home Audience 3 Amitriptyline has dual or triple action. Properties, rules of use and side effects of amitriptyline. Interaction with alcohol

Amitriptyline has dual or triple action. Properties, rules of use and side effects of amitriptyline. Interaction with alcohol

It's time to make a separate article about this drug. Moreover, I have something to say about him.

This is by far my favorite antidepressant. I tolerate it better than others, my performance does not drop, there is no fog in my head. One minus is that at therapeutic doses (medium and high) it causes weight gain. But let's talk about everything in more detail.

I first heard about amitriptyline from my not quite normal boyfriend, whose relative was taking it. In his characteristic manner of generalizing everything, he put it on a par with haloperidol, and this is a serious antipsychotic for completely psychotic people (schizophrenics, for example). So for me, amitriptyline became associated with complete abnormality. And at my first appointment with the doctor, she told me something like “well, I can, of course, prescribe you cheap amitriptyline, but then you won’t be able to walk.” Yeah. I was doing great on amitriptyline. This is not such a terrible drug as they try to show us. By the way, I switched to it from the “ideal” Cipralex, which could not completely eliminate my panic attacks.

What does amitriptyline help with?

For depression, panic attacks, anxiety and so on. It is part of a large group of tricyclic antidepressants that are quite powerful, but only if the dosage is adequate. They love to give it in hospitals, since it gives an effect almost immediately due to the fact that the anti-anxiety and hypnotic effects appear after the first dose. Antidepressive drugs develop gradually and can be counted on only after three weeks.

Amitriptyline is also often used for chronic pain. They even treat ulcers! True, treatment can only begin when the acute period has passed. I can also say with confidence that the drug perfectly fights pain in the intestines, especially if they are caused by such a nasty diagnosis as irritable bowel syndrome. Amitriptyline also helps with (it really helps, it’s been tested!). For all these illnesses, smaller doses are usually taken than for depression.

Manufacturer

Personally, I (and everyone else too) have encountered three different amitriptylines - Denmark (Amitriptyline Nycomed), Slovenia and Russia. Some say they don’t feel the difference, others say that only Slovenian is good. From personal experience I can say that I like Amitriptyline Nycomed the most - that’s what I’m taking now. It acts more delicately; I didn’t notice any effect like “I got hit on the head with a dust bag.” Of course, it is more expensive than the domestic one, but people, it still costs 55 rubles for 50 25 mg tablets! It's practically free! By the way, some are beginning to doubt a drug with such a cost, but I tell you with all responsibility - do not doubt it! It works, and how.

Dosage

Amitriptyline is available in two dosages - 10 and 25 mg. The minimum therapeutic dose is 75 mg per day. The antidepressant effect of the drug is revealed at a dosage of at least 150 mg per day - that’s 6 tablets of 25 mg. They can be distributed approximately like this - 2-2-2 (morning-afternoon-evening), 3-3 (morning-evening), 1-1-4 (morning-afternoon-night). The instructions allow you to drink most of the dose at night, since the drug has quite severe side effects (especially at the beginning of use), but then I drank it and lay down, fell asleep, did not feel anything.

I’ll say right away that doctors outside hospitals avoid prescribing normal doses of amitriptyline. I don’t know why - are they afraid that the patient won’t reach them later and will fall somewhere along the way? The last time I said that I usually take three tablets a day (that is, those same 75 mg), they asked me “isn’t that too much?” This speaks well of the professionalism of doctors in mental health centers, since lower dosages simply will not have the desired effect. Or do they simply hope that with a small dosage the patient will receive an anti-anxiety effect, and no more is needed?

In small doses, according to both patients and researchers, only a sedative and hypnotic effect predominates. I use this regularly, and it usually takes me two weeks on 50 mg to get back to normal. But if you need a serious effect, then you can’t do without serious doses.

You should start taking it with a minimum dosage, because if you immediately take a 25 mg tablet, you will be knocked out so much that you will not want to continue. Half, and even that - for the night. Every 3-4 days, add half a dose until you reach 75 mg per day. Sit on this dose and let your body get used to it. Then you can add one tablet a week to the desired dosage - let me remind you, it should be no less than 100-150 mg. As soon as you reach the desired dose, you can count down 3 weeks. There is no desired effect - raise it again. At home, I do not recommend drinking more than 150 mg, so if you decide to do this, then either consult a doctor or go to the hospital.

