- Depression associated with anxiety and sleep disturbances.
- Initially 50-75mg nocte or in divided doses; increase by 25 mg every 5-7 days up to 200mg daily
- Initially 50-75mg nocte or in divided doses; increase by 25 mg every 5-7 days up to 200mg daily
- Nocturnal enuresis in children for a max of 3 months including gradual withdrawal,(minimum age is 6 years):
- 7-10 years: 10-20mg nocte
- 11-16 years: 25-50mg nocte
- Bulimia nervosa (Off-label):
- 150 mg nocte * 8/52
- 150 mg nocte * 8/52
- Post-herpetic neuralgia (Off-label):
- 65-100 mg OD for at least 3 weeks
- 65-100 mg OD for at least 3 weeks
- Migraine prophylaxis (Off-label):
- 10-25mg nocte
- Tablet:
- 25mg
- Taken at night due to its sedative effects.
- To discontinue, dose is gradually tapered off.
- When beginning the medication, mood swings can occur therefore stay alert for any suicidal tendencies.
- Not approved for children < 6 years.
- Avoid exposure to sunlight. Amitriptyline increases sunburn tendencies.
Tricyclic anti-depressant.
It is a potent inhibitor of serotonin and noradrenaline re-uptake at noradrenergic nerve endings. It is an anticholinergic blocking muscarinic cholinergic receptors in the CNS and in the periphery.
Its use as an antidepressant may be due to its ability to inhibit monoamine re-uptake.
- Arrhythmias
- Severe hypotension
- Heart block
- Convulsions
- Hepatic reactions
- Drowsiness
- Syncope
- Dry mouth
- Postural hypertension
- Orthostatic hypotension
- Urinary retention
- Constipation
- Dizziness
- Tremor
- Rashes
- Sexual function interference
- Withdrawal symptoms on abrupt cessation
- Sweating
- Hypersensitivity to tricyclic depressants
- Acute recovery phase following myocardial infarction
- Arrhythmias
- Severe hepatic disease
- CCF
- Abrupt withdrawal
- Coronary artery insufficiency
- During manic phase of bipolar disorder
WARNING
Increased suicidality risk in children, adolescents and young adults with major depressive or other psychiatric disorders
CAUTION:
- CVS disease
- Chronic constipation
- Diabetes
- History of epilepsy, bipolar disorder or psychosis
- Hyperthyroidism (risk of arrhythmias)
- Patients with risk of suicide
- Phaeochromocytoma (risk of arrhythmias)
- Susceptibility to angle-closure glaucoma
- Urinary retention
- MAO inhibitor use within 14 days
- Cisapride
- Procainamide
- Pentamidine
- Alcohol
- Rifampicin
- Antiepileptics
- Cimetidine
- Methylphenidate
- CCBs
Drug Status
| Availability | Prescription only |
| Pregnancy | Not recommended |
| Breastfeeding | Not recommended |
| Schedule | Controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Amiline | 25mg | Tablet | 100’s | Dawa Ltd | Dawa Ltd |
| Amitrip | 25mg | Tablet | 100’s | Laboratory & Allied | Laboratory & Allied |
| Amitriptyline | 25mg | Tablet | 100’s | Cosmos Ltd | Cosmos Ltd |
| Amitriptylline | 25mg | Tablet | 100’s, 1000’s | Biodeal Labs | Biodeal Labs |
| Tryptil | 25mg | Tablet | 100’s | Pharma Life Science | Pharma Life Science |