Antidepressant medications are administered for the treatment of mood based disorders and mental conditions such as depression, anxiety, phobias as well as a few other related disorders. There are many types of antidepressants; of which, tricyclic genre of antidepressant medications are widely used to treat mood swings. Building blocks of this drug’s chemical compounds form three (3) rings, thus these are categorized as “tricyclic” genre. Amitriptyline is one such tricyclic antidepressant; owing to a 3-ringed formation of its basic structure. However, the structure of amitriptyline is not similar to the conventional 3-rings seen in other similar drugs like say, imipramine, etc. Amitriptyline works by stopping neuro transmitting chemicals – serotonin, norepinephrine, etc., thus controlling persistent spells of depression. But, you need to be aware that this drug is likely to trigger a few adverse side effects.

The reuptake of neuro messengers is critical for the passing of brain messages to feel pain, moods and other emotions. Amitriptyline primarily works by stopping the reuptake of serotonin and norepinephrine. Thus drug is often used as a second-line treatment for mood shifts including depression. In moderated dosage strength, amitriptyline is administered for reducing muscular pains, weariness as well as to boost sleep. As an extended use, this drug is prescribed for the treatment of chronic headaches; especially, headaches caused by a build-up of pressure or tension. This drug is directly absorbed through the gastric tract in a gradual manner. It often takes nearly 5 hours (or, slightly less) to get it completely absorbed into your system.

Amitriptyline is taken orally, and is usually during night times. Intake of this drug in the evening is recommended to avoid sleepiness during active workhours or at daytimes. At times, this drug is prescribed more than once. The number of doses per day, strength of its dosage as well as duration of medication plan depends on the nature of your mental condition. Apart from severity of mood disorders, your age, gender and how well your body responds to the initial doses of amitriptyline also can determine its dosage levels.

Side effects of amitriptyline

This drug is known to trigger a few adverse side effects. In order to minimise several discomforts or adverse side effects, your treating physician may start with low dosage levels of amitriptyline. Based on how well your mental condition improves, doses are then slowly increased over a period of time. If you expect immediate results soon after taking two or three doses, it is unlikely to occur. Instead, it may take a while for the positive results to show up. This is mainly because this drug works very slowly and may hence take time for its effects to show up.

Common side effects

The most common side effects of this drug are dryness of mouth, blurring of eyesight, difficulties to pass stool, feeling dizzy, inexplicable increase in body weight, problems in discharging urine and dizziness. Many of these discomforts may cease to exist when your body gets used to the active ingredients of amitriptyline. However, if you notice one or more of these side effects to persist, you need to quickly report about them to your treating doctor. Dryness of mouth is another common side effect of amitriptyline; your pharmacist may advise you to suck-on ice chips or boiled candies (preferably, sugarless). You may also try chewing gum (a sugarless gum). If candies, gums or ice chips are not available, you can either drink a glassful of water. As a last resort, you can also take saliva as an alternative to reduce oral dryness or dehydration.

Ways by which the side effects triggered by intake of amitriptyline are managed

Most people who took amitriptyline have experienced drowsiness or dizziness. Your physician may also tell you to stay aware of this risk. You are likely to fall or faint – especially while shifting postures. So, when you shift from a lying-down posture to a sitting posture or trying to stand-up, it is important to make these shifts very slowly. In order to counter difficulties in discharging stools, your doctor may tell you to drink needful amounts of water and consume foods rich in fiber. As another measure to reduce risks of constipation, you can opt for workouts or do exercises regularly. If you are experiencing chronic spells of constipation (i.e., severe and persistent problems while passing stools), your doctor may prescribe a laxative. It is important to take a laxative only for a shorter time period. A long term use of laxatives can lead to dependence or formation of habits, and hence can be addictive.

