Elavil belongs to the group of antidepressants called tricyclic because the chemical composition of the medicines included in this group has a three-ring chemical structure. The active substance is Amitriptyline. Elavil is supplied as 10, 25, 50, and 75 mg tablets. The mechanism of action is the inhibition of the reuptake of catecholamines, such as dopamine, norepinephrine, and serotonin. Amitriptyline acts on m-cholinergic receptors. Elavil also has antihistamine, analgesic, antiulcer, and anabolic effects. In addition, it promotes the elimination of bedwetting and reducing appetite. Elavil may also be used for purposes not listed in this short guide.
Elavil absorbs from the gastrointestinal tract, and the maximum concentration observes after 4-6 hours. It binds to plasma proteins, which is about 95%. It metabolizes in the liver to an active substance called nortriptyline. The half-life takes an average of 24 hours for Amitriptyline and up to 80 hours for nortriptyline. It is excreted by the kidneys in the form of metabolites, about 5% unchanged.
Elavil is actively used to treat the following diseases and ailments: Depression of various origins, especially effective in endogenous Schizophrenic psychoses Bulimia nervosa Enuresis Chronic pain syndrome Organic brain damage
Elavil is prescribed to eliminate bedwetting (enuresis) as it reduces the tone of the smooth muscles of the bladder. During treatment, it lowers blood pressure and body temperature. The effect usually occurs after 3 weeks.
The dosages are individually for each person. Please consult a doctor to get a proper treatment course. It is necessary to take the drug after meals 1 time a day before bedtime. When taking high doses, it is recommended to divide the intake into 3 parts.
The initial dose of the drug is 25-50 mg at bedtime, with a gradual increase. The maximum dosage is 300 mg per day, should be divided into 3 intakes, with the highest dose at bedtime. The therapeutic effect occurs in 2-3 weeks. The duration of treatment with Elavil varies from 2 months to a year and depends on how the patient feels. Also, short courses of 10-14 days or a single dose of the drug are possible in dosages prescribed by the attending physician. There are also cases when a lifelong intake of Elavil has taken place. Drug withdrawal should also be carried out gradually, reducing the dosage by 50 mg every 3-4 days.
For children from 6 years of age, the dosage is 1-1.5 mg/kg. With enuresis 10-20 mg per day. Adolescents are prescribed up to 100 mg/day, starting at 50 mg/day, preferably before bedtime.
Addiction to Elavil is also possible. It manifests with the following symptoms: malaise, headaches, irritability, terrible dreams, nausea, vomiting, and diarrhea.
Taking Elavil during pregnancy and lactation is possible only if the benefits exceed the potential risks. The drug should be withdrawn gradually, at least 7 weeks before childbirth, because of the occurrence of a withdrawal syndrome in newborns. Drug withdrawal syndrome characterizes by intestinal colic, tremors, high/low blood pressure, overexcitation, and shortness of breath. Amitriptyline passes into breast milk and causes drowsiness in babies.
Take medicine as soon as possible. In case if it is almost time for your next dose, you must skip the missed ones. Do not take two doses at one time.
The development of side effects may not appear immediately, but only after 14-21 days. It is recommended to monitor the patient during this period actively.
• Dry mouth • Mydriasis - dilated pupils • Disturbance of eyes and blurred vision • Constipation, up to intestinal paralysis and obstruction • Tremor • Drowsiness • Dizziness • Apathy • High body temperature
The lethal dosage of the drug Elavil is 1200 mg/day. Overdose manifests itself in each person individually and begins with the following symptoms: drowsiness, apathy, or, on the contrary, agitation, hallucinations, and agitation.
• Critical changes on the ECG are possible such as: ventricular tachyarrhythmia, arrhythmias, fibrillation, and heart failure.
• Cholinergic effects: urinary retention, acute intestinal obstruction and heart failure.
• Neuropsychic influence: confusion, coma, respiratory arrest, seizure, etc.
Immediately stop taking Amitriptyline. It is also recommended to monitor the ECG for a week. A relapse is possible on the second day or later.
It might be necessary to wash the stomach with water at room temperature if the intake was no later than 2 hours ago.
Inject physostigmine up to 3 mg IV every 2 hours, but it is usually prescribed for severe forms of poisoning, such as coma, respiratory failure, convulsions, or arrhythmias.
Monitoring of water-salt metabolism and blood pressure are also recommended.
It is not recommended to take the drug for prostatic hypertrophy, glaucoma, coronary heart disease, heart failure, and bladder atony. It is also contraindicated for children under 6 years old.
Amitriptyline increases the effect of substances that depress the central nervous system: sympathomimetics, antiparkinsonian, and medications with a hypnotic effect.
• Alcohol is prohibited as it weakens the effect of Elavil. • Anticonvulsants lower blood pressure. • Carbamazepine, barbiturates, and other inducers of microsomal oxidation reduce the concentration of the drug in the blood.