Why do I describe the initial and subsequent dosages this way? Because even though amitriptyline is a well-studied drug, many doctors make quite serious mistakes. Either they immediately prescribe large doses, or initially they do not want to go to even the minimum therapeutic level. But, in any case, I always recommend that all dosage changes be coordinated with your doctor, and if you do something on your own, it is only at your own peril and risk.

And remember that taking beta blockers (such as, for example,) significantly increase the concentration of amitriptyline in the blood, so the dosage should be minimal (best of all - two times lower than required).

Duration of admission

You need to take amitriptyline in the required dosage for six months (counting from the complete disappearance of symptoms). Then you can reduce the dosage - very, very gradually, half a week, otherwise withdrawal symptoms will set in. It is not as strong as the same Paxil, but for some it can give indescribable sensations. I always lowered smoothly, so I didn’t feel anything like that.

When you reduce it to 2-3 tablets a day, sit on this dose longer, do not reduce it completely. This is a maintenance dose; it can be taken for a year or several years. If you do not go through this, then you may have to take this dose for the rest of your life. My depression usually returns after about a month if I took the pills for a long time, and after two weeks if the course was short. Therefore, it is best not to reduce it to zero, leave the minimum dose. I now have one tablet a day, that’s enough for now.

Side effects

Ooooh, this is just a huge field for writing Talmuds. Any antidepressant will have side effects, but some people call amitriptyline just a beastly drug in this regard. Well, it's actually not that scary. So what can you have?

Dry mouth. This is the first thing even a doctor will tell you. Some say that it is difficult to even speak; the tongue cannot move in the mouth. I didn’t experience this even at high dosages. I don't know what's wrong with me.

Tachycardia. The resting pulse can be up to 120 beats per minute. During my first course, I was afraid of this side effect, but gradually everything calmed down for me. The maximum can be 90-100 strokes. By the way, in general, amitriptyline is considered cardiotoxic, that is, it can cause heart failure. But this only applies to high doses and long periods of use. But, in any case, it is better to do an ECG every six months.

Pupil dilation. Everyone close to you may mistake you for a drug addict (wear dark glasses, ha ha!). But gradually it will pass. Personally, I didn’t have this.

Constipation. This can be a real problem if you don't immediately grab this side by the tail. If you have a penchant for this matter, then it is best to start consuming more fiber. And if this does not help, then there is an excellent drug called Duphalac, which you can take for a long time.

Weakness, lethargy. It will probably be at the beginning of the reception. We take the main dose at night and wait for the body to adapt. Gradually everything will pass.

Decreased cognitive abilities. The pot stops cooking. This also happens at the beginning of treatment. Personally, he always cooks for me, but not everyone is like me. You have to endure this. Naturally, you don’t need to start taking amitriptyline before important exams or projects, otherwise you’ll fail everything.

Weight gain. This is the main side effect of amitriptyline for me! I usually gain from 10 to 25 kg per cycle, and that's a lot! My doctor tried to put me on a diet that prohibited almost everything. It didn’t work, there were breakdowns, and because of them I gained even more than I could have. So now I just “surrender to the will of the waves” and eat. But at the same time, I try to walk and play sports to minimize the harm.

Amitriptyline and anesthesia

The instructions for the drug say that if you take it, you need to inform the doctor who is going to give you anesthesia - both local and general (for example, this could be a dentist). But in practice, you will get a perplexed face and complete ignorance of what amitriptyline is and how dangerous it can be during anesthesia. I was very interested in this issue and this is what I found out. If you are taking medium or high doses of amitriptyline, it is best to avoid anesthesia altogether at this point. If you can’t do without this, then this should be the minimum possible dose of anesthetic for a short time. It's best to do everything in a clinic, where they have everything you need in case you pass out. In general, it is better if the clinic is not very far from the hospital. Scary? So do I. So it is best not to mix amitriptyline with anesthesia. Well, at low doses you can, of course, but also with caution.

The simultaneous use of antidepressants and alcohol is recognized as one of the most dangerous combinations, which increases the risk of increased depression, psychosis, and death many times over.

