home Consultations Antidepressants in the treatment of alcohol withdrawal syndrome and alcohol dependence. Consequences of consuming amitriptyline and alcoholic beverages

Antidepressants in the treatment of alcohol withdrawal syndrome and alcohol dependence. Consequences of consuming amitriptyline and alcoholic beverages

Amitriptyline is used as an antidepressant and sedative by reducing the sensitivity of serotonin and beta-adrenaline receptors. The drug is able to inhibit processes in the brain. Joint reception Amitriptyline and alcohol are contraindicated. This combination can lead to dangerous consequences. These include renal and liver failure, a sharp decrease in blood pressure and even death.

Indications and contraindications

Amitriptyline Nycomed is prescribed for the treatment of the following conditions:

The drug effectively eliminates pain.

The effect of the drug does not appear immediately. It should take three weeks for the results to appear.

The medication is contraindicated for diseases such as:

hypertension;
renal and liver failure;
myocardial infarction;
arrhythmia.

Adverse reactions may include stomach pain, tremors, tinnitus, and fainting. Uncontrolled use of the medicine by the patient can lead to fatal outcome. Lethal dose equal to approximately 1100 mg.

Instructions for use

The instructions for use indicate that the tablets are absorbed in the stomach and intestines. The accumulation of the maximum norm occurs after 8 hours. The drug is completely eliminated after 40 hours.

The tablets should be taken whole, washed down big amount water. For pain syndrome, it should be taken in the evening. The dosage is 25 mg. The maximum is 100 mg.

For depression, take the drug three times a day, 25 mg. It is possible to increase the daily dose to 300 mg.

If there is enuresis, at the age of 6-12 years the medicine is taken at a dose of 10-25 mg. Children with depression are prescribed 15-30 mg, in adolescence up to 100 mg per day.

The maximum duration of therapy is 3 months. The dosage is prescribed only after consultation with the attending physician.

Discontinuation of therapy should be gradual. This is necessary to prevent withdrawal syndrome from developing.

A child's body is more sensitive to an overdose. During pregnancy, the medicine is used only in isolated cases. The drug is contraindicated in childhood up to six years. During lactation, its use is prohibited. This is due to the fact that Amitriptyline is able to penetrate into breast milk and cause in children adverse reactions.

Compatibility and Interoperability

At joint use Amitriptyline enhances the effects of alcohol. The interaction has the following effects:

reduces blood pressure;
inhibits the respiratory center;
depresses the central nervous system.

This interaction has a bad effect on the liver, reduces the reserves of liver enzymes, and factors are formed for the accumulation of metabolic substances. For both substances the reaction will be highly active.

Acetaldehyde in alcohol-containing substances becomes toxic in the body. The result of this interaction is the substance – nortriptyline. It does not leave the body for three days, thereby poisoning it.

The antidepressant Amitriptyline and alcohol are not compatible.

Currently, efforts have intensified to find new methods and means of treatment alcohol addiction. The main task is to achieve stable remission and prevent possible relapses. This problem can be solved with an adequate choice of therapeutic target. Today there is no doubt that the main target is the core disorder of the dependence syndrome - pathological craving for alcohol. In the complex clinical structure of pathological attraction syndrome, affective disorders, mainly of a depressive nature, are constantly present. Numerous patient studies chronic alcoholism revealed a close connection between pathological craving for alcohol, its exacerbation and reduction with the intensification and weakening of depressive and dysphoric phenomena. These clinical data are supported by the results of biological studies indicating the commonality of the underlying neurochemical mechanisms of depression and pathological craving for alcohol.

In most cases, the doctor first encounters a patient when he is clearly diagnosed with a state of withdrawal syndrome. Adequate treatment alcohol withdrawal and post-withdrawal syndromes largely determine the further course of the disease, since at this stage of therapy the foundation is laid for preventing early relapse of the disease. IN last years as means pathogenetic therapy Various antidepressants are increasingly used. However, research on comparative analysis antidepressants different groups for the treatment of pathological craving for alcohol, to date there is no.

