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Amitriptyline
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About amitriptyline
| Type of medicine | Tricyclic Antidepressant |
| Used for | Treatment of depression Treatment of night-time bedwetting in children May also be used to treat neuropathic (nerve) pain and migraine |
| Available as | Tablets Liquid |
Amitriptyline works by preventing certain chemicals (serotonin and noradrenaline) from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of these chemicals, and so helps relieve depression.
In addition, amitriptyline blocks certain receptors in the wall of the bladder, and prevents a chemical (acetylcholine) from acting on these receptors. Acetylcholine normally causes the bladder to empty, so by stopping this action, amitriptyline reduces the need to pass urine.
Before taking amitriptyline
Before taking amitriptyline make sure your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have ever taken an antidepressant known as a Monoamine Oxidase Inhibitor.
- If you take medication for thyroid problems.
- If you have recently suffered a heart attack, or have experienced any other heart trouble.
- If you suffer from mood swings.
- If you receive electroconvulsive therapy (ECT).
- If you suffer from liver problems.
- If you suffer from phaeochromocytoma (tumour that secretes catecholamines).
- If you suffer from porphyria (group of diseases in which there is a disturbance in the levels of chemicals known as porphyrins).
- If you suffer from epilepsy.
- If you have experienced difficulty passing water, or had prostate trouble.
- If you suffer from glaucoma (increased pressure in the eye).
- If you are due to have surgery in the near future.
How to take amitriptyline
- Follow the instructions given to you by your doctor.
- The dose is best taken at night as it may cause drowsiness.
- When used to treat depression, the starting dose is usually low, and increased gradually as your body gets used to the medicine.
Getting the most from your treatment
- It can take a few weeks for the antidepressant action to become apparent- don't stop taking amitriptyline in the belief that it is not working.
- Your doctor may ask you to carry on taking amitriptyline after you feel better- this is to avoid you experiencing a relapse.
- Eating regularly and avoiding or cutting down on alcohol can help you to feel better.
- Try and tell people who are close to you how you feel. It is not weak to cry or admit that you are struggling.
- When taken for night-time bed-wetting, amitriptyline is taken for up to 3 months only.
Can amitriptyline cause problems
Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.
| Common side-effects - these affect less than 1 in 10 people who take this medicine | What can I do if I experience this |
| Dry mouth | Try chewing sugar-free gum, sucking pieces of ice or sugar-free sweets. |
| Constipation | Try to eat a well balanced diet containing plenty of fibre and drink 6 - 8 glasses of water each day. |
| Fast and fluttery heart beat | Speak to your doctor if this persists. |
| Increased appetite and weight gain | Try to eat a well balanced diet containing plenty of fibre and drink 6 - 8 glasses of water each day. Increase your exercise levels. |
| Drowsiness, blurred vision | Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert. Avoid alcohol- it will increase any feelings of drowsiness. |
| Difficulty passing water | Speak to your doctor if this persists. |
| Headache | Ask your pharmacist to recommend a suitable pain-killer. |
Other possible side effects include feeling sick, sweating, shaking, rash, sexual problems, enlarged breasts, pins and needles, changes in taste, ringing in the ears, fever. If you notice any behavioural changes or any other problems which you think may be due to this medicine speak to your doctor.
Important: If you notice yellowing of skin or whites of the eyes (jaundice), contact your doctor as soon as possible.
Important: Suicidal thoughts have been associated with medicines that are used to treat depression (such as amitriptyline) particularly early in treatment or soon after stopping. Tell your doctor straight away if you are having thoughts of harming yourself.
How to store amitriptyline
- Keep all medicines out of the reach of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
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References
- British National Formulary; 54th Edition (September 2007) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF).
- Manufacturer's PIL, Amitriptyline Tablets, Actavis UK Ltd, electronic Medicines Compendium. Text revised January 2007, accessed December 2007.
- Summary of Product Characteristics, Amitriptyline Oral Solution, Rosemont Pharmaceuticals Ltd, electronic Medicines Compendium. Text revised March 2007, accessed December 2007.
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The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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