Amitriptyline

Indications for the use of the tricyclic antidepressant Amitriptyline are depression, emotional disorders, behavioral disorders, schizophrenic psychosis, neurogenic pain syndrome, neurotic, organic brain damage.

Amitriptyline has an antidepressant and sedative effect by reducing the sensitivity of serotonin and beta-adrenergic receptors. It has an inhibitory effect on processes in the brain.

The drug soothes pain, promotes tissue scarring in stomach ulcers, and reduces appetite. When treating depression, the effect of the drug does not appear immediately. It takes on average up to 3 weeks for treatment results to appear. Accordingly, the question arises: is it possible to take Amitriptyline with alcohol?

Properties

Tablets and pills are absorbed in the stomach and intestines. The drug accumulates in the blood in maximum concentration after 3-8 hours. The half-life is from 10 to 26 hours, Amitriptyline metabolites are eliminated within 18 to 44 hours.

It takes several days to completely cleanse the body of the medicine. Abrupt withdrawal of the drug causes withdrawal syndrome. The drug is used for treatment and taking ethyl alcohol is contraindicated.

Contraindications

Amitriptyline is contraindicated in the following diseases:

hypertension;
acute liver, kidney failure;
intestinal obstruction;
stomach ulcer.

Amitriptyline is prescribed with caution for high intraocular pressure, heart disease, and arrhythmia.

Side effects are observed mainly in the heart, nervous, vascular system, and stomach.

When taking the drug the following are observed:

In case of an overdose of Amitriptyline, life-threatening conditions develop, convulsions, hallucinations, cardiac arrhythmia occur, psychosis, and coma are possible.
The video describes the drug Amitriptyline:

Interaction with alcohol

Amitriptyline enhances the effects of alcohol. The compatibility of these drugs causes a decrease in blood pressure, has an inhibitory effect on the respiratory center, and depresses the central nervous system.

Ethyl alcohol also enhances the side effects of Amitriptyline. With simultaneous use, the risk of visual impairment, hallucinations, and disorientation in the surrounding space increases.

Ethanol negatively affects the urinary system, causes significant difficulties with urination, provokes constipation, having a depressing effect on intestinal motility.

Ethanol and medicine negatively affect the liver, exhaust the capabilities of liver enzymes, and create conditions for the accumulation of metabolic products. Moreover, both ethanol and Amitriptyline metabolites are highly active.

Thus, acetaldehyde is a metabolite of alcohol, several times more toxic than ethyl alcohol itself. The activity of Amitriptyline’s metabolite, the compound nortriptyline, is also high. In addition, nortriptyline takes a longer time (up to 3 days) to be eliminated from the body.

Consumption of alcohol-containing beverages lengthens the half-life of the drug and its metabolites, which creates the risk of overdose and the appearance of all symptoms accompanying an overdose in a more pronounced manifestation.

Possible consequences

Alcohol in combination with Amitriptyline:

increases depression, causes panic attack, psychosis;
disrupts liver function, leading to;
complicates urine excretion, contributes to renal failure;
causes a sharp decrease in blood pressure, a decrease in body temperature, coma;
can cause respiratory arrest and death.

Taking 5 g of Amitriptyline causes poisoning, and the lethal dose of the drug in the absence of alcohol in the blood is 12 g. Ethyl alcohol increases the side effects of the antidepressant, which in an unpredictable way reduces the lethal dose of the drug.

The degree to which the side effects of the drug increase depends on the condition of the patient’s liver, the characteristics of his metabolism, and the ability to utilize alcohol, antidepressants and their metabolites.

A person, simply out of ignorance, can exceed the lethal dose if he combines the medicine, even in the prescribed therapeutic dosage, with drinking alcohol.

Admission rules

Amitriptyline and its metabolites remain in the blood for a long time. It may take several days for the medication to be completely eliminated from the body. You can drink alcohol no earlier than 3 days after your last antidepressant intake.

But the tradition of drinking wine, unfortunately, is ineradicable. They drink “for company” even during treatment with antidepressants. Such extreme sports enthusiasts need to remember the danger of drug overdose as a result of the enhancing influence of alcohol, and take alcoholic beverages in a minimal dose.

In order not to cause an exacerbation of the disease or increased side effects, you should not take alcohol after Amitriptyline earlier than one day later, and in a dose exceeding 50 mg of vodka or 100 mg of dry wine. It is advisable to drink this portion over 2-3 hours, and not drink it at once.