In this regard, the purpose of our work was a comparative study therapeutic options antidepressants such as fluvoxamine, valdoxan, heptral, lerivon (mianserin), and their antikiolitic, sedative, hypnotic, vegetostabilizing effects. Special attention focused on the effect of these drugs on pathological craving for alcohol.

The study was conducted in abstinence and post-abstinence states. 40 patients received fluvoxamine for 10 days; some of them were in a state of withdrawal syndrome; in another part of the patients, an exacerbation of the pathological craving for alcohol outside the withdrawal syndrome was observed.

Coaxil was prescribed to 25 patients with alcoholism in withdrawal and post-withdrawal states for 40 days; heptral – 20 patients in withdrawal and post-withdrawal states for 30 days; lerivon – 30 patients in withdrawal and post-withdrawal states for 30 days. At the same time, for comparison, 15 patients received amitriptyline.

The study included only those patients who, according to DSM-IV, were diagnosed with alcohol dependence, alcoholism withdrawal syndrome or affective disorders associated with alcohol dependence. The age of the patients ranged from 18 to 55 years. The duration of the disease varied from 4 to 25 years. The rate of development of the disease was different: from highly progressive (minority of patients) to low progressive. But in most patients the rate of development of the disease was classified as moderately progressive. The pseudo-binge form of alcohol abuse predominated. Clinical picture alcohol withdrawal syndrome included somatovegetative and mental disorders. Mental disorders were characterized mainly by depressive disorders: depressed mood, feelings of internal tension, anxiety, irritability, mild ideational and motor retardation, hypochondriasis, ideas of self-blame and self-deprecation, periodic suicidal thoughts, sleep disturbances, decreased interest in usual activities, weight loss, decreased libido with a pronounced craving for alcohol. About depressive state the patients had not been previously treated.

The drugs were prescribed in the following doses: fluvoxamine – 50-100 mg/day, Valdoxan – 25 mg once a day (at night). Heptral was prescribed parenterally for the first 2 weeks at 800 mg per day; the next 2 weeks - in tablets - 1600 mg per day. Lerivon – 1 tablet 2 times a day ( daily dose 50 mg).

To assess the effectiveness of these drugs, the following scales were used: a scale for assessing somatovegetative manifestations, a scale for assessing psychopathological manifestations, a scale for assessing affective and neurosis-like disorders in the post-withdrawal period, the Hamilton scale and a scale for general clinical impression.

When analyzing the results of using fluvoxamine, its ability to influence pathological craving for alcohol, manifested by low mood with irritability, anxiety, fear, and sleep disturbance in deprivation syndrome, was clearly revealed. The spectrum of activity of the drug is presented in table. 1. As can be seen from the table, in most observations from day 3 there was a clear effect of fluvoxamine on the pathological craving for alcohol. Its severity decreased by more than 2 times, and from day 4 the drug had a positive effect on mood and other mental disorders. To a lesser extent, fluvoxamine affected somatovegetative disorders; The hypnotic effect of fluvoxamine was insufficient. The spectrum of therapeutic activity of fluvoxamine in relieving pathological craving for alcohol outside of withdrawal syndrome is presented in Table. 2. In most observations, already on day 3 outpatient setting There was a clear improvement in the patients' condition: the severity of the pathological craving for alcohol decreased by 2 times, anxiety and irritability decreased. On day 4 my mood leveled off.

Thus, despite the pronounced effect of fluvoxamine on the pathological craving for alcohol and its sufficient anxiolytic, antidepressant, and sedative effects, in general it should be noted that the drug has a clearly weak hypnotic and vegetative-stabilizing effect. The effect of heptral on the somatovegetative manifestations of alcohol withdrawal syndrome was studied separately. Both coaxyl and heptral have minor effect on pathological craving for alcohol, especially heptral. In a relationship sedative effect It should be noted that coaxil has a significant advantage over heptral. These drugs are ineffective as a means of normalizing sleep, which is extremely important for starting treatment for patients with alcoholism. The antidepressant, sedative and vegetostabilizing effects of heptral turned out to be quite low.

