Antidepressants are a special class of drugs about which there are a lot of myths and speculation. Meanwhile, their popularity is increasing more and more every year: the modern rhythm of life is forcing people to compromise with their own psyche and nervous system. Amitriptyline-Grindeks is a tricyclic antidepressant, which was widely used in the Soviet years and is actively prescribed in the practice of modern psychiatry. The article describes under what diseases and conditions it is advisable to take it, the principle of action, patient reviews, as well as a comparison with the now more popular antidepressants from the pharmacological group of SSRIs (selective serotonin reuptake inhibitors).
The principle of the drug
"Amitriptyline-Grindeks" is an antidepressant from the group of tricyclic compounds, a derivative of dibenzocycloheptadine. How does taking the drug allow you to achieve a lasting marked improvement in mood and getting rid of depressive, anxious and obsessive conditions? After metabolites break down and enter the bloodstream, they are able to influence the concentration of norepinephrine and serotonin in the synapses and central nervous system. After some time (provided that the patient regularly takes the drug and there is no violation of the rules for admission), the action accumulates. As a result, a person feels differently than before taking the drug: he becomes efficient, resistant to criticism, disappears in a bad mood, apathy and irritability disappears, and obsessive states disappear.
The drug is advisable to use in all kinds of conditions: from the period of schizophrenic psychosis in a patient to eating disorders. It is forbidden to take it independently, not to mention deciding on the duration of therapy or the optimal dosage. The drug belongs to strictly prescription - it just won’t work out in a pharmacy. This will require a prescription from a psychiatrist certified by a seal or signature. Another way to get a pill is to go for treatment at a full-time or full-time hospital. In this case, if the doctor considers it necessary to prescribe such an appointment, the patient receives the drug for free.
Common myths and conjectures about antidepressants
In Soviet times, the drug was not sold in pharmacies and was not available for purchase to ordinary people. It was used exclusively in PND establishments, as well as in LTP for the relief of acute conditions in people prone to harm themselves or others. Since then, the drug has been followed by a "bad name": people still have myths that Amitriptyline can turn a person into a "vegetable", paralyzing his will, libido and personal aspirations. These fears are groundless: the drug belongs to the first generation antidepressants, its effect is rather weak. There can be no question of a person losing his “I” on the course of admission or his volitional aspirations being exposed to some kind of influence.
For comparison: the same “Paxil” in comparison with “Amitriptyline-Grindeks” suppresses libido and motivation for actions much more. Meanwhile, “Paxil” belongs to a more modern class of antidepressants and its effect is milder, since the drug is classified as selective inhibitors of the reuptake of this neurotransmitter. So most of the myths and conjectures surrounding the pharmacological action of Amitriptyline are fiction, which has nothing to do with reality. The drug is still actively prescribed to patients both as a means as part of complex therapy, and as an independent drug.
Composition and conditions of dispensing from pharmacies
Composition of Amitriptyline-Grindeks (1 tab): 25 mg of the main active ingredient - amitriptyline hydrochloride, as well as auxiliary components - microcrystalline cellulose, talc, lactose monohydrate, silicon dioxide, magnesium stearate, pregelatinized starch.
The standard "Amitriptyline" has several forms of release (depending on the manufacturer): these are tablets, dragees and a solution for intravenous or intramuscular administration. "Amitriptyline-Grindeks" is available only in tablets. However, earlier ampoules with solution were also on sale. Grindeks JSC (one of the largest pharmacological concerns in the CIS countries and the former Soviet Union) produces many pharmacological agents, and at the moment the release of Amitriptyline in ampoules has been suspended.
You can only buy the drug if you have a prescription from a psychiatrist or psychotherapist. After the drug is sold to the patient, the pharmacist will put a special seal on the prescription - after that it will be impossible to use it again. Psychoanaleptics are currently prohibited from selling without a prescription. Otherwise, the pharmacist who released the goods may be subject to penalties.
Indications for use "Amitriptyline-Grindeks"
In some cases, if the treating psychiatrist considers it necessary, the drug may be prescribed for a disease that is not included in the list below. Instructions for use with Amitriptyline tablets indicate that the drug has the following indications for use:
- depression of various etiologies (reactive, involutional, anxiety, childhood and adolescence, endogenous, etc.);
- various kinds of eating disorders - in particular, anorexia, in which drugs of the SSRI group can only aggravate the condition;
- post-traumatic neuropathy;
- chronic pain syndrome (chronic pain in cancer patients, migraine, rheumatic pain, atypical pain in the face,
- postherpetic neuralgia,
- diabetic neuropathy
- disorders of an emotional nature (in some cases, reception during the period of premenstrual syndrome in women is possible);
- peripheral neuropathy
- chronic alcoholism - in order to prevent the development of delirium and acute psychosis;
- migraine prophylaxis.
In no case should you prescribe yourself a drug, even if the diagnosis is included in the list of the above.