You can resume treatment after drinking alcohol no earlier than 24 hours later. The most dangerous consequence of taking alcohol and Amitriptyline can be a severe coma.

And doctors are not always able to save the victim. And recovery from a coma is accompanied by deterioration of vision, cardiac dysfunction, and long-term depression, which is very difficult to treat.

conclusions

Amitriptyline should not be combined with alcohol. Taking even small doses of alcohol-containing drinks can cause severe depression, undoing the results of several weeks of treatment for depression, stomach ulcers, and schizophrenic psychosis.

According to reviews from doctors, alcohol is contraindicated both in treatment with Amitriptyline and in the diseases for which it is prescribed. Drinking alcohol causes diseases for which antidepressants are prescribed. And combining the use of a depressant, which is alcohol, with the antidepressant Amitriptyline is unacceptable.

Amitriptyline is a drug from the group of antidepressants that is used in the treatment of depressive conditions and mixed emotional and phobic disorders.

It has a pronounced thymoanaleptic and sedative effect. These are some of the strongest drugs at a fairly reasonable price. But today, experts are divided on the possibility of recommending this drug in the first line of therapy.

In this article we will look at why doctors prescribe Amitriptyline, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Amitriptyline can be read in the comments.

Composition and release form

The drug is available in the form of tablets, dragees and solution.

1 tablet contains amitriptyline hydrochloride in terms of amitriptyline - 25 mg;
excipients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hypromelose, magnesium stearate, aerosil, macrogol 6000, titanium dioxide, talc, Tween-80, acid red 2 C.

Clinical and pharmacological group: antidepressant.

Amitriptyline: indications for use

Amitriptyline is a drug often used in the treatment of the following psychopathological conditions and disorders:

All types of schizophrenia.
Inorganic psychoses of unspecified etiology and genesis.
Depressive symptoms of all types.
Recurrent depressive disorder.
Bulimia of nervous origin.
Emotionally unstable personality disorder.
Behavioral and social adaptation disorders.
Inorganic enuresis.
Migraine.
Constant pain resistant to therapy.

There are positive reviews about Amitriptyline, used for gastrointestinal ulcers, to relieve headaches, and to prevent migraines.

pharmachologic effect

The drug belongs to the group of tricyclic antidepressants. In addition to the pronounced sedative effect, Amitriptyline has the following number of therapeutic effects:

Analgesic effect (associated with a decrease in serotonin concentration);
Blocking acetylcholine receptors in the central and peripheral nervous system;
Antiulcer effect (associated with blocking histamine receptors in the digestive system);
Increasing the tone of the bladder sphincter and increasing its ability to stretch (associated with blocking serotonin and acetylcholine receptors).

The therapeutic effect of the drug develops 2-3 weeks after the start of treatment.

Instructions for use

According to the instructions for use, the medicine is taken orally immediately after eating, without chewing, which ensures the least irritation of the stomach walls.

The initial daily dose when taken orally is 50-75 mg (25 mg in 2-3 doses), then the dose is gradually increased by 25-50 mg until the desired antidepressant effect is obtained.
The optimal daily therapeutic dose is 150-200 mg (the maximum dose is taken at night).
For severe depression resistant to therapy, the dose is increased to 300 mg or more, to the maximum tolerated dose.
In these cases, it is advisable to begin treatment with intramuscular or intravenous administration of the drug, using higher initial doses, accelerating the increase in dosage under the control of the somatic condition.

After obtaining a stable antidepressant effect after 2-4 weeks, the dose is gradually and slowly reduced. If signs of depression appear when reducing doses, you should return to the previous dose.

If the patient's condition does not improve within 3-4 weeks of treatment, then further therapy is not advisable.

Contraindications

The drug should not be used in the following cases:

individual hypersensitivity reactions;
myocardial infarction (even during the recovery period);
heart failure or intracardiac conduction disorders;
atony of the bladder;
high blood pressure;
prostatic hyperplasia;
intestinal obstruction;
disorders of the liver and kidneys;
exacerbations of stomach or duodenal ulcers;
under 6 years of age.

