How to use Amitriptyline? (Elavil, Endep, Vanatrip) - Doctor Explains

In this video we will cover everything you need to know about Amitriptyline, also known as Elavil. This video is part of a video series on mental health problems. So for more mental health related videos check out this playlist:
https://www.youtube.com/playlist?list=PLaG3Bo3L0gX6Q9c7x0nRJ9sN_8pR8BB6m

Generic name: Amitriptyline.
Brand names: Elavil, Endep and Vanatrip.
Available as a tablet.

How to use it?
Tablet: Swallow the tablet completely with half a glass of water.
It does not matter at what time of day you take this medicine. However, it is advised to always take it at the same time every day. If you experience dazing effects when taking it, it might be helpful to take amitriptyline in the evenings. However if you on the other hand experience agitation, than it would be better to take it in the morning.

Duration of treatment:
Furthermore if Amitriptyline has no effect within 6-12 weeks, it is probably not effective for you. Your prescribing doctor will most likely prescribe you another antidepressant. However if you do experience improvements of your symptoms, your doctor will usually continue your treatment for 6 months up to several years.

When to use it?
Amitriptyline is part of a group of drugs called Tricyclic antidepressant (TCA). It has a strong anti-histaminergic and strong anticholinergic effect. In addition it inhibits the re-uptake of norepinephrine and serotonin in the brain, which is probably related to its antidepressant effect.
This is why Amitriptyline can be used to treat several mental health conditions:
- severe depression;
- Neuropathic pain;
- Chronic tension headache;
- Migraine;
- Polyneuropathy.

What is the correct dosage?
Unfortunately I can’t provide you with specific dosages, as these differ a lot depending on the specific indication of use, the side effects you experience and the severity of your complaints.
Furthermore, your maintenance dose will be adapted overtime based on the blood levels of Amitriptyline you will be having and your symptoms.
Therefore always use the precise amount and frequency your doctor prescribed you.
However the usual starting dose most doctors prescribing is 10-25mg 1-2x/day. If needed this can be gradually increased with steps of 10-25mg up to a maximum of 75mg 2x/day depending on your indication of use.

What are common the side-effects?
Very common (more than 10%): dry mouth, nausea, constipation, palpitations, fast heart rate, low blood pressure, weight gain, somnolence, dizziness, headache, tremor, nasal congestion, excessive sweating and aggression.
Common (1-10%): difficulty concentrating, taste disturbance, confusion, agitation, fatigue, thirst, decreased libido, erectile dysfunction and urination problems.
Uncommon (0.1-1%): convulsion, ringing in the ears, high blood pressure, heart problems, fainting, vomiting, diarrhea, rash, urticaria, anxiety, insomnia and nightmares.

Safety:
You should be careful to combine amitriptyline with alcohol. As this might increase the dazing effect of this drug.
In addition it is usually safe to drive while using Amitriptyline, however it can cause you to become drowsy, sleepy and/or dizzy. If you experiencing any of these side effects then please do not drive.
Furthermore, amitriptyline can have interactions with several drugs. Therefore always discuss this with your treating physician.

Pregnancy and Lactation:
Amitriptyline can be dangerous in both cases, however there are some exceptions. Therefore always discuss this with your doctor.

- Disclaimer: this video and the comments are meant purely informational! This is not medical advice! If you are looking for medical advice always contact your own doctor. -

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Literature:
1: Farmacotherapeutisch Kompas. (2020). Amitriptyline.
2: Apotheek.nl (2021). Paroxetine.

* The images in this video are used for educational purposes only. Most of the images and video material in this video come from https://www.canva.com/.

Music:
1. Verified Picasso, Fish Room
2. Patrick Patrikos, Good Times
3: Patrick Patrikios, Rockville
4: Patrick Patrikios, Grut

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