Amitriptyline belongs to a group of medicines called tricyclic antidepressant drugs.
Everybody has substances called serotonin and noradrenaline in their brains. It is thought that people with depression have less of these substances compared to those without depression. Amitriptyline works by increasing the amounts of serotonin and noradrenaline in the brain.
Amitriptyline also helps the muscle in the bladder wall to relax and reduces the need to pass urine. That's why it is also used for the relief of bed-wetting at night by children known as nocturnal enuresis
 BRAND NAMES
 MECHANISM OF ACTION
Amitriptyline is a tricyclic antidepressant (TCA). It is metabolized to nortriptyline which acts by decreasing the reuptake of norepinephrine and serotonin (5-HT).
- To treat depression
- To treat pain of neuropathic origin like post-herpetic neuralgia (shooting, stabbing or burning pains)
- Attention deficit hyperactivity disorder (ADHD)
- Nocturnal enuresis in children
- To manage some eating disorders.
- To prevent migraine headaches
- Pain: starting dose for amitriptyline for pain is 10mg once a day, 1 or 2 hours before bedtime. It may take up to 2 weeks before you feel the full benefit of this treatment. The dose of amitriptyline may be slowly increased to 50-75 mg a day depending on how helpful it is for your pain
- Depression: 50-100mg/day, It may take up to 4-6 weeks before you feel the full benefit.
- Migraine prophylaxis: 10 mg once daily at bedtime
Amitriptyline is contraindicated in patients with a history of glaucoma, prostatic hypertrophy and cardiac arrhythmias.
- TCA decrease the seizure threshold. Amitriptyline should be used with caution in patients with history of epilepsy.
 PREGNANCY AND LACTATION
 SIDE EFFECTS
The most common side effects of Amitriptyline are drowsiness, dry mouth, constipation, feel lightheaded, dizziness, orthostatic hypotension, Weight Gain, blurred vision and problems passing urine.
 RELATED LINKS
|Tricyclic antidepressants||Amitriptyline (Elavil, Laroxyl) • Clomipramine (Anafranil) • Doxepin (Sinequan) • Imipramine (Tofranil) • Nortriptyline (Aventyl, Pamelor) • Trimipramine (Surmontil)|
|Selective serotonin reuptake inhibitors (SSRIs)||Citalopram (Celexa, Seropram) • Escitalopram (Cipralex, Lexapro) • Fluoxetine (Prozac) • Fluvoxamine (Luvox, Maveral) • Paroxetine (Paxil, Seroxat) • Sertraline (Zoloft)|
|Serotonin–norepinephrine reuptake inhibitors (SNRIs)||Desvenlafaxine (Pristiq) • Duloxetine (Cymbalta, Xeristar) • Venlafaxine (Efexor, Effexor)|
|Serotonin antagonists and reuptake inhibitors (SARIs)||Trazodone (Desyrel, Oleptro)|
|Norepinephrine reuptake inhibitors (NRIs)||Maprotiline (Ludiomil) • Reboxetine (Edronax)|
|Norepinephrine-dopamine reuptake inhibitors (NDRIs)||Bupropion (Wellbutrin)|
|Noradrenergic and specific serotonergic antidepressants (NaSSAs)||Mianserin (Lantanon) • Mirtazapine (Remeron)|
|Norepinephrine-dopamine disinhibitors (NDDIs)||Agomelatine (Valdoxan, Thymanax)|
|Monoamine oxidase inhibitors Nonselective||Tranylcypromine (Parnate)|
|Monoamine oxidase inhibitors B-Selective||Selegiline (Transdermal) (Emsam)|
|Others||5-Hydroxytryptophan • S-Adenosyl methionine • Hypericum (St John's wort)|