Relative contraindications requiring additional examination of the patient and consultation with a doctor are:

epilepsy;
arrhythmia;
hyperthyroidism,
ischemic disease;
glaucoma.

Side effects

The use of Amitriptyline can cause blurred vision, urination, dry mouth, increased intraocular pressure, increased body temperature, constipation, and intestinal obstruction.

Judging by the reviews of Amitriptyline, all these side effects disappear after reducing the prescribed doses or after the patient gets used to the drug.

In addition, after treatment, weakness, ataxia, tachycardia, nausea, heartburn, stomatitis, vomiting, anorexia, discoloration of the tongue, epigastric discomfort, fatigue, insomnia, dizziness, nightmares, confusion, irritability, tremor, motor agitation, hallucinations may be observed. , drowsiness, impaired attention, paresthesia, convulsions, arrhythmia, increased activity of liver enzymes, diarrhea, jaundice, galactorrhea, changes in potency, libido, testicular swelling, urticaria, itching, purpura, hair loss, enlarged lymph nodes.

Pregnancy and lactation

In pregnant women, the drug should be used only if the expected benefit to the mother outweighs the potential risk to the fetus.

Passes into breast milk and may cause drowsiness in nursing infants. To avoid the development of withdrawal syndrome in newborns (manifested by shortness of breath, drowsiness, intestinal colic, increased nervous excitability, increased or decreased blood pressure, tremor or spastic phenomena), amitriptyline is gradually discontinued at least 7 weeks before the expected birth.

Analogs

Amitriptyline – INN (that is, international nonproprietary name). Patented products containing Amitriptyline as an active ingredient include:

Attention: the use of analogues must be agreed with the attending physician.

The name in Latin is amitriptyline.
The active ingredient is amitriptyline.
Pharmacological properties – antidepressant, non-selective norepinephrine and serotonin reuptake inhibitor.
Manufacturers: Moscow Endocrine Plant, ALSI Pharma, Ozon, Dalkhimfarm, ZiO-Zdorovye, Moskhimfarmpreparaty im. N. A. Semashko, Grindeks (Latvia), Zentiva (Czech Republic), Takeda (Japan), Sintez, Bryntsalov-A, Apotex Inc. (Canada), Veropharm, H. Lundbeck A/O (Denmark).

Amitriptyline is a classic tricyclic antidepressant. The drug was one of the first to be synthesized; it is called the “old antidepressant.” However, today the medicine occupies a leading place in the treatment of severe depression and chronic pain syndromes. The advantage of amitriptyline is its pronounced dual effect on serotonin and norepinephrine. This ensures the high effectiveness of the drug both in cases of depression and chronic pain. However, the medicine has a number of contraindications and side effects. Therefore, it is impossible to talk about the universality of drugs in this group.

pharmachologic effect

A remedy against depression. Reduces anxiety, severe emotional arousal, and depressive symptoms. The principle of action against depression is due to an increase in the amount of norepinephrine in synapses and/or serotonin in the central nervous system (decreasing their reabsorption). The accumulation of these neurotransmitters is observed due to the suppression of their reuptake by the membranes of presynaptic neurons.

The effect of the antidepressant occurs within two to three weeks from the start of the medication.
Amitriptyline has a sedative, M-anticholinergic, antihistamine, antiserotonin, thymoleptic, anxiolytic and analgesic, antiulcer effect.

During general anesthesia, it reduces blood pressure and body temperature.
Does not inhibit monoamine oxidase.

Dosage forms of the drug

Amitriptyline is made by many manufacturers. The main forms of the medicine are tablets, injection solution:

solution for injection – ampoules 20 mg/2 ml, vials 10 mg/ml;
tablets 0.025 g;
sugar-coated tablets 10 mg, 25 mg;
tablets, film-coated 10 mg, 25 mg, 50 mg, 75 mg;
dragee 25 mg;
extended-release capsules 50 mg.

The quantitative composition of the drug, as well as the specific gravity of the active substance, may be different.

Compound

Composition of solution for injection:

active agent – amitriptyline hydrochloride;
excipients – glucose (dextrose), water for injection.

Composition of film-coated tablets:

excipients – magnesium stearate, talc, povidone, potato starch, microcrystalline cellulose, lactose monohydrate.

