AMITRIPTYLINE

Sedating tricyclic antidepressant

Dosage Forms

Tablet

10 mg
25 mg

Uses

  • Anxiety
  • Depression
  • Neuropathic pain
  • Migraine prophylaxis

Dose and Duration

Anxiety
Adult: 25–50 mg once at night
Depression
Adult and child >16 years: Initially, 75 mg daily in divided doses or as a single dose at bedtime increased gradually as necessary to 150–200 mg Reduce dose in elderly
Neuropathic pain
Initially 12.5–25 mg at night or every 12 hours depend ing on response
Migraine prophylaxis
Initially 12.5–25 mg at night, increased if necessary to maintenance of 50–75 mg at night (max 150 mg)

Contraindications

  • Recent heart attack
  • Arrhythmias
  • Depression in children <16 years
  • Manic phase in bipolar disorders
  • Severe liver disease
  • Epilepsy
  • Diabetes

Side Effects

  • Sedation
  • Abdominal pain, inflammation of the mouth
  • Irregular heartbeat, oedema and hypertension
  • Restlessness and fatigue
  • Increased size of pupils and intra-ocular pressure

Interactions

  • Alcohol (increased sedative effect)

Patient Instructions

  • Take at night
  • Do not take with alcohol
  • Drowsiness may affect ability to perform skilled tasks, such as operating machinery or driving

Pregnancy

  • Do not use in 1st and 3rd trimesters

Breastfeeding

  • Can be used

⚠️ Caution

  • Overdose can lead to death. Signs of overdose are dry mouth, blurred vision, constipation, urinary retention, anxiety, confusion, and sleep disorders
  • Reduce dose in liver disease and for elderly
  • Avoid abrupt withdrawal to avoid withdrawal syndrome