Brand Name: Celexa
Other Name: Etrafon, Perphenazine, Endep, Tryptizol, Elavil
Drug Class: Antidepressant, TCA
Uses of apo Amitriptyline hcl
Amitriptyline hydrochloride is used primarily to treat major depression
(both psychotic and endogenous), especially depression associated with a sleep disturbance. Because of its sedative effects, it may be useful in treating anxiety associated with depression. Elavil should not be used for bipolar disorder (manic depression) as it may precipitate a manic episode.
Amitriptyline hydrochloride is a heterocyclic antidepressant - a class of drugs that inhibits the nerve cells' ability reuptake norepinephrine and serotonin and brings the levels of these neurotransmitters back up to normal. Amitriptyline is very sedating.
Amitriptyline hydrochloride medication is sometimes prescribed for other uses ask your doctor or pharmacist for more information.
INDICATIONS
For the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than are other depressive states.
DOSAGE AND ADMINISTRATION
Oral Dosage
Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerance.
Initial Dosage for Adults: For outpatients 75 mg of amitriptyline HCl a day in divided doses is usually satisfactory. If necessary, this may be increased to a total of 150 mg per day. Increases are made preferably in the late afternoon and/or bedtime doses. A sedative effect may be apparent before the antidepressant effect is noted, but an adequate therapeutic effect may take as long as 30 days to develop.
An alternate method of initiating therapy in outpatients is to begin with 50 to 100 mg amitriptyline HCl at bedtime. This may be increased by 25 or 50 mg as necessary in the bedtime dose to a total of 150 mg per day.
Hospitalized patients may require 100 mg a day initially. This can be increased gradually to 200 mg a day if necessary. A small number of hospitalized patients may need as much as 300 mg a day.
Adolescent and Elderly Patients: In general, lower dosages are recommended for these patients. Ten mg 3 times a day with 20 mg at bedtime may be satisfactory in adolescent and elderly patients who do not tolerate higher dosages.
Maintenance: The usual maintenance dosage of amitriptyline HCl is 50 to 100 mg per day. In some patients 40 mg per day is sufficient. For maintenance therapy the total daily dosage may be given in a single dose preferably at bedtime. When satisfactory improvement has been reached, dosage should be reduced to the lowest amount that will maintain relief of symptoms. It is appropriate to continue maintenance therapy 3 months or longer to lessen the possibility of relapse.
Intramuscular Dosage
Initially, 20 to 30 mg (2 to 3 ml) four times a day.
When amitriptyline HCl injection is administered intramuscularly, the effects may appear more rapidly than with oral administration.
When amitriptyline HCl injection is used for initial therapy in patients unable or unwilling to take amitriptyline HCl tablets, the tablets should replace the injection as soon as possible.
Usage in Pediatric Patients: In view of the lack of experience with the use of this drug in children, it is not recommended at the present time for patients under 12 years of age.
Plasma Levels: Because of the wide variation in the absorption and distribution of tricyclic antidepressants in body fluids, it is difficult to directly correlate plasma levels and therapeutic effect. However, determination of plasma levels may be useful in identifying patients who appear to have toxic effects and may have excessively high levels, or those in whom lack of absorption or noncompliance is suspected. Adjustments in dosage should be made according to the patient's clinical response and not on the basis of plasma levels.14