Shell composition: propylene glycol, hypromellose, titanium dioxide, talc.
Composition of tablets:

active ingredient – amitriptyline;
excipients – lactose, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, polyethylene glycol 6000, talc, polysorbate 80, colloidal silicon dioxide, hypromellose, titanium dioxide (E 171), carmoisin (E 122).

Composition of extended-release capsules:

active substance – amitriptyline hydrochloride;
excipients - stearic acid, sugar spheres, shellac (unwaxed shellac), talc, povidone.

The composition of the empty capsule is gelatin, red iron oxide dye (E 172), titanium dioxide (E 171).

Indications

severe forms of depression, especially with typical symptoms of anxiety, emotional arousal, sleep disturbances: recurrent (repeating), reactive (after mental trauma), neurotic, drug-induced, with alcohol withdrawal, organic brain damage, including in childhood;
schizophrenic mental disorders, depressive states in patients with schizophrenia;
mixed emotional state disorders;
disturbances of attention, vigorous activity;
nocturnal enuresis (except for patients with decreased tone of the bladder walls);
nervous;
chronic pain syndrome - pain in cancer patients, rheumatic diseases, atypical pain in the face, postherpetic neuralgia, neuropathies of various origins (diabetic, post-traumatic, other peripheral neuropathy);
migraine prevention;
peptic ulcer of the stomach and duodenum.

Tricyclic antidepressants become first-line drugs for severe disorders.

Contraindications

Individual hypersensitivity to amitriptyline, excipients included in the drug.
Use simultaneously with drugs that suppress monoamine oxidase and two weeks before starting treatment.
in the acute and subacute period.
Acute alcohol intoxication.
Acute intoxication with hypnotics, analgesics and psychoactive drugs.
Angle-closure glaucoma.
Severe cardiac dysfunction - second degree atrioventricular block, intraventricular conduction disorders (bundle branch block).
Children up to 6 years of age when administered orally, children up to 12 years of age when administered by injection.
Amitriptyline is used with caution for arrhythmias, coronary heart disease, heart failure, thyroid diseases, a history of convulsive syndrome, pheochromocytoma, porphyria, and anesthesia.
Amitriptyline is not prescribed during pregnancy (primarily in the first and third trimesters), except in cases of extreme necessity. There have been no controlled clinical studies of the safety of amitriptyline during pregnancy.
Breastfeeding is contraindicated during therapy.

Method of administration and dosage

Amitriptyline is taken orally without chewing immediately after eating to reduce irritation of the gastric mucosa.
The initial dose for adults is 25-50 mg at bedtime, then the dosage increases over 5-6 days to 150-200 mg per day in three doses, the largest part of the dose is prescribed. If after 14 days there is no improvement, the daily dose is increased to 300 mg.

When signs of depression disappear, the dose is reduced to 50–100 mg per day and therapy is continued for at least three months.
In old age, with mild disorders, a dose of 30–100 mg per day at night is prescribed; after achieving a therapeutic effect, they switch to the minimum effective dose – 25–50 mg per day.

Injections should be administered slowly at a dose of 20–40 mg four times a day, gradually replacing oral administration. The duration of treatment is no more than 6–8 months.
For nocturnal enuresis:

in children 6 – 10 years old – 10 – 20 mg per day at night;
in children 11 – 16 years old – 25 – 50 mg/day.

For children as an antidepressant:

from 6 to 12 years – 10 – 30 mg or 1 – 5 mg per kilogram of weight per day in fractions;
for adolescents – 10 mg three times a day, if necessary – up to 100 mg per day.

For the prevention of migraines, for neurogenic pain of a chronic nature, long-term headaches - from 12.5 - 25 to 100 mg per day. The maximum dose is taken at night.

Side effect

In addition to its effect on neural processes, amitriptyline has many secondary neurochemical effects that cause their side effects:

antagonism of M1-cholinergic receptors determines the development of anticholinergic syndrome - tachycardia, dry mouth, impaired accommodation, constipation, urinary retention, confusion (delirium or hallucinations), paralytic ileus;
blockade of alpha1-adrenergic receptors causes orthostatic circulatory disorders (dizziness, weakness, blackouts, fainting), reflex tachycardia;
blockade of H1-histamine receptors – sedation, weight gain;
changes in ion metabolism in the tissue of the brain and heart reduce the threshold of convulsive readiness and contribute to the manifestation of cardiotoxic effects - the rhythm of contractions and conduction of impulses to the myocardium is disrupted.

