AMITRASEC

Class:

Tricyclic Antidepressant (TCA)

Form:

Tablet (commonly 10 mg, 25 mg)

Mechanism of Action:

Amitriptyline inhibits the reuptake of serotonin and norepinephrine at nerve terminals, enhancing their levels in the synaptic cleft. It also has anticholinergic, antihistaminic, and sedative properties.

 Typical Adult Dosage:

• Depression: 75–150 mg/day (divided or single dose at bedtime)
• Neuropathic pain / Migraine: 10–25 mg at bedtime, titrated up based on response

Dose should be individualized; elderly or sensitive patients may require lower doses.

Primary Indications:

• Depression (especially with anxiety or agitation)
• Neuropathic pain (e.g., diabetic neuropathy, post-herpetic neuralgia)
• Migraine prophylaxis
• Fibromyalgia
• Insomnia (low-dose off-label use)
• Irritable Bowel Syndrome (IBS) – off-label for pain modulation

Common Side Effects:

• Drowsiness, fatigue
• Dry mouth, constipation
• Blurred vision
• Weight gain
• Urinary retention

Important Notes:

• May take 2–4 weeks for antidepressant effect.
• Avoid abrupt discontinuation.
• Risk of QT prolongation at higher doses.
• Not recommended with MAO inhibitors or within 14 days of MAOI use.