At the same time, a fairly high anxiolytic effect of Coaxil and Heptral has been established. In fact, on the 3rd day the feeling of anxiety disappears, although sleep disturbances still remain. This allows us to conclude that the hypnotic effect of these drugs is low. The effect of heptral on somatovegetative disorders in addiction syndrome was studied separately. The intensity of the vegetotropic effect of this drug is also very insignificant.

In addition, when comparing fluvoxamine, coaxil and heptral, another significant disadvantage of fluvoxamine should be noted - its high cost.

Evaluating the results comparative research effectiveness of lerivone and amitriptyline, the following can be noted: lerivone had a pronounced suppressive effect on the craving for alcohol, reducing its intensity already on the 3rd day of treatment and by more than 4 times on the 7th day.

The therapeutic effectiveness of amitriptyline in this regard was lower.

The anxiolytic effect of lerivone was also significantly higher than that of amitriptyline. Clinical manifestations Already by the 3rd day of treatment with lerivone, anxiety was practically leveled out, while with amitriptyline these changes occurred much more slowly.

The same patterns emerged when assessing the sedative effect. Lerivon turned out to be clearly preferable: the intensity of such painful manifestations as irritability, while taking it, decreased by 2.5 times already on the 3rd day of treatment. The sedative effect of amitriptyline occurred later.

Normalization of sleep in patients taking lerivon occurred much faster compared to patients treated with amitriptyline.

In terms of antidepressant effect, lerivone was not inferior to amitriptyline - the results were almost identical.

Analysis of the therapeutic dynamics of somatovegetative disorders in a state of withdrawal syndrome showed more high efficiency lerivone versus amitriptyline. Symptoms such as ticcardia, tremor, hyperhidrosis, and lack of appetite were either completely stopped by the 3rd day of treatment with lerivone, or their intensity decreased by more than 2 times.

The higher therapeutic activity of lerivone compared to amitriptyline is visible in the total assessment of affective and neuropsychiatric disorders in the post-withdrawal period. This is evidenced by the dynamics of relief of such disorders as craving for alcohol, irritability, sleep disorders, having great importance to characterize the period of remission. Normalization of mood, relief of anxiety, irritability, absence of sleep disturbances and a sharp decrease in the intensity of pathological craving for alcohol indicate a significant therapeutic effect of lerivone.

It should also be emphasized that lerivon is well tolerated by patients, side effects and there were no complications.

It should be especially noted that lerivone, unlike amitriptyline, does not produce such typical side effects as anticholinergic and cardiotoxic.

There were also no cases of addiction to the drug, which suggests the safety of its use.

Thus, the comparative therapeutic activity of lerivone and amitriptyline allows us to draw the following conclusion: lerivone, as a means of suppressing the pathological craving for alcohol, is preferable to amitriptyline. It is also superior to amitriptyline in its anxiolytic, sedative, hypnotic, and vegetative-stabilizing effects, and is not inferior to amitriptyline in its antidepressant effect.

Summing up the overall results of the clinical data obtained in a comparative study of fluvoxamine, coaxil (tianeptine), heptral, lerivone and amitriptyline, we can say with confidence that such wide range therapeutic action none of the above antidepressants has, which lerivon has, which is extremely important in the treatment of patients with a pathological craving for alcohol. Naturally, this indicates an advantage this drug when recommending it for use in practical healthcare. No less important factor is the cost of lerivon. It is much cheaper than fluvoxamine, coaxil, and heptral.