The severity of side effects often provokes doctors to use inappropriately low dosages, and also significantly reduces patient adherence to therapy, which sharply reduces the effectiveness of treatment.

Due to the risk of severe poisoning with tricyclic antidepressants, they are chosen by patients with suicidal tendencies to realize their aspirations. Therefore, drugs are prescribed so that the patient cannot accumulate enough of them to commit suicide.

Interaction with other drugs

Ethanol, drugs that depress the central nervous system (CNS) including antidepressants, barbiturates, benzadiazepines and general anesthetics	Significantly increased inhibitory effect on the central nervous system, respiratory depression and hypotensive effect. Increases sensitivity to drinks containing ethanol.
Medicines with anticholinergic activity - phenothiazines, antiparkinsonian drugs, amantadine, atropine, biperiden, antihistamines	Increases anticholinergic effect, increases the risk of side effects from the central nervous system, vision, intestines and bladder.
Antihistamines, clonidine	Increased CNS depression.
Atropine	Increases the risk of paralytic ileus.
Indirect anticoagulants - derivatives of coumarin or indadione	Increased anticoagulant activity.
Anticonvulsants	Strengthening the inhibitory effect on the central nervous system, reducing the threshold of convulsive activity when used in high doses, reducing the effectiveness of anticonvulsants.
Medicines for the treatment of thyrotoxicosis	Increase the risk of developing agranulocytosis.
Phenytoin and alpha-blockers	Reduces effectiveness.
Microsomal oxidation inhibitors (cimetidine)	They prolong T1/2 and increase the risk of developing toxic effects of amitriptyline.
Inducers of microsomal liver enzymes (barbiturates, carbamazepine, phenytoin, nicotine and oral contraceptives)	Reduce plasma concentrations and reduce the effectiveness of amitriptyline.
Fluoxetine and fluvoxamine	Increase the concentration of amitriptyline in plasma.
Anticholinergics, phenothiazines, benzodiazepines	Mutual enhancement of sedative and central anticholinergic effects, increasing the risk of epileptic seizures. Phenothiazines increase the risk of neuroleptic malignant syndrome.
Clonidine, guanethidine, betanidine, reserpine, methyldopa	Reducing the hypotensive effect of these drugs.
Cocaine	Risk of developing heart rhythm disturbances.
Estrogen-containing oral contraceptive medications	Increases the bioavailability of amitriptyline.
Antiarrhythmic drugs such as quinidine	Increase the risk of developing arrhythmia.
Disulfiram, other acetaldehydrogenase inhibitors	Simultaneous use provokes delirium.
Monoamine oxidase inhibitors	Incompatible with amitriptyline. Increased frequency of periods of hyperpyrexia, severe convulsions, hypertensive crises, death.
Pimozide, probucol	Increased cardiac arrhythmia.
Epinephrine, norepinephrine, isoprenaline, ephedrine, phenylephrine	Amitriptyline enhances the effect of these drugs on the cardiovascular system, increases the risk of developing heart rhythm disturbances, tachycardia, and severe arterial hypertension.
Thyroid hormones	Mutual enhancement of therapeutic effect and toxic effect.
M-anticholinergics, antipsychotic drugs (neuroleptics)	Increase the risk of developing hyperpyrexia (especially in hot weather).

Amitriptyline analogues

Drugs whose main active ingredient is amitriptyles are Amizol, Elivel, Saroten retard. Conventionally, analogs of the drug can be called drugs belonging to the group of tricyclic antidepressants: imipramine, clomipramine, desipramine, doxepin, pipofezin, tianeptine. However, their pharmacological activity differs.

In general, the effect of treatment with any antidepressant, especially with long-term use, is realized through a complex effect on most neurotransmitter and receptor systems of the brain. Therefore, the individual spectrum of psychotropic, neurotropic and somatotropic effects of drugs against depression depends on the relationship between the primacy and strength of these effects. Their combined accounting makes it possible to select the only correct drug in each specific case, which ultimately determines the clinical success of therapy.

Attention! The description of the drug is a simplified and expanded version of the official instructions for use. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication.