Side effects of the drug
Instructions for use with Amitriptyline-Grindeks warns that the following side effects may develop:
- from the nervous system: asthenia, insomnia or excessive drowsiness, fainting, tremor of the extremities, disorientation, depersonalization, hallucinations (especially in patients with Parkinson's disease), impaired memory, the appearance of unmotivated aggression and irritability, depersonalization, migraine with and without aura;
- from the digestive tract: pain in the epigastric region, nausea after taking the pill, a change in the taste of food (relatively rare), increased or, conversely, decreased appetite;
- on the part of the cardiovascular system: pressure surges, tachycardia, conduction disturbances, dizziness, intraventricular conduction disturbance, ECG examination may show various kinds of deviations in the heart rhythm.
Judging by the reviews of patients, most often side effects are observed in the first two to three weeks of admission. Then they usually disappear. Side effects of Amitriptyline-Grindeks is a serious reason to consult your doctor. Most likely, drug therapy will be adjusted - either a tranquilizer is added to alleviate the severity of symptoms, or the treatment plan is completely changed.
Against the background of taking, many patients note a decrease in concentration of attention: it is difficult to concentrate on doing the work that was previously easily feasible. If the patient’s professional activity is related to mental activity, then it is advisable to simultaneously introduce a nootropic into the course - for example, "Phenotropil" or similar in effect.
Contraindications
Instructions for use with the amitriptyline tablets indicate that the drug has the following contraindications:
- recovery period in patients after myocardial infarction;
- period of alcohol intoxication of the body;
- angle-closure glaucoma;
- period of pregnancy and lactation;
- children's age up to six years - taking a tablet form of the drug;
- children under 12 years of age - for injection;
- acute intoxication with sleeping pills and painkillers;
- taking MAO inhibitors;
- severe violations of AV- and intraventricular conduction.
With increased sensitivity to the metabolites of amitriptyline, side effects may develop that will not go away even with a decrease in dosage. In this case, you should refuse to take the drug, replacing it with other antidepressants - for example, try therapy with selective serotonin reuptake inhibitors. It is forbidden to independently increase or decrease the dosage without the knowledge of the attending psychiatrist - this can provoke an increase in the symptoms of the underlying disease.
Consequences of sharing with alcohol
The simultaneous administration of the drug with drinks containing ethyl alcohol, almost guaranteed to lead to a pronounced sedative effect. Usually, before starting a course of tricyclic antidepressants, the psychiatrist always warns the patient that even with a small amount of alcoholic drinks and taking any psychoactive substances, you will have to completely refuse.
If you violate this ban and abuse alcohol during treatment with "Amitriptyline-Grindeks", then the effect of therapy disappears. Ethyl alcohol is a powerful depressant that is extremely toxic to the nervous system and to the psyche. Most people believe that alcohol only harms the internal organ, while completely forgetting the true properties of ethanol. This is a real poison not only for liver and pancreatic cells, but also for neurons.
Other drug interactions
It should be noted that with the simultaneous use of "Amitriptyline" with sedatives, the inhibitory effect on the central nervous system increases. Perhaps a hypotensive effect, a person may begin to suffocate, experience panic attacks or suffer from excruciating anxiety, anxiety. It is not recommended to take "Amitriptyline" with drugs that have a pronounced sedative effect.
With simultaneous administration with drugs that support the functioning of the cardiovascular system, the risk of developing heart failure, tachycardia, arrhythmias, and spikes in blood pressure increases.
With the parallel use of antipsychotics, the inhibitory effect on metabolism is enhanced. A decrease in the level of convulsive readiness is characteristic.
Concurrent administration of Amitriptyline with antihypertensive drugs increases the risk of orthostatic hypotension.
Patient reviews on the action of Amitriptyline-Grindeks
Reviews about the drug are extremely mixed. Some patients are convinced that they were able to maintain working capacity and an adequate perception of reality only thanks to Amitriptyline-Grindeks. The reviews of some patients, on the contrary, are sharply negative: a lot of side effects, severe drowsiness, weakness, irritability and nervousness made life even worse during the intake than it was before the intake.
Alas, many patients of a psychiatrist do not adhere to the rules of admission: they forget to take the drug on time, they allow the intake of alcoholic beverages during treatment. As a result of this frivolous approach, patients are disappointed in the effect of the drug. Meanwhile, "Amitriptyline-Grindeks" is a psychotropic drug, any deviations from the course of administration of which are fraught with a change in the mental state and resistance of the nervous system to irritating factors.
Comparison with SSRI antidepressants: what to prefer?
In most cases, psychiatrists prefer to prescribe sertraline-based antidepressants to patients prone to psychotic behavior, and fluoxetine-based antidepressants to patients prone to negative depressive symptoms. This pattern is almost always followed. Tricyclic antidepressants, which include Amitriptyline, are relatively rare today. A greater number of side effects and a comparative frequency of their occurrence are an additional factor in favor of SSRI drugs.
"Amitriptyline" can be used injectively, while SSRIs do not suggest this possibility. They are ideal primarily for therapy at home. The basic rule of success is to strictly observe the course prescribed by the psychiatrists, the dosage and the rules for admission. "Amitriptyline" can also be used as a drug for therapy at home, but even in a hospital, it is used very often - both in tablet and injection forms.