For anxiety and depressive disorders, doctors prescribe Amitriptyline. Reviews about this medicine are different. Patients note a pronounced sedative effect of the drug, but at the same time report its unpleasant side effects. This medicine belongs to tricyclic antidepressants and is a rather old remedy. The drug was synthesized more than 55 years ago, but still finds application in medical practice. It is used not only in psychiatry, but also in the treatment of somatic diseases of neurogenic origin. To understand the advantages and disadvantages of this tool, you need to understand its principle of action, as well as examine the indications, contraindications and side effects.
Composition and effect of the drug
The active substance of the antidepressant is amitriptyline. The medicine is produced in the form of tablets and dragees (10 mg or 25 mg), as well as in the form of a solution (10 mg) for injections into the muscle and intravenous infusions.
In addition to the active substance, the tablet contains additional ingredients: cellulose, lactose, talc, starch, silicon and magnesium compounds. Dragee also contains talc, lactose, magnesium salts and starch, also includes povidone.
The injection contains amitriptyline, distilled water, sodium hydroxide and chloride, dextrose and bactericidal preservatives.
In the body, substances are formed - catecholamines. These include dopamine and norepinephrine. They affect the mental state of a person. Amitriptyline does not allow nerve cells to capture these substances back. This leads to an antidepressant effect. An individual's anxiety decreases, his mood improves, his psychomotor agitation decreases .
It is a sedative antidepressant. It does not have stimulating properties. Amitriptyline calms the psyche, but does not give a person activity. Therefore, it is indicated for anxious depression. In asthenic disorders, it can not be taken, it will only exacerbate the symptoms, increase lethargy and drowsiness.
The drug does not work immediately. Its effect is fully manifested only 3 weeks after the start of treatment, this is indicated by the instructions for use of "Amitriptyline". Reviews of the antidepressant indicate that in the early days of therapy the effect was not noticeable. And only a few weeks later the anxiety began to go away and the mood improved.
The disadvantages of the drug include its anticholinergic effect. Thanks to this, the drug can be used as a sleeping pill. However, unpleasant side effects of the drug are also associated with this effect: excessive dryness of the mucous membranes, accommodation spasm, etc.
Indications
Instructions "Amitriptyline" and reviews indicate its effectiveness in depression and anxiety-type neurosis. It well removes fear, mental stress, promotes rapid falling asleep. The drug can be taken for violations of the emotional state of various etiologies, including during alcohol withdrawal.
In addition, an antidepressant is prescribed for somatic diseases, especially of psychogenic origin. It eliminates nocturnal enuresis, reduces pain in migraines, oncological pathologies, neuralgia, gastric ulcer, rheumatism. The drug is used in the treatment of pathological overeating (bulimia).
Contraindications
However, not all patients can take tricyclic antidepressants. Such drugs are contraindicated in the following diseases and conditions of the body:
- allergies to amitriptyline and other tricyclic antidepressants;
- myocardial infarction;
- severe pathologies of the heart and blood vessels;
- angle-closure glaucoma;
- poisoning with alcohol and psychotropic medicines;
- pregnancy and breastfeeding.
There are diseases in which the use of an antidepressant is not prohibited, but caution and the appointment of minimum doses are required. These are bronchial asthma, hematopoietic pathologies, bipolar disorder, epilepsy, decreased tone of the bladder and hyperthyroidism.
Undesirable symptoms
Instructions "Amitriptyline" and drug reviews report such unpleasant side effects as dry mouth, difficulty urinating and defecating, blurred vision, dilated pupils, and decreased sweating. This is due to the fact that the drug works as an anticholinergic. Its effect on the body resembles the effect of the medication Atropine.
In addition, undesirable symptoms from the central nervous system quite often occur. Patients complain of severe lethargy, drowsiness, lethargy, and a feeling of tiredness. This is due to the strong sedative effect of the drug. In some cases, a paradoxical reaction of the body occurs - psychomotor agitation.
Negative manifestations from other organs are less common. The instructions mention the following unpleasant symptoms:
- heart palpitations;
- dyspeptic symptoms;
- hormonal disorders;
- pressure surges;
- dizziness.
An antidepressant can be addictive and addictive. Its reception cannot be stopped abruptly. Otherwise, withdrawal syndrome may develop, it is characterized by the resumption of signs of depression, insomnia, severe anxiety, irritability, tearfulness. Dyspeptic symptoms and autonomic disorders are noted. Therefore, the medicine is canceled gradually, reducing the dosage for several weeks.
How to take medicine
The dosage of the medicine is determined by the doctor individually for each patient. If the medication is used in the form of tablets or dragees, then the therapy begins with a minimum amount: 25-50 mg per day before bedtime. In the future, the doctor prescribes higher doses up to 200-300 mg, depending on the patient's condition. Increasing the amount of the drug is carried out gradually, within 7-14 days. With somatic diseases, dosages of 12.5-100 mg are used.
