Re: Amitriptyline
AMITRIPTYLINE 0.0 OVERVIEW A. AMITRIPTYLINE is a tricyclic antidepressant. B. DOSING INFORMATION: Initial oral doses are 75 to 100 mg/day as a single dose or in divided doses, with increases to 200 to 300 mg/day; intramuscular doses are 80 to 120 mg/day in 4 divided doses; geriatric patients should receive reduced doses; adolescent oral doses are 1 to 1.5 mg/kg/day in 3 divided doses. C. PHARMACOKINETICS: Therapeutic effects begin in 7 to 21 days; peak serum levels occur within 4 h and protein binding is 90% to 95%; elimination half-life is 9 to 25 h, with an average of 15 h; hepatic metabolism to NORTRIPTYLINE (active), 10-hydroxy derivatives, and conjugated derivatives is followed with renal excretion of approximately 18% as unchanged drug. D. CAUTIONS: Adverse effects include aplastic anemia, leukopenia, pancytopenia, purpura, thrombocytopenia, electrocardiogram changes, heart block, ventricular tachycardia, ventricular extrasystoles, cardiomyopathy, hypotension, malignant hypertension, aggression, confusion, agitation, disorientation, seizures, dyskinesias, sedation, delirium, psychomotor impairment, paresthesias, mania, myoclonus, galactorrhea, inappropriate ADH secretion, weight gain, hypoglycemia, porphyria, hyperthermia, dry mouth, stomatitis, paralytic ileus, constipation, abdominal distention, gastroesophageal reflux, impotence, sexual dysfunction, hepatotoxicity, ophthalmoplegia, phototoxicity, myasthenia gravis, and withdrawal symptoms. E. CLINICAL APPLICATIONS: AMITRIPTYLINE is an effective antidepressant for the treatment of major depressive disorders. The drug has also been used for postherpetic neuralgia, chronic pain, panic attacks, and agitation. The drug has been favorably compared to many of the tricyclic antidepressants, FLUOXETINE, and TRAZODONE.
|