Amitriptyline is an antidepressant (tricyclic) also used in pain and migraine.
It has antimuscarinic and sedative effects.
Use suitable dosage form of tablets or solution according to the prescribed daily dose.
The usual dose for the treatment of depression ranges from 75 to 150 mg per day.
The initial dose is usually 75 mg but can be individually adjusted in the range of recommended doses. This dosage may be reassessed after 3 weeks of effective treatment at effective doses.
In child psychiatry, the effective daily dose is less than or equal to 1 mg / kg body weight (one drop per kilo).
The pharmacokinetic characteristics of this drug allow a single daily during meals or at a distance from it.
Taking most important may be given in the evening to facilitate sleep.
Treatment with antidepressants is symptomatic. Treatment of an episode is several months (usually about 6 months) to prevent the risk of relapse of the depressive episode.
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Treatment should be started at low doses: 12.5 mg to 25 mg per day for a week. The dose is then gradually increased by increments of 12.5 mg to 25 mg every week as tolerated.
The dosage is individual, it varies from 50 to 150 mg per day and should take into account the associated pain treatments.
The dosage depends on the age, the daily dose is administered at bedtime depending on the dose, it may use the form drops:
Presenting as drops (1 drop = 1 mg) can adapt to the nearest milligram dose for each patient to achieve an effective dose in increments each time the doctor sees fit (children, elderly). The 25 mg tablet can take over form drops.
The recommended dosages are low compared to those used in depression. Sedation is utilized by administering the drug at bedtime, and peripheral anticholinergic effect is a benefit in this indication.
Treatment should be initiated at low dose, that is to say, in practice, half of the minimum dosage recommended (see Pharmacokinetics). Increasing doses, if necessary, will be gradual, practicing clinical monitoring: adverse effects of imipramine may indeed have serious consequences in the elderly (falls, confusion).
Hepatic and renal impairment:
Should reduce the dose (see section Pharmacokinetic properties).
Biochemical effects, presumably the origin of the therapeutic effect, based on a decrease in the presynaptic reuptake of norepinephrine and serotonin which synaptic transmission is facilitated.
The sedative effect is related to the histaminergic component of the molecule.
In addition, it has a central and peripheral anticholinergic effect, to cause adverse effects.
Adrenergic properties may cause orthostatic hypotension.
Improving specifically on mood is often delayed compared to symptomatic improvements such as ideomotor slowing, insomnia or anxiety. This concept should be taken into account before treatment interruption due to inefficiency, as well as the adjustment of effective doses.
Amitriptyline has proven its effectiveness in the treatment of severe major depressive disorder during clinical studies, randomized, double-blind pipes.
This medicine may weaken the mental and physical faculties necessary for the performance of hazardous tasks, such as handling devices or driving motor vehicles.
This medicine SHOULD NEVER BE prescribed in the following cases:
They derive most of the pharmacological properties of tricyclic antidepressants.
Related to peripheral effects of the molecule:
They are usually mild and most often yield continued treatment or dose reduction.
Related to central effects:
Related to the nature of depressive illness:
Cases of suicidal ideation and behavior have been reported during treatment with Amitriptyline or early after treatment discontinuation (see Precautions).
The tricyclic antidepressants can also cause:
Some of these side effects can be prevented or combated by adjuvant therapeutic or corrective or a reduction in dosage.
In the case of enuresis, recommended dosages are low compared to those used in depression and adverse effects are less pronounced.
Due to the presence of glycerol, risk of digestive disorders and diarrhea.
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