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Doctors' Answers to "Frequently Asked Questions" - Amitriptyline
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Amitriptyline [posted 1/14/99]
Question: I am a court reporter working on a transcript, which discusses
amitriptyline. I need to know what term is used for digested amitriptyline in the body.
Nortriptyline? Narcotriptyline? I would truly appreciate help with this as quickly as
Answer: Well, it is metabolized by the liver using the P450 system.
I'm not aware of any specific names, but I suspect the scientific department of Zeneca
would (brand name Elavil by the way): 302-886-8000.
Amitriptyline & Nortriptyline [posted
Question: What is the difference between amitriptyline and
nortriptyline? Is one better than the other for insomnia? Also, is it ok to drink taking
either one of these tricyclic antidepressants?
Answer: They belong to the same class of antidepressants, the
tricyclics. They have a somewhat different structure;but, similar side effects and
toxicities. Amitriptyline tends to be somewhat more sedating and better as a sleep
adjunct. Alcohol should be avoided due to boths ability to cause cardiac irregularity.
Amitriptyline & Blood Pressure
Concerns [posted 12/02/98]
Question: My mom is 78 years old, she has High Blood Pressure
she was taking Hyzaar 50-12.5 once a day also Lanoxin 0.25mgs a day, She was doing ok ,she
is going to have eye surgery for a cateract removal and was nervous about this and her BP
was rising , So we went in to see her DR. He changed her medicines to Verapamil 240mgs
once a day and added Amitriptyline 25mgs to help her relax, its been just a few days. My
mom BP when from 150/90 to 220/120 ..we are seeing the doctor this morning..would
Amitriptyline have made her BP jump like this..Thanks
Answer: Probably not.
Amitriptyline: Concerns about
Longterm Side Effects [posted 10/23/98]
Question: I am a user of amitriptyline for the purpose of sleeping. I am 28 yrs old
and have had insominia for about 6 yrs off and on. My doctor presribed amitriptyline for a
way of me to sleep, so what I would like to know is what the long term effects are? What I
really want to know is who can my doctor refer to me to..Eg sleep clinic, psychiatrist,
Answer: The long term side effects are the same as the short, drowsiness,
constipation and irregular heart beats. If you wish to continue to explore this area, see
a sleep specialist not a psychiatrist.
Amitriptyline: Concerns about
Addictiveness [posted 10/23/98]
Question: I recently lost my husband after an agonizing death of lung cancer. He
died at home with no help from his hospice. I am having trouble sleeping and my primary
physician has prescribed 10mg. amitriptyline for the restlessness and inability to get a
good nights sleep. Is this a safe drug to take for this problem?
Answer: Yes. Non-addictive and a mild antidepressant to boot.
Amitriptyline [posted 8/13/98]
Question: I have had a serious virus enter my shoulder and damage a large area of
nerves and some muscle tissue breakdown. Even though the virus is gone, the recovery
period has been over six months. The chronic pain (mostly nerve based) has been severe
enough to inhibit me from regular everyday activities. I have been on 20 or so pain
killers with no luck. The only drug that seemed to work a little was Ultram. The latest
drug is Amitriptyline (3, 25 mg tablets per day). For the entire period of recovery, I
haven't been able to gain back the 15 pounds that were lost due to the sickness. However,
from a week or so after taking this new drug, I have blotted/gained more weight than ever
before in my entire life. The only information on side effects of this drug that I have
found is that it induces an increased appetite for sweets. What happens if I continue
taking this drug for the next year or so for pain suppression? Will I continue to gain
weight at this pace? I'm an athlete and am very concerned that this drug has produced
something I've never dealt with before.
Answer: About 40-50% of patients on antidepressants will have a ongoing weight
gain. I suspect it will continue as long as you take the medication, possibly plateau -
Question: I would like to know the medical uses and any side effects of
Amitriptyline Tab (100 mg).
Answer: This is a drug used to treat depression, chronic pain and sleep
disorders. Initially, it was used in depression and is moderately effective. It does
produce somnolence in many patients, dry mouth, constipation, and in large does irregular
heart beats (occasionally fatal in large doses). Consequently, it was found to be
effective in sleep disorders, especially fibromyalgia, and also as an adjunct in chronic
Amitriptyline and Alcohol
Question: I realize that amitriptyline and alcohol, when taken together, have a
compounding effect as to sleepiness. I am taking 75 mg per day to control pain. Will this
drug effect the way alcohol is absorbed by the liver? Will it hold the alcohol in the
system longer or intensify the effects other than sleepiness? The reason for the question
is that I had three strong drinks in about one hour and became very drunk. I was a two to
three drink a day person, but since starting on this drug, I seldom drink because of the
feeling of tiredness. I did not expect the extra drunk feeling even though I hadn't drank
anything for about two months previous to this occasion.
Answer: The combination of these two drugs magnifies the effect of both. It does
not appear to work through the liver, but at a central acting site.
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