Quite often, for depression, doctors prescribe amitriptyline to patients, the indications for its use are various psycho-emotional disorders. In our country, it has not been customary to treat such conditions for a long time, but, according to recent research, depression is a disease and it requires treatment.

It affects about 20% of the population of all developed countries of the modern world, which puts it on a par with diseases such as cardiovascular diseases and oncology. The main danger is that a person loses his taste for life, he is not interested in anything, no desires arise. And this disrupts the ability to work, affects the functioning of internal organs and relationships with loved ones. The disease in its initial stages rarely manifests itself as disorders of the body’s systems, and the person does not consider it necessary to visit a specialist. And when it comes, the depression is already severe and protracted.

With the modern rhythm of life with many problems, difficult situations and instability, depression is increasingly diagnosed by psychologists and psychiatrists. Typically, this disease develops after a severe stressful situation, which was preceded by a long emotional overstrain: a serious illness of a loved one that ended in his death, a wave of layoffs at work and dismissal, long preparation for an exam and failure to pass one of them, etc.

Depression usually manifests itself with the following symptoms:

In order to get rid of the disease, it is necessary to undergo complex and rather long-term treatment, including taking various antidepressants, psychosocial therapy and attending special courses that increase emotional stability.

Drug therapy for depression

Treatment with drugs comes down to taking various drugs that restore a person’s mental and emotional state - antidepressants. They have different mechanisms of action on the nervous system, which determines their belonging to one or another class of medications. They are divided into the following classes:

tricyclic;
inhibitory;
selective.

Representatives of the first class of drugs are used most often in medicine, one of which is Amitriptyline Nycomed. In addition to depressive conditions, this drug has other indications for use.

In psychiatry it is prescribed for a variety of diagnoses, even very severe ones. Amitriptyline Nycomed is effective for the treatment of depression of all types, including neuroses that have led to brain damage. Depression in alcohol addiction, which is reflected by feelings of anxiety, sleep disorders, and restlessness.

This drug is also prescribed for nighttime urinary incontinence, various phobias, eating disorders (bulimia, anorexia), for the prevention of migraines. It is often part of complex therapy for diseases of the gastrointestinal tract (ulcers, gastritis, gastric bleeding), and can be prescribed for severe pain in cancer patients suffering from rheumatism and neuropathy.

Composition of the drug and its effect

The medicine is based on the active substance amitriptyline hydrochloride. The pharmacological action of Amitriptyline Nycomed is very broad, which determines a wide range of its prescriptions. It has such effects as a pronounced sedative, hypnotic and antihistamine. In addition, Amitriptyline Nycomed relieves anxiety well, has an analgesic effect, slightly stimulates the nervous system, gives a feeling of energy and promotes the healing of ulcers on the mucous membranes of the stomach and intestines.

Thanks to the action of this drug, patients' mood improves, lethargy is eliminated, anxiety and emotional stress disappear, sleep improves and appetite is restored.

How to use Amitriptyline Nycomed?

The drug is available in two forms - uncoated tablets and intramuscular injections. For mild psycho-emotional disorders, Amitriptyline Nycomed is prescribed in tablet form in the smallest doses. It is taken after meals, without chewing and with plenty of liquid.

The specialist prescribes the dose, it depends on the general condition of the patient, his age and the presence of concomitant diseases. On average, the therapeutic effect of the drug occurs within 3 weeks from the day you start taking it.

In the first stages of treatment and for not very severe conditions, the minimum dosage is prescribed. If there is no improvement, the frequency of administration or dose may be increased. For severe emotional disorders or schizophrenia, Amitriptyline Nycomed can be prescribed in the form of injections, followed by a course of tablet treatment.

The duration of treatment depends on the patient’s diagnosis and the severity of his illness, and the general therapeutic course is at least one month. The maximum course of taking an antidepressant should not exceed 12 months, as this can lead to severe and irreversible complications, the most severe of which is death.

Like any drug, Amitriptyline Nycomed has contraindications for use. It is not prescribed to patients after myocardial infarction and in the acute stage of cardiovascular disease, if the patient is intoxicated, suffers from angle-closure glaucoma, or intraventricular obstruction. Amitriptyline Nycomed should not be used together with sleeping pills, strong psychotropic drugs and analgesics. This medicine is not prescribed to children and women during breastfeeding.