Thus, the results obtained are of great practical significance for the treatment of patients with alcohol dependence syndrome and allow us to recommend the inclusion of lerivone along with psychotherapy in complex therapeutic programs. The most optimal is the appointment of lerivone in the initial period of treatment of alcohol withdrawal syndrome.

Scale for the dynamics of psychopathological manifestations in the structure of withdrawal syndrome during treatment with fluvoxamine

Symptoms	Total patients	Therapy effectiveness, points
		Before treatment	Treatment day
		Before treatment
Craving for alcohol
Sleep disturbance
Low mood

Irritability

Here and in Table 2, the severity of symptoms is assessed in points: 0 - absent, 1 - mildly expressed, 2 - moderately expressed, 3 - severely expressed.

Scale for assessing affective and neurosis-like disorders in remission

Manifestations	Therapy effectiveness, points
	Before treatment	Treatment day
	Before treatment
Psychological
Feeling inside discomfort
Unreasonable decline mood
Irritability
Internal tension
Anxiety
Sleep disorders
Alcohol theme dreams
Conscious attraction to alcohol
Somatovegetative
Unpleasant sensations from the outside internal organs, hypersalivation, thirst, sweating, general weakness, brokenness, etc.
Behavioral
Increased conversations on alcoholic topics, desire to stay in alcoholic companies

Amitriptyline is a tricyclic antidepressant. Has a stimulating effect, promotes the production of hormones that cause positive emotions. Namely dopamine, serotonin, norepinephrine.

An important feature of taking this drug is the individuality of doses - for one person, 4-5 tablets of the drug per day are enough to achieve a therapeutic effect, for another, much more. Treatment with amitriptyline is possible only with a doctor's prescription.

Who is the drug prescribed for?

Most often, the need to take amitriptyline is determined by a psychiatrist. People who need to take this drug:

with depression of an endogenous nature. We will talk about the endogenous cause of the disease when the cause of anxiety and bad mood lies in one’s own experiences that are not related to the outside world.
with pathological fears of a psychogenic nature - phobias. The use of an antidepressant helps to normalize the perception of the world and, as a result, fear disappears.
for nutrition correction. In the pathological absence of anorexia and increased appetite, bulimia, there is usually only one reason. The psychogenic nature of these conditions and appetite disorders is an indication for the prescription of an antidepressant.
In case of family quarrels, neuroses, as well as hereditary predisposition, children develop bedwetting - enuresis. In this case, it is recommended to use amitriptyline.

Contraindications for the use of amitriptyline

There are a number of diseases that may worsen while taking amitriptyline:

for pathologies excretory system in the form of urinary retention and intestinal obstruction, the cause of which is a decrease in muscle tone, the use of the drug provokes a worsening of atony.
with angle-closure glaucoma. The reason is that in this disease, amitriptyline causes pupil dilation and leads to acute attack glaucoma.
prostate adenoma or, speaking in simple language, its increase leads to impaired urine output. Taking this antidepressant aggravates the course of the disease, and urination becomes even more scarce.
poisoning with alcohol, painkillers, sleeping pills and psychoactive substances are absolute contraindication to the use of amitriptyline. Its action increases intoxication of the body and contributes to the deterioration of the condition.
use during pregnancy is possible if the consequences for the fetus are less than from the disease itself. The medicine passes through the placenta to the baby, as well as into breast milk and is partially excreted with it.
Contraindicated in children under 6 years of age and people with hypersensitivity to the components of the drug.

Caution when taking amitriptyline

During the entire period of treatment, some groups of patients require increased attention to their condition.

With alcoholism, bronchial asthma, epilepsy, stroke, thyrotoxicosis and schizophrenia, constant monitoring of well-being is indicated. Elderly people and people with heart disease should also first assess the risks before prescribing the drug.

Exacerbation of stomach ulcers and 12 duodenum, as well as increased intraocular pressure will warrant additional monitoring of people taking amitriptyline. For renal and liver failure it is necessary to carefully monitor the condition.

