Amitriptyline Hydrochloride

structure of the amitriptyline

Indications

1. Depressive illness, particularly where sedation is required.
2. Nocturnal enuresis in children.

Cautions to be considered

1. cardiac diseases (arrhythmias)
2. Epilepsy
3. Pregnancy and breast feeding.
4. Elderly
5. Hepatic impairment
6. Thyroid diseases
7. Phaeochromocytoma
8. History of mania
9. Angle closure glaucoma
10. History of urinary retention

Contraindications (where you have to avoid Amitriptyline)

1. recent myocardial infarction
2. arrhythmias (particularly heart block)
3. severe liver disease

Side-effects

1. Dry mouth
2. sedation
3. blurred vision
4. constipation
5. cardiovascular side-effects (ECG changes, arrythmias)
6. syncope
7. behavioral disturbances
8. interference with sexual function
9. testicular enlargement
10. gynaecomastia

Dose

1. Depression; initially 75mg (elderly and adolescents 30-75mg)daily in divided doses or as a single dose at bed time increased gradually as necassary to 150-200mg; child under 16 years not recommended fordepression.
2. Nocturnal enuresis; child 7-10years 10-20mg: 11-16years 25-50mgat night. maximum period of treatment (including gradual withdrawal) 3 months, need a full physical examination before further course.

Amitriptyline preparations

1. tablets, coated, amitriptyline hydrochloride 10mg.
2. oral solution, amitriptyline hydrochloride 25mg/5ml.