detrimental effects on human foetus or neonates without causing malfunctions. These effects may be reversible |
| Drug Category | DRUGS ACTING ON CNS |
| Drug Sub-Category | Antidepressants, anxiolytics |