If the drug is administered in the form of a solution into a muscle or into a vein, then daily doses of 80-160 mg are used. As soon as the patient's condition improves, the patient is transferred to take the medicine inside.
The course of antidepressant therapy can last up to 8 months.
special instructions
The drug is strictly forbidden to combine with another group of antidepressants - monoamine oxidase inhibitors (MAO). This can lead to the development of arousal and a sharp rise in blood pressure. Between taking these two groups of drugs, you must observe a break of at least 14 days.
It is not recommended to combine "Amitriptyline" with other antidepressants of the tricyclic series. Taking a large number of drugs of the same effect does not increase the therapeutic effect. For an effective fight against depression, one correctly selected drug is enough.
During the entire course of treatment, it is necessary to completely abandon alcohol. The combined use of sedative antidepressants and ethanol can cause severe depression of the nervous system and respiration.
Reviews of "Amitriptyline" often indicate severe inhibition and a decrease in concentration during treatment. Therefore, during the course of therapy, you can not drive a car and engage in complex types of work.
Price and analogues of medicine
"Amitriptyline" is dispensed from pharmacies strictly by prescription. Such a medicine can not be taken alone. This is an inexpensive drug. The price of tablets and dragees is from 30 to 60 rubles. A solution for injection costs from 45 to 70 rubles.
Patients are interested in analogues of an antidepressant for the active substance. Such drugs include Saroten Retard. Its active component is also amitriptyline. Reviews of the analogue indicate that the effect of the drug on the body continues for a long time. This is a prolonged form of an antidepressant. It has the same advantages and disadvantages as the usual "amitriptyline." The price of this medication is from 200 to 370 rubles.
Often patients are interested in drug analogues with less pronounced side effects. Such drugs can be selected. They contain other active ingredients, but are also old-generation antidepressants. These include:
- Melipramine
- Anafranil
- "Lyudyomil."
Let us consider in more detail each analogue. "Melipramine" also refers to tricyclic antidepressants. But he has a more pronounced activating effect, and not sedative. It acts as an anticholinergic, but rarely causes side effects. The drug is prescribed for depression with asthenic manifestations. As well as indications for the use of the drug are psychosomatic diseases indicated in the instructions "Amitriptyline". Reviews of the analogue indicate that this medicine eliminates lethargy in depression, but weakly affects anxiety. The price of Melipramin is from 310 to 430 rubles.
Anafranil is also a tricyclic antidepressant. Its side effects are much less pronounced than that of Amitriptyline. The medicine is able to eliminate both excessive retardation and anxiety. The price of medicine in pharmacies is from 270 to 600 rubles.
Lyudiomil is a newer drug. It has a different structure, not the same as tricyclic drugs, it is a tetracyclic antidepressant. The medication does not belong to anticholinergics, it does not have such side effects as dry mouth, accommodation spasm, difficulty urinating. In this case, the medicine well eliminates anxiety and somatic signs of depression. The cost of the drug in pharmacies is from 550 to 850 rubles.
Doctors reviews
Reviews about the use of "Amitriptyline" by doctors are usually positive. This old remedy is well studied by specialists, and its effect is known. Psychiatrists believe that in the treatment of depression with manifestations of longing and anxiety, this drug is indispensable. It effectively eliminates all the symptoms of the disease in 2-3 weeks.
Therapists consider this antidepressant to be a good analgesic. It reliably relieves pain, especially with migraines.
As for the side effects of the drug, experts believe that such manifestations do not require abandonment of the drug, but dose adjustment. Therefore, treatment always begins with a small amount of the drug, paying attention to the well-being of the patient.
Positive patient reviews
You can find many positive reviews of patients about "Amitriptyline". People with depression and neurosis note that within a week after taking the medicine, their mental state improved significantly. Longing and anxiety disappeared, irritability decreased, sleep normalized. Patients noted some lethargy and lethargy at the beginning of treatment. But these symptoms disappeared as the body adapted to the drug and when adjusting the dose.
Good reviews about "Amitriptyline" leave and patients suffering from pain. They write that the drug effectively relieves discomfort in migraines, spinal hernias, gastrointestinal diseases and other somatic pathologies.
Negative patient reviews
Some patients in reviews of Amitriptyline report severe drowsiness in the first days of treatment. Patients experienced lethargy and lethargy; they had to spend most of the day in a dream. However, doctors believe that this gives rest to the body. Prolonged sleep helps to restore the psyche of depression.
Other negative reviews relate to anticholinergic side effects: dry mouth, urinary retention, constipation, and tachycardia. This is a significant disadvantage of this drug. Therefore, many patients prefer to take more modern antidepressants. However, the cost of such drugs is much higher.