Antidepressant Medications Anti-depressant Drugs Antidepressant: amitriptyline, Elavil, Typtanol, Saroten, Trytizol, Serotex

Antidepressant: amitriptyline, Elavil, Typtanol, Saroten, Trytizol

In the drug management of depressive illness.

Amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) may be used in depressive illness of psychotic or endogenous nature and in selected patients with neurotic depression. Endogenous depression is more likely to be alleviated than are other depressive states. Amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) , because of its sedative action, is also of value in alleviating the anxiety component of depression.

As with other tricyclic antidepressants, amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) may precipitate hypomanic episodes in patients with bipolar depression. These drugs are not indicated in mild depressive states and depressive reactions.

In patients who have shown prior hypersensitivity to it. It should not be given concomitantly with a MAO inhibiting compound. Hyperpyretic crises, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressant and MAO inhibiting drugs simultaneously. When it is desired to substitute amitriptyline for a MAO inhibitor, a minimum of 14 days should be allowed to elapse after the latter is discontinued. Amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) should then be initiated cautiously with gradual increase in dosage until optimum response is achieved

Concurrent administration of amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) and electroshock therapy may increase the hazards of therapy. Such treatment should be limited to patients for whom it is essential.

Close supervision is required when amitriptyline is given to hyperthyroid patients or those receiving thyroid medication.

May impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle.

When amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) is used to treat the depressive component of schizophrenia, activation or aggravation of existing psychotic manifestation may occur. Likewise, manic depressive patients may experience hypomanic or manic episodes and hyperactive or agitated patients may become overstimulated. Paranoid delusions, with or without associated hostility, may be exaggerated. A reduction in dose or discontinuation of amitriptyline may be indicated and administration of a neuroleptic such as a phenothiazine, be considered under these circumstances.

Seriously depressed patients should be carefully supervised. The possibility of suicide in depressed patients remains during treatment. Patients should not have access to large quantities of this drug during treatment.

Discontinue the drug several days before elective surgery if possible.

Amitriptyline ( Elavil, Typtanol, Saroten, Tryptizol, Serotex ) may enhance the response to alcohol and the effects of barbiturates and other CNS depressants. Delirium has been reported with concurrent administration of amitriptyline and disulfiram.

Abrupt cessation of treatment after prolonged administration may produce nausea, headache, and malaise. Gradual dosage reduction has been reported to produce, within 2 weeks, transient symptoms including irritability, restlessness, and dream and sleep disturbance. These symptoms are not indicative of addiction. Rare instances have been reported of mania or hypomania occurring within 2 to 7 days following cessation of chronic therapy with tricyclic antidepressants.

Adverse Reactions:

Included in this listing which follows are a few adverse reactions which have not been reported with this specific drug. However, pharmacological similarities among the tricyclic antidepressant drugs require that each of the reactions be considered when amitriptyline is administered.

These are:
Drowsiness, fatigue, activation of latent schizophrenia, disorientation, confusional states, hallucinations, delusions, hypomanic reactions, disturbed concentration, nightmares, insomnia, restlessness, agitation, excitement, jitteriness, anxiety, giddiness. Epileptiform seizures, coma, dizziness, tremors, numbness, tingling, paresthesias of the extremities, peripheral neuropathy, headache, ataxia, alteration in EEG patterns, extrapyramidal symptoms including abnormal involuntary movements and tardive dyskinesia, dysarthria, tinnitus, incoordination, and slurred speech. Urinary retention, dilatation of the urinary tract, constipation, paralytic ileus, especially in the elderly, hyperpyrexia, dry mouth, blurred vision, disturbance of accommodation, increased intraocular pressure, precipitation of latent glaucoma, aggravation of existing glaucoma, and mydriasis. Quinidine-like effect and other non-specific ECG changes and changes in AV conduction, prolonged conduction time, asystole, hypotension, syncope, hypertension, palpitation, arrhythmias, heart block, ventricular tachycardia, fibrillation, myocardial infarction, stroke, unexpected death in patients with cardiovascular disorders. Bone marrow depression, including agranulocytosis, leukopenia, eosinophilia, purpura, thrombocytopenia. Skin rash, urticaria, photosensitization, edema of the face and tongue, itching. Nausea, epigastric distress, heartburn, vomiting, hepatitis (including altered liver function and jaundice), anorexia, stomatitis, peculiar taste, diarrhea, parotid swelling, black tongue may occur. Testicular swelling, gynecomastia and impotence in the male, breast enlargement and galactorrhea in the female, increased or decreased libido, elevation and lowering of blood sugar levels, syndrome of inappropriate ADH (antidiuretic hormone) secretion. Weakness, increased perspiration, edema, urinary frequency, alopecia, increased appetite, weight gain, weight loss.

Overdose

High doses may cause temporary confusion, disturbed concentration, or transient visual hallucinations. Overdosage may cause drowsiness, hypothermia, tachycardia and other arrhythmic abnormalities, such as bundle branch block, ECG evidence of impaired conduction, congestive heart failure, disorders of ocular motility, convulsions, severe hypotension, stupor, coma, polyradiculoneuropathy and constipation. Other symptoms may be agitation, hyperactive reflexes, muscle rigidity, vomiting, hyperpyrexia, or any of those listed under Adverse Effects. In patients with glaucoma, even average doses may precipitate an attack.

Treatment is symptomatic and supportive.

BACK TO THE LIST