AMITRIPTYLINE

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Registered names: (Elavil, Laroxyl, Triptyzol)

Function

The drug is tricyclic antidepressant with the following;

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sedative properties: drug that reduces excitability and calms a person.

Anxiolytic: tranquilizer used to relieve anxiety and reduce tension and irritability.

Usage

It often use to treat the following;

Neuropathic pain in combination with carbamazepine

And treating major depression mostly when there is requirement of sedative.

Availability

Come in 25mg  tablets

Prescription

The drugs is used to treat adult only;

For treatment of the following

Neuropathic pain: Pain caused by damage to nerves or by damage to the brain, brainstem, or spinal cord.

The patient should be given 25mg once daily when on the bed for a maximum of one week, on the following week the drugs should be increase to 50mg in a single dose/day the time when on the bed for a week, then should be increase in the following week to 75mg in a single dose/day on the bed time.

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The maximum dose required per days is 150mg at such it should never be administer above 150mg/day until the patient recovered.

Depression: the startup dose is from 75mg to 150 mg/day, but the administration depend on the effectiveness and how the patient is able to tolerate the drugs. The drugs should be administered when the patient on the bed times. In terms of increase dosage, there should be little bit of rapid increment of the dosage treatment when treating depressing patient. And should last for over 8 to 10 days.

But in case of the elderly, and patient with hepatic disorder, the treatment should be reduce halfly.

Duration of Administration

for neuropathic pain the treatment should last  for several month at list 4 to 6 month pending when pain relief is obtained, then make an effort to stop the treatment.

Depression: minimum of 6 month is required for the treatment, gradual discontinuation of the treatment when there is an improvement of the treatment.

The dose should be narrow for over for week. But is the condition go back to the previous state, the dose should be increase.

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Precaution

Never administer the drugs to a patient with the following

Recent myocardial infection

Prostate disorder

Close angle glaucoma

Arrhythmia

Administer with extremely care to the following patients;

Patient above 60 years

Epilepsy patient

Patient with chronic constipation

Patient with renal or hepatic disorder

Patient with history of bipolar disorders

Adverse Effect

Drowsiness

Orthostatic hypotension

Sexual dysfunction

Anticholinergic Effects

Constipation

Blurred vision

Dry mouth

Tachycardia

Disorder of micturition

The above effect usually disappear when there reduction in the intake dosage.

Psychotic Disorder

At the beginning of the drugs, there may be possible of suicide attempt by the patient.

Increase of anxiety

Manic occur frequently

Stop immediately treatment when the following sign and symptom take place;

Mental confusion

Retention of urine

Cardiac rhythm disorder.

Advice

Never combine the drugs with another antidepressant

Proper monitoring should be adhere to when taken the drugs with central nervous system depressant such as opioid analgesics, H1 antihistamine, sedative drugs, etc), drugs with anticholinergic effect ( atropine, chlorpromazine, promethazine, carbamazepine etc) and drugs that lower the seizure threshold ( antipsychotic, mefloquine, tramadol etc) many more

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Never take any alcohol during treatment

Pregnant women;  proper examination of the patient is necessary, to outline either the patient rely need the treatment, if the patient really need the treatment, the dosage should be reduce at the end of the pregnancy in other save the baby from neurological and gastrointestinal disorder.

Breast feeding; the child should be monitor for over somnolence

Opinion

Calmness take place when the initial dose commence, analgesic effect is delay for 7 to 10 days. It is advisable to wait for 3 weeks before ascertaining the efficacy of the treatment. At such the patient should be inform about the development.

Storage; no specific temperature requirement for storage.

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