Acute side effects of amitriptyline

You need to remember that your physician has prescribed this drug as its benefits clearly outweigh the risks of its side effects. It is important to know that most users of amitriptyline did not notice any major or acute side effects. In some remote instances, a few users of amitriptyline developed a few acute side effects. Such adverse side effects include tremors or shakes, spasms or muscular cramps, decrease in levels of libido or absence of desire to have sex, etc. A few other acute side effects are persistent pains in the lower abdomen or stomach, pain in breasts or softening of breasts, acid reflux, chronic heartburns, bleeding or development of bruises. Those who take blood thinning drugs like heparin or warfarin need to stay cautious of added risks of bleeding and bruising.

A few serious side effects triggered by regular intake of amitriptyline

Doses of amitriptyline are unlikely to trigger adverse side effects. In extremely rare cases, side effects such as extreme spells of drowsiness or dizziness, passing out, epileptic fits, convulsions, discharge of darkened stools, etc. are observed. In very remote instances, side effects like blurring of vision or altered eyesight, enlargement of pupils, discoloration of eyes or ocular pains are also reported. If you notice any of these reactions, you need to quickly seek needful medical attention. The immediate thing to do is to talk to your pharmacist for needful safety precautions.

Allergic reactions linked with intake of amitriptyline

Amitriptyline may very rarely trigger allergies or associated reactions. In some inexplicable situations, this drug may cause allergies like persistent itchiness, inflammation or swelling, an acute spell of drowsiness, respiratory problems like wheezing, gasping for breath, etc. In some people, amitriptyline has also caused skin conditions like hives or rashes, discoloration of skin, etc. You need to always remember that these allergic reactions do not form a complete list of all such allergic discomforts. It is possible to develop a few allergies or allergic reactions soon after starting a medication plan. So, upon witnessing side effects or allergies that are not mentioned above, you need to seek medical help promptly.

As an extremely remote occurrence, a small minority of users have reported an acute neurological condition known as neuroleptic malignant disorder or syndrome. This occurs when a drug controls the production of dopamine – a substance made in your brain. This condition is characterised by stiffening of muscles and as a result, impairment of motor function. The other symptoms associated with this condition are increase in body temperature, sweating profusely, rapid or erratic heartbeats, etc. In some people, this condition may lead to persistent spells of restlessness or being in a confused frame of mind.

Ways by which the side effects triggered by intake of amitriptyline are managed
Most people who took amitriptyline have experienced drowsiness or dizziness. Your physician may also tell you to stay aware of this risk. You are likely to fall or faint – especially while shifting postures. So, when you shift from a lying-down posture to a sitting posture or trying to stand-up, it is important to make these shifts very slowly. In order to counter difficulties in discharging stools, your doctor may tell you to drink needful amounts of water and consume foods rich in fiber. As another measure to reduce risks of constipation, you can opt for workouts or do exercises regularly. If you are experiencing chronic spells of constipation (i.e., severe and persistent problems while passing stools), your doctor may prescribe a laxative. It is important to take a laxative only for a shorter time period. A long term use of laxatives can lead to dependence or formation of habits, and hence can be addictive.

Acute side effects of amitriptyline

You need to remember that your physician has prescribed this drug as its benefits clearly outweigh the risks of its side effects. It is important to know that most users of amitriptyline did not notice any major or acute side effects. In some remote instances, a few users of amitriptyline developed a few acute side effects. Such adverse side effects include tremors or shakes, spasms or muscular cramps, decrease in levels of libido or absence of desire to have sex, etc. A few other acute side effects are persistent pains in the lower abdomen or stomach, pain in breasts or softening of breasts, acid reflux, chronic heartburns, bleeding or development of bruises. Those who take blood thinning drugs like heparin or warfarin need to stay cautious of added risks of bleeding and bruising.

A few serious side effects triggered by regular intake of amitriptyline

Doses of amitriptyline are unlikely to trigger adverse side effects. In extremely rare cases, side effects such as extreme spells of drowsiness or dizziness, passing out, epileptic fits, convulsions, discharge of darkened stools, etc. are observed. In very remote instances, side effects like blurring of vision or altered eyesight, enlargement of pupils, discoloration of eyes or ocular pains are also reported. If you notice any of these reactions, you need to quickly seek needful medical attention. The immediate thing to do is to talk to your pharmacist for needful safety precautions.

