Patients suffering from depression can benefit from a range of medications all of which are classified into several groups. Doctors can choose among selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), atypical antidepressants, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and other medications. The therapist in charge will determine what drug is the best for the particular case. If the chosen medication fails to provide with desirable effects, patients are prescribed another one. Eventually the suitable drug and its dose are determined which brings the condition under control.
Amitriptyline for Depression
Amitriptyline is a member of tricyclic antidepressants. These medications have been used for many years. In spite of being practically equally efficient compared to other antidepressants, tricyclic antidepressants are generally prescribed only if the disorder fails to respond well to SSRIs.
Amitriptyline, in particular, improves one's mood by affecting some chemicals in the brain that may be unbalanced. This makes the drug quite suitable for most symptoms of depression.
Prior to prescribing the drug the doctor must make sure that the patient is not allergic to amitriptyline or has not recently had a myocardial infarction. What is more, if the person has been taking any of monoamine oxidase inhibitors for the past two weeks, he/she should not immediately start with amitriptyline because of potential adverse effects.
During the treatment, especially in the beginning, patients may think about committing a suicide. This is mostly reported among young people. Such thoughts are supposed to be reported to a psychiatrist without hesitation. Fortunately, the doctor has insight in the patients emotions, mood and behavior since regular visits for at least the initial twelve weeks of the treatment are obligatory. During the sessions all the problems such as mood/behavioral changes, anxiety/panic attacks or trouble sleeping are shared and discussed.
Patients suffering from certain medical conditions might not be suitable candidates for amitriptyline. This is why those with diabetes, heart conditions, a history of stroke or heart attack, patients with epilepsy, hyperthyroidism, glaucoma or urinary retention should undergo thorough exams and perhaps be eventually prescribed the drug or they receive other antidepressant instead. What is more, the drug may not be suitable for bipolar disorder or schizophrenia.
Being classified as FDA pregnancy category C amitriptyline is not recommended in pregnant women or breastfeeding ones.
Naturally, there are measures of precaution when intake of the drug is concerned. First of all, amitriptyline is always taken exactly as prescribed. One should not make any changes regarding the dose or the schedule. If one needs to undergo some surgery, the drug may be briefly discontinued. However, abrupt discontinuation should be avoided at all costs.
If by any chance more drug than recommended is taken one must seek emergency medical attention. Overdose may be fatal. Some symptoms and signs of amitriptyline overdose are uneven heartbeats, lethargy, confusion, agitation, hallucinations and seizures.
Side Effects of Amitriptyline
One of the most serious adverse effects associated with amitriptyline is allergy to the drug. It may develop in the form of hives, swelling of the face, lips and throat or even breathing difficulties as a part of anaphylaxis. These allergic reactions are sometimes fatal and require prompt medical attention.
Naturally, worsening of the symptoms are also considered as side effects. Even though these may withdraw in time they need to be reported and evaluated. For example, patients who experience mood or behavioral changes, suffer from panic attacks, become impulsive, agitated, hostile and aggressive need to consult their therapists at once. Suicidal thoughts and thoughts of hurting oneself are particularly detrimental and demand special attention.
In rare instances patients may experience even greater health problems. Discontinuation of the drug is indicated when there is chest pain especially if it radiates towards the arm/shoulder and there is accompanying nausea and vomiting. Additionally, amitriptyline should be replaced with other antidepressant in case one develops sudden weakness on one side of the body, suffers severe headaches or develops problems with vision, speech and balance.
Immediate help is also indicate when there are palpitations, confusion, hallucinations and seizures or restless muscles movements affecting the eyes, tongue, jaw etc. Similarly, patients experiencing numbness, burning/tingling sensation, those prone to bleeding and bruising as well as individuals who cannot urinate undergo thorough examination and if necessary replacement of the drug.
Less severe side effects are well tolerated and do not require drug discontinuation. These include gastrointestinal disturbance, lack of saliva production, concentration problems, nightmares, breast swelling and decreased sex drive or impotence along with problems reaching the climax.
In the end, although the drug has various adverse effects and there are many precautionary measures regarding its use, amitriptyline is actually quite efficient against symptoms of depression and helps many patients overcome overwhelming feeling of sadness/unhappiness, loss of interest in normal activities, insomnia/excessive sleeping, changes in appetite, slow thinking and persistent fatigue as well as other symptoms of depression.