Elavil should be prescribed strictly under the supervision of a physician. It should be noted that the drug administration should be no more than 2-3 weeks in advance for outpatient treatment. It is essential because the low mood and depression disappear no earlier than 2 weeks from the beginning of taking the drug, and the patient's physical strength and energy appear almost immediately. Consequently, the patient may be even more likely to commit suicidal attempts. For greater safety, the treatment of endogenous depression should begin in a psychiatric hospital with strict supervision or under the supervision of the patient's relatives. It is crucial to control the number of tablets remaining in the package because of the high probability of an overdose.
Strict supervision might be reduced when the patient's condition improves, and the risk of suicide disappears.
Depression is a mental illness characterized by a constantly low mood, depression, lethargy, lack of positive emotions, reticence, unwillingness to do anything, and slowness. According to the WHO, more than 300 million people in the world have this mental illness. Depression can be endogenous, somatogenic, or psychogenic.
Somatogenic depression is symptomatic and arises from other diseases, such as brain tumors, diabetes mellitus, Etc.
Psychogenic depression is associated with a person's response to external stimuli.
Endogenous depression is the rarest form, occurring in no more than 6% of all cases. There is no exact data on the causes of the occurrence. At the same time, the genetic predisposition associated with the transfer of genes, which are responsible for increased emotional susceptibility to even the most insignificant negative situations, is especially highlighted.
A particular type of depression is called postpartum depression . The cause is abrupt hormonal changes and develops within the first month after childbirth. This type of depression manifests as emotional instability, high anxiety for the newborn, lack of interest in the child, and disturbed sleep patterns.
Medically, depression is called a depressive episode. It lasts from 3 weeks to a year. A depressive episode occurs only once in a lifetime, but if a person does not receive adequate treatment, then there is a risk of repeated episodes.
Repeated episodes, in this case, would be referred to as recurrent depressive disorder. These disorders start during puberty when the phases of low mood alternate with periods of well-being. This type is unipolar.
Unipolar is a type of disorder characterized only by depression without phases of mania and hypomania. In different studies, you can find the term classical depression, which designates exactly recurrent depression.
Dysthymia is a type of depression characterized by a less vivid clinical picture. However, the disorder is persistent and might last for up to 2 years. That is why it is also called chronic. Dysthymia can progress to bipolar disorder. This condition consists of a change of suppressed into an overly elevated mood.
Manic phases are periods of illness characterized by decreased need for sleep, constantly elevated mood, anxiety, fussiness, and hyperactivity. In this phase, a person most often commits irresponsible actions: unwanted sexual intercourse misspends money and performs actions that would undoubtedly regret in a normal state of mind.
• Decreased mood for more than 2 weeks; • Irritability; • Loss of meaning in life; • Loss of initiative; • Psychomotor agitation - hyperactivity, numbness; • Loss of pleasure in life; • Loss of self-esteem and self-confidence; • Unjustified feelings of guilt; • Increased self-criticism; • Thoughts about death; • Feelings of indecision, weakening of attention and ability to focus on essential things; • Sleep disturbance; • Change in appetite
A prolonged depressive state is dangerous because the patient completely loses the instinct for self-preservation. Life does not bring joy, and nothing holds the sufferer in it.
Constant devastation, mental pain, the search for the meaning of life, and its absence lead the patient to thoughts of death. In such a state, a feeling of guilt constantly pursues, tormenting thoughts about punishing oneself push the person to commit suicide. According to the study, about 15% of patients with significant depressive syndrome end their lives by suicide. The onset of the disease is characterized by a decrease in physical strength and energy; therefore, patients cannot do anything at these moments. However, even then, thoughts of suicide may arise. It is vital at this moment to identify the problem at the stage of psychotherapy.
A person can create a deceptive impression about self well-being and recovery and still commit suicide. The risks of developing suicide are most increased among single people suffering from severe somatic diseases and patients who have had similar cases in their families.
Independent methods and unconventional methods can help get rid of a lowered mood, but in more severe cases, consultation and supervision of a specialist are necessary. Self-medication is unacceptable.
Healthy sleep; Proper nutrition; Normalized physical activity; Cognitive-behavioral therapy; Meditation; Yoga; Green tea; Probiotics, Etc.
Medical therapy, where Amitriptyline occupies a special place, as well as psychotherapy (which has its clinical subtypes) and other medical solutions.
Social support is the final stage of treatment, which includes: social activities, physical activities, rest, Etc. All these methods are auxiliary and used only at the stage of recovery.
At the initial stage of the disease, people suffering from depression are afraid to seek specialized help. It mainly happens due to stigmatization in society, social restrictions, or fear of taking medications, which is based on a false idea of the effect of antipsychotic drugs on the human body and mind. Situations often occur when a person cannot recognize the nature of a personal mental state in time. It seems to patients that this is a normal reaction to some incident, which will go away on its own. Sometimes depression is characterized by the physiological manifestations of