Introduction
Amitriptyline is a tricyclic antidepressant prescribed for treatment of various forms of pain associated with the nerves (neuropathic pain) and to prevent migraine headaches. Amitryptilline was originally formulated as an antidepressant although when used to treat pain it is given as an anti-neuropathic pain medication.
This medication works by increasing the amount of certain natural substances in the brain and is commonly marketed under the brand names Elavil and Endep.
Conditions for use
Dosage
The usual dose of Amitriptyline for pain management is between 10 mg to 150 mg, normally given at bedtime. The health care provider generally starts on a lower dose.
In general, it may take up to 2 weeks or more for the patient to start feeling better. There is a large amount of Evidence Based Medicine (EBM) regarding the eficacy (effectiveness) of Amitryptilline for patients with neuropathic pain.
In case of a missed dose, the patient should take the missed dose as soon as possible. However, if it is almost time for the next dose, the previous one should be skipped.
Adverse Effects
Amitriptyline is known to have a wide range of adverse effects. These can be divided into two categories- common and rare. Here we give a brief list of the main side effects:
A) Common adverse effects
These side effects are commonly observed and do not require medical attention, unless they persist for long or are severe. These include:
· Upset stomach
· Drowsiness
· Vomiting
· Weakness or fatigue
· Sleep disorder
· Anxiety
· Dry mouth
· Constipation
· Headache
· Blurred vision
· Pain, burning or tingling in the hands or feet
B) Rare adverse effects
These symptoms are quite uncommon and medical attention should be sought if these occur. These include:
· Speech disorder
· Dizziness or faintness
· Crushing chest pain
· Yellowing of the skin or eyes
· Seizures
· Unusual bleeding
· Severe skin rash
However, it is recommended that the patients should never discontinue this medicine abruptly. When required, the dosage should be reduced gradually. In case the drug is abruptly stopped, the patient may experience headache, nausea, and discomfort throughout the body or even worsening of the original symptoms.