You should not combine a course of an antidepressant with taking antipsychotics and anticonvulsants. In persons prone to drinking alcohol, their behavior should be carefully monitored to prevent combination with amitriptyline.

Side effect

Even when taking therapeutic dose drug, symptoms similar to an overdose may appear. This normal reaction body and, as a rule, after addiction or dose reduction, all discomfort pass.

The most common manifestations of addiction are fever, blurred vision, dry mouth and constipation.

Somewhat less often, symptoms characteristic of the lesion may appear a certain system body:

from the central nervous system weakness, irritability, increased fatigue, decreased concentration.
from the outside of cardio-vascular system increased heart rate and irregular heartbeat appear.
the appearance of dyspeptic disorders in the form of decreased appetite, nausea, heartburn and diarrhea will indicate a reaction to taking the drug from the outside gastrointestinal tract.
when in pathological process gets involved endocrine system, there is an increase mammary glands, potency, libido. Allergic reactions may occur - itching, rash, urticaria.

For more severe addiction, dose adjustment is necessary. The indications will be severe symptoms: headache, hallucinations, hand tremors, dizziness, confusion, convulsions. Unstable blood pressure, fainting, vomiting, jaundice, increased or decreased blood sugar levels, angioedema are also important reasons for reducing the dose of the drug.

Overdose

The drug package contains 10 tablets. Taking this amount at once leads to an overdose. Basically, the poisoning is intentional because Amitriptyline is most often taken by people with mental disorders.

Symptoms increase slowly. First, drowsiness, shortness of breath, hallucinations appear, and the temperature rises. Then the person gets lost in space, his consciousness becomes confused. Characterized by speech disorder, agitation, seizures, and vomiting.

In the absence of help, consciousness is depressed to the point of coma, the pupils dilate, blood pressure decreases, heart failure develops and breathing stops. If resuscitation measures are not carried out in time, an overdose will result in death.

Lethal dose

How many tablets will cause death? It is enough to drink a jar of medicine containing 50 tablets. In fact, the number for critical poisoning is 40. The simultaneous use of amitriptyline and alcohol can also cause death.

Help with overdose

If you are outside the hospital, call urgently ambulance. Need to drink several times a large number of water and induce vomiting. The procedure is repeated until the wash water is clean.

After the stomach has been cleansed as much as possible, it is recommended to give activated carbon at the rate of 1 tablet per 10 kg of the patient’s weight. You can use Polysorb or another sorbent.

It is important to remember that an overdose of amitriptyline ends in death or the development of persistent mental disorders.

Drinking alcohol with amitriptyline

Many medications are prohibited from being combined with alcohol, and the case with antidepressants is no exception. Amitriptyline and alcohol have similar effects, meaning that when taken at the same time, they enhance each other's effects. In this case, the nervous system is affected. Hallucinations, agitation, drowsiness, disorientation, and increased sweating appear. In more serious cases, there is difficulty breathing.

The manifestation of dyspeptic disorders in the form of nausea, heartburn, vomiting and diarrhea in a patient will indicate simultaneous administration amitriptyline with alcohol. Negative influence on the liver in this case can lead to its toxic necrosis.

How is amitriptyline eliminated from the body?

The kidneys take on all the main work of removing the drug - they cleanse the body of drug breakdown products by 80%. The rest is excreted from the body with bile. Complete absence traces of the drug are observed only 7-14 days after stopping use.

Withdrawal syndrome

With abrupt cessation of treatment, withdrawal syndrome may develop. It appears in the form increased excitability, headache, irritability. Characteristic symptoms are vivid dreams, with unusual stories. Digestive disorders are also observed, nausea, vomiting, and diarrhea occur.

How to stop using amitriptyline correctly? To avoid this state, it is necessary to discontinue the drug gradually. Usually, the dose is first reduced, and only if the normal mental and somatic state is maintained, the dose is completely stopped.

