Select therapeutic use:
Indications for Amitriptyline:
Depression especially endogenous.
Initially 75mg daily in divided doses or 50–100mg daily at bedtime; max 150mg daily. Elderly and adolescents: reduce dose.
During or within 14 days of MAOIs. Acute post MI.
History of seizures, urinary retention, glaucoma. Cardiovascular disease. Suicidal tendencies. Surgery. ECT. Psychosis. Hyperthyroidism. Liver dysfunction. Diabetes. Gradually reduce to lowest effective maintenance dose. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
During or within 5 weeks of fluoxetine. Hyperpyretic crises, severe convulsions, and death with MAOIs (see Contraindications). May block guanethidine. Potentiates alcohol, barbiturates, other CNS depressants. Delirium with disulfiram, ethchlorvynol. Paralytic ileus with anticholinergics. Hyperpyrexia with anticholinergics, sympathomimetics. Monitor serum levels with CYP450 inhibitors (eg, quinidine, cimetidine, phenothiazines, propafenone, flecainide, others: see literature).
Drowsiness, anticholinergic effects, CNS overstimulation, arrhythmias, stroke, coma, confusion, extrapyramidal symptoms, hypo- or hypertension, nausea, fatigue, rash, increased perspiration, headache, photosensitivity, edema, blood dyscrasias, alopecia, libido changes, changes in blood sugar; women: breast enlargement, galactorrhea; men: testicular swelling, gynecomastia.
Formerly known under the brand name Elavil.