Allergic reactions linked with intake of amitriptyline

Amitriptyline may very rarely trigger allergies or associated reactions. In some inexplicable situations, this drug may cause allergies like persistent itchiness, inflammation or swelling, an acute spell of drowsiness, respiratory problems like wheezing, gasping for breath, etc. In some people, amitriptyline has also caused skin conditions like hives or rashes, discoloration of skin, etc. You need to always remember that these allergic reactions do not form a complete list of all such allergic discomforts. It is possible to develop a few allergies or allergic reactions soon after starting a medication plan. So, upon witnessing side effects or allergies that are not mentioned above, you need to seek medical help promptly.

As an extremely remote occurrence, a small minority of users have reported an acute neurological condition known as neuroleptic malignant disorder or syndrome. This occurs when a drug controls the production of dopamine – a substance made in your brain. This condition is characterised by stiffening of muscles and as a result, impairment of motor function. The other symptoms associated with this condition are increase in body temperature, sweating profusely, rapid or erratic heartbeats, etc. In some people, this condition may lead to persistent spells of restlessness or being in a confused frame of mind.

If you notice the above condition or any other serious side effects, it is important to call 911 without any further delay. In the US, you can reach out to the food and drug administration (FDA). As FDA watches over all the drugs it has cleared, serious side effects triggered by an FDA-approved drug – say, like amitriptyline – can lead to a quicker access to needful medical support. Those living in Canada are advised to immediately call Health Canada or contact a poison control center located in your province.

Other needful precautions to minimise or avoid likely side effects of amitriptyline
It is important to tell your doctor about prior medical conditions – especially, cardiac conditions. This is because of the capability of amitriptyline to influence your heartbeats which can in turn lead to prolonged-QT; if not properly cared for, this prolongation can result in drowsiness, loss of consciousness, fainting or passing out. So, you are advised to lay added emphasis and care if you already have heart conditions such as a recent cardiac arrest, slowing down of pulse rate or heartbeats, etc. If you do not heed to these signs, they can soon turn into near-fatal or at times, fatal outcomes!

Amitriptyline is known to interact with a few drugs. You need to share your medication plans with your doctor before starting to take amitriptyline. This drug may work adversely when co-administered with thyroid drugs, non-steroidal anti-inflammatory drugs (NSAID) like ibuprofen or naproxen, antiplatelet medicines such as clopidogrel, MAO inhibiting meds like linezolid, safinamide, etc. As amitriptyline may cause excessive levels of dizziness or drowsiness, it is highly recommended to stay away from alcohol or intoxicating substances like cannabis or marijuana. Also, if you have a history of substance abuse, your medical team needs to know about it prior to starting doses of amitriptyline.

It is highly recommended not to discontinue the intake of amitriptyline without the consent of your doctor. You need to know that your mental condition may turn worse if the drug is stopped in an abrupt manner. The best way to stop taking this drug is to taper down the strength slowly. Also, you are advised to take this drug without any breaks. Regular intake is essential to maximise its benefits. However, taking this drug for longer periods – i.e., longer than the prescribed timeline – can often lead to serious side effects. You need to stay aware that such long-term usage or consuming it in increased strengths is unlikely to expedite your recovery process. Instead, the risks of adverse reactions or allergies tend to get more if it is taken excessively or for a longer time.

As an additional safety measure, you are advised to inform hypersensitivities or known-allergies to antidepressants – especially of the tricyclic genre. It is also essential to keep your caregiving team updated about your medical history if it includes myocardial infarction, hyperactive thyroid gland (also known as hyperthyroidism), hepatic disorders such as cirrhosis as well as inflammation of liver. It is equally important to tell about urinary problems as well as respiratory disorders like bronchitis or asthma. If your clinical history or family’s medical history includes conditions such as depression, mood-based disorders, suicidal thoughts or other mental conditions, your doctor needs to be aware of such conditions. People living with convulsions or epileptic fits must share details about frequency of such spells, intensity and the associated symptoms or discomforts with their treating physician; especially before starting to take amitriptyline.

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