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    Amitiptrin

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    Teguh Fatwa Panuntun
    - Amitriptyline is a sedating tricyclic antidepressant used to treat depression and neuropathic pain in adults. - For depression, the initial dose is 75 mg/day increasing up to 150 mg/day. For neuropathic pain, the initial dose is 25 mg/day increasing up to 75 mg/day. Lower doses are recommended for elderly patients. - Treatment duration is a minimum of 3 months for depression and several months after pain relief for neuropathic pain. The drug should be withdrawn gradually to prevent relapse.

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    Amitiptrin

    Uploaded by

    Teguh Fatwa Panuntun
    26 views2 pages
    - Amitriptyline is a sedating tricyclic antidepressant used to treat depression and neuropathic pain in adults. - For depression, the initial dose is 75 mg/day increasing up to 150 mg/day. For neuropathic pain, the initial dose is 25 mg/day increasing up to 75 mg/day. Lower doses are recommended for elderly patients. - Treatment duration is a minimum of 3 months for depression and several months after pain relief for neuropathic pain. The drug should be withdrawn gradually to prevent relapse.

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    amitiptrin

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    - Amitriptyline is a sedating tricyclic antidepressant used to treat depression and neuropathic pain in adults. - For depression, the initial dose is 75 mg/day increasing up to 150 mg/day. For neuropathic pain, the initial dose is 25 mg/day increasing up to 75 mg/day. Lower doses are recommended for elderly patients. - Treatment duration is a minimum of 3 months for depression and several months after pain relief for neuropathic pain. The drug should be withdrawn gradually to prevent relapse.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    26 views2 pages

    Amitiptrin

    Uploaded by

    Teguh Fatwa Panuntun
    - Amitriptyline is a sedating tricyclic antidepressant used to treat depression and neuropathic pain in adults. - For depression, the initial dose is 75 mg/day increasing up to 150 mg/day. For neuropathic pain, the initial dose is 25 mg/day increasing up to 75 mg/day. Lower doses are recommended for elderly patients. - Treatment duration is a minimum of 3 months for depression and several months after pain relief for neuropathic pain. The drug should be withdrawn gradually to prevent relapse.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    HTherapeutic action

    – Sedating tricyclic antidepressant

    Indications – Depression in adults, especially when a sedative effect is required (anxiety, agitation,

    insomnia)

    – Neuropathic pain in adults

    Presentation

    – 10 mg, 25 mg and 50 mg tablets

    Dosage – Depression

    Initial dose of 75 mg/day in 2 to 3 divided doses, or once daily at night, gradually

    increased, if necessary, to a maximum dose of 150 mg/day

    – Neuropathic pain

    Initial dose of 25 mg/day at night for one week, followed by 50 mg/day at night for one

    week then 75 mg/day at night

    – Reduce the dose by one-half in elderly patients.

    Duration – Depression: minimum 3 months. The treatment should be withdrawn gradually ; if signs
    of

    relapse occur, increase the dose.

    – Neuropathic pain: continue several months after pain relief is obtained, then attempt to stop

    treatment.

    Contra-indications, adverse effects, precautions – Do not administer if: recent myocardial infarction,
    arrhythmia, impaired liver function,

    acute mania. Do not administer to children. – May cause:

    • antimuscarinic effects: dry mouth, urinary retention, disturbance of accommodation,

    constipation, tachycardia

    • orthostatic hypotension, arrhythmia, cutaneous reactions, endocrine disorders, weight

    gain, sweating

    • frequent drowsiness, tremor, insomnia, transient mental confusion

    • effects linked to depressive illness: may exacerbate suicidal tendencies and psychotic

    symptoms

    Adverse effects occur particularly in the elderly and in the event of overdosage.

    – Do not combine with another antidepressant, especially an MAOI.

    – Avoid combination with atropine, epinephrine (adrenaline), methyldopa (increased


    hypotension).

    – Use with caution when driving or operating machinery: risk of drowsiness.

    – Do not drink alcohol during treatment.

    – Administer with caution, under medical supervision, in epilepsy, cardiovascular disease,

    hepatic or renal failure, prostatic hyperplasia, thyroid disease.

    – Closely monitor patients with suicidal tendencies, especially in the initial stage of

    treatment.

    – Pregnancy: avoid, especially at the end of pregnancy (antimuscarinic effects in neonates)

    – Breast-feeding: avoid

    Remarks

    – In the treatment of neuropathic pain, amitriptyline is often combined with carbamazepine

    (except in pregnant women).

    – Sedative action occurs following initial doses. Antidepressant and analgesic effects are

    delayed for 10 to 20 days. Wait for several weeks before assessment of efficacy. This must

    be explained to the patient to encourage compliance.

    – Combination with an anxiolytic or a neuroleptic may be useful in anxious or agitated

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