Amitriptyline is medicinal product, which has antidepressant, sedative, anxiolytic and thymoleptic effects. Widely used in psychiatric practice in the treatment of the following conditions:

Also sometimes prescribed for migraine prevention and complex therapy chronic pain syndrome.

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Amitriptyline – potent remedy. Treatment with it should be carried out strictly as prescribed by a doctor and under his supervision, otherwise there is a high probability of developing unwanted effects, including overdose.

Taking Amitriptyline usually starts with a minimum dose of 50 mg per day. Then this dose is increased daily by 25–50 mg until a stable therapeutic effect is achieved, but not more than 300 mg per day. During treatment severe forms depression and provided that Amitriptyline is well tolerated by patients, the daily dose can be increased to 500 mg, but therapy at such doses is carried out exclusively in a hospital setting, with round-the-clock medical supervision.

At the beginning of therapy, Amitriptyline can exhibit a suicidal effect, which sometimes prompts patients to take excessively. high dose. Another reason for overdose is addiction to the drug, which develops over time, causing patients to independently increase the dose.

Signs of an overdose of Amitriptyline appear when taking more than 12 tablets (300 mg) per day, and a daily dose of 1200 mg (48 tablets) is fatal.

Signs of overdose

Symptoms of Amitriptyline overdose increase gradually, the speed of their manifestation and severity is determined by the amount taken drug And individual characteristics body.

In the first hours after taking a toxic dose, psychomotor agitation or, conversely, weakness, drowsiness, and lethargy may be observed. Then hallucinations and other signs associated with the m-anticholinergic effect of Amitriptyline appear:

After a few hours, the activity of the central nervous system is sharply inhibited, which leads to impaired consciousness, even to coma. This is accompanied by the following symptoms:

acute respiratory failure;
violations heart rate(ventricular fibrillation and flutter, ventricular tachyarrhythmia);
acute heart failure;
severe arterial hypotension.

Metabolic acidosis subsequently develops, cardiogenic shock, hypokalemia. Lethal outcome occurs against the background of progressive cardiovascular and respiratory failure.

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First aid for Amitriptyline overdose

First aid should begin by calling an emergency medical team; while awaiting its arrival, rescue measures are carried out.

If the victim is conscious:

Rinse the stomach: drink 1 liter of activated carbon suspension, then induce vomiting by irritating the root of the tongue. Repeat the procedure 2-3 times.
Accept Activated carbon at the rate of 1.0 g (4 tablets) per kilogram of body weight.

If the victim is in unconscious:

Give correct position body: lay on its side, which will prevent the tongue from retracting and aspiration of vomit.
Provide access fresh air: loosen tight clothing, open the window.

Rinse the stomach for prehospital stage and it is impossible to give medications to patients who are unconscious, as this can lead to blockage of the lumen (obstruction) of the airways.

Antidote

There is no specific antidote to Amitriptyline.

When is medical help needed?

An overdose of Amitriptyline can be fatal, so health care needed in 100% of cases.

In the hospital, the victim is connected to a cardiac monitor, which allows monitoring the respiratory rate, blood pressure, heart rate and rhythm. Regular laboratory monitoring of the concentration of electrolytes in the blood, as well as the acid-base state (ABC), is carried out. Even with a favorable course, such observation should continue for at least 3–5 days.

There is no specific treatment for Amitriptyline overdose; extracorporeal detoxification methods are ineffective, so symptomatic therapy is carried out:

when respiratory failure increases - tracheal intubation, connecting the victim to ventilator(artificial ventilation);
at metabolic acidosis – intravenous administration sodium bicarbonate solution, artificial ventilation in hyperventilation mode, infusion hypertonic solution sodium chloride;
at ventricular arrhythmias antiarrhythmic drugs are prescribed if this does not lead to persistent therapeutic effect, perform cardioversion or defibrillation;
at vascular insufficiency– intravenous administration saline solutions and colloids. If collapse is severe, Dopamine infusion may be required;
for cupping seizures and psychomotor agitation - Valium or Seduxen.

