Download Amitriptyline

9
Antidepressants
Amitriptyline (Elavil; Lentizol)
Why has
amitriptyline
been prescribed
for me?
Amitriptyline has a sedative and an antidepressant effect. It may therefore be
useful for individuals who have feelings of anxiety as well as depression. It has
also been given to children who have problems with bed wetting, and to
individuals with pain associated with nerve damage.
How much
should I take?
A relatively low dose (up to 75 milligrams a day in an adult of working age) may
be prescribed at first. It might later be increased, so that the best balance of side
and treatment effects is found.
What will
happen when I
start taking
amitriptyline?
Improved sleep may be enjoyed within a few days. But the antidepressant effect
can take several weeks or a month to take full effect, while side effects can be
experienced almost immediately. This can naturally be discouraging. Yet for those
who continue to take the medicine the benefits may ultimately outweigh the costs.
When you have depression it often takes some time before the most acceptable
dose of the most effective drug is identified.
What are the
side effects of
this drug?
•
More common side effects include: blurred vision; constipation; drowsiness; dry
mouth; weight gain; urinary retention; dizziness on standing.
•
Less common side effects include: insomnia; racing heart beat; seizures; skin
rashes.
Sometimes (normally only when given in high doses) amitriptyline can adversely
affect the cardiovascular system and may cause more significant changes in blood
pressure, or heart rhythm abnormalities. People with manic depression may
experience manic episodes if they take amitriptyline (or other antidepressants) at the
wrong stage in their illness. If you drink alcohol it can make you sleepy.
What should I do
if I get any side
effects?
The standard advice to service users is contact your doctor, talk over the issues
and then decide together whether or not you can cope with the side effects and
want to stay on the medication, if the dose you are taking needs to be altered, or
whether you need a different treatment.
You might also want to talk to your pharmacist, and/or check the web and other
information sources. If this is the first antidepressant you have tried you might
want to ask why you have been prescribed it. Why does the person
recommending it think it is likely to be the best medicine for you, given the other
options available?
May 2004
What will
happen if I
don’t take the
medicine as
recommended?
Some people who stop taking TCAs (or other antidepressants) before they have
recovered for long enough and moved on in their lives find that their symptoms
come back. If amitriptyline users stop taking it abruptly they may experience some
withdrawal symptoms, like anxiety or insomnia. Stopping antidepressant
treatment should normally be a planned, gradual, process.
Is there
anything else I
should know?
This drug is toxic in overdose. You will have to judge the situation, but the best
advice is that if you or someone else has taken a TCA in excess of the
recommended amount, get medical help quickly.
You can take amitriptyline without food. It is very unlikely that you will become
addicted to amitriptyline
Due to its sedative effect, people using this medicine should consider the safety of
activities such as driving, operating machinery and other tasks that require
alertness and good physical coordination. It is always sensible to be careful, for
example, about drinking and driving, especially if you are taking a psychotropic
medicine. Experts such as pharmacists specialising in mental health say you
should avoid alcohol when you start using drugs like amitriptyline, and later
experiment carefully if you feel you would like a drink. TCAs taken with alcohol
sometimes cause extreme drowsiness.
Are there any
additional
therapies that
may be able to
help me?
There are many other therapies or activities which can help to relieve depression.
Counselling or psychotherapy are useful for some people, and recent research has
shown that exercise can decrease feelings of anxiety and depression. Some find it
also helps relaxation and sleeping. Moderate exercise such as walking or cycling,
even just for half an hour a day, can have good effects. Yoga and meditation
techniques may also prove relaxing. Other forms of therapy which some people find
helpful include acupuncture and herbal drugs such as St Johns Wort. However, your
are advised not to experiment with the latter while taking a prescribed drug or drugs,
because of possible interactions.
Questions you
might like to ask
about your
medication
include:
•
How long should take for this medicine to start working?
•
Why has amitriptyline been prescribed for me?
•
What happens if I still don’t feel any better in a few weeks time?
•
What side effects should I watch out for, and what should I do if I think I am
getting them?
•
How do I contact you if I feel I need help urgently?
•
Is there anything else I can do to recover from this depression?
For help lines and other information sources see the Contacts and Resources Information Sheet. This guide cannot provide all the facts
you may need to know about your medicines – it is a starting point, not the last word.