Drug information

Elavil is a depressant drug from the group of tricyclic antidepressants with sedative and anxiolytic effects. It is used to treat depression on the one hand, on the other hand, for chronic pain (eg nerve pain, headache prophylaxis, irritable bowel). In the application, the numerous precautions and possible interactions are considered. The most common adverse effects include dry mouth, nausea, constipation, weight gain, tremors, drowsiness, headache, dizziness, increased sweating, and accommodation disturbances.

Generic name: amitriptyline, amitriptyline hydrochloride.

Structure and properties

Elavil (C20H23N, Mr = 277.4 g / mol) is as amitriptyline hydrochloride as a white or almost white powder before or as colorless crystals. The dibenzo-cycloheptadiene derivative is derived from imipramine and belongs to the tricyclic antidepressants. In the liver it is metabolized by N-demethylation by cytochrome also in the pharmacologically active metabolite nortriptyline.

Effects

Elavil (N06AA09 ATC) is an antidepressant, anxiolytic, stress relieving, agitation absorbing, sedating and promotes sleep. It has anticholinergic, antihistamine and analgesic properties.

Action mechanism

Amitriptyline affects the neurotransmitter system in the central nervous system. It inhibits the reuptake of serotonin and norepinephrine in the presynaptic neuron.

Amitriptyline also acts on muscarinic acetylcholine receptor antagonist, on histamine receptor of type 1, the 5-HT2 receptor and the alpha1-adrenoreceptor.

Indications

Elavil (amitriptyline) is used for various depressive disorders, including the endogenous, reactive and neurotic depression and depression in geriatrics. It can be used in combination with the antipsychotic drug on depressive symptoms in schizophrenic psychoses from the group of response forms. Amitriptyline is also indicated for the treatment of mood disorders in somatic.

Elavil (amitriptyline) is approved for patients with chronic pain who have not responded to conventional treatment. It is with irritable bowel used in fibromyalgia, nerve pain and prevent tension headaches.

Dosage

According to the SPC. The dose is adjusted individually. The dosage is built up slowly and the administration are generally in the evening. Upon satisfying effect, the maintenance dose is adjusted to ensure the therapeutic effect. The antidepressant effect usually occurs only after 2 to 3 weeks. The completion of the therapy is tapering.

Contraindications

Hypersensitivity to amitriptyline, during the immediate recovery phase after a myocardial infarction, conduction disturbances in the heart and acute alcohol, barbiturate and Opiatvergiftungen. Amitriptyline should not be combined with MAOIs (including moclobemide and selegiline) because serious and sometimes fatal reactions have been observed. The drug is contraindicated in pyloric stenosis, prostatic hyperplasia with urinary retention and paralytic ileus. Because amitriptyline is also an anticholinergic, an untreated narrow-angle glaucoma and Harnentleerungsstörungen are also considered contraindications. Amitriptyline should not be used during pregnancy and lactation and in children and adolescents under 18 years applied. Amitriptyline is contraindicated in taking cisapride because of cardiac adverse effects may occur, including QT prolongation, arrhythmias, and transmission line problems.