Possible consequences

An overdose of Amitriptyline, especially severe, is often fatal. If the victim can be saved, early and late complications. The early ones include:

pneumonia;
hypocoagulation syndrome, accompanied by massive internal and external bleeding;
acute renal failure;
acute liver failure.

Long-term consequences:

diseases of the nervous system and psyche caused by toxic and/or hypoxic damage to the brain;
worsening depression;
chronic cardiac, renal and liver failure.

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Medicines and alcohol are a priori incompatible things. And if a person drinks alcohol simultaneously with treatment with seemingly harmless drugs, then the harm to his health can be irreparable. Tandem of alcohol and drug therapy can sometimes lead to death. How can the use of alcohol and Amitriptyline be combined? What could be the consequences of this “duet”?

Amitriptyline is an antidepressant medicine. It is used to improve the condition of people who are depressed. Treatment with Amitriptyline imposes strict ban for drinking alcohol. The drug is prescribed only after consulting a doctor and with a prescription. Amitriptyline reduces anxiety and psychomotor agitation, feelings of fear and tension, insomnia and panic attacks. It is used to treat phobias and childhood enuresis, psychogenic anorexia and the prevention of migraines, chronic pain syndrome and gastric and duodenal ulcers.

In practice, Amitriptyline is used in the form of tablets, dragees, and injections.

Such a combination is taboo and the doctor always warns the patient about this. The mechanism of action of the drug and alcohol is similar: inhibition of the central nervous system. And it’s not difficult to guess that alcohol and medicine enhance each other’s effects. The consequence may be increased blood pressure and respiratory depression. Combination can also enhance side effects that everyone has synthetic drug. That is, the simultaneous use of an antidepressant and any type of alcohol can lead to hallucinations and agitation, drowsiness and increased sweating, disorientation and allergic reactions. Some patients may experience fever. In worst cases, heart rhythm disturbances can occur, resulting in a stroke or heart attack.

The simultaneous use of strong drinks and Amitriptyline has a negative effect on the kidneys, because they remove both substances. From the gastrointestinal tract, the “duet” can result in nausea and vomiting, stomatitis and heartburn, darkening of the tongue and impaired taste, diarrhea. But the liver experiences the greatest load from this combination. For the organ that is the filter of our body, this is just a blow. The liver takes on 90% of the toxins of all alcohol consumed; it also breaks down the antidepressant. Combining these two tasks can lead to toxic necrosis.

The attending physician is simply obliged to inform his patient about such consequences. A person must understand that even small dose alcohol (a glass of wine, a glass or two of vodka) can cause irreversible consequences, including death.

First aid for a person after combining alcohol and Amitriptyline

There are many people who do not pay attention to doctors' warnings. They believe that they are completely healthy, that the consequences of the combination may threaten someone else, and doctors are simply reinsuring themselves. Therefore, at festive feasts they drink without remorse along with other people.

If a person using Amitriptyline feels ill after a glass or two, he must act decisively. Before the ambulance arrives, the victim’s stomach needs to be rinsed. To do this, he should be forced to drink up to 2 liters of water. Then by pressing the root of his tongue you need to call vomiting reflex. After this, the victim should be given activated charcoal. Usually they take one tablet per 10 kilograms of weight, so 5-6 tablets at once will not be superfluous. Activated carbon is an excellent sorbent; it removes all toxins from the body. This way, the remnants of Amitriptyline and alcohol will be eliminated naturally. Further help the victim should be under medical supervision in a hospital.

So, the combination of alcohol and Amitriptyline is strictly prohibited. You don’t need to think that warnings won’t affect you, that your body is strong and invulnerable. Sometimes myself healthy person threaten much more serious consequences, rather than those warned about by the drug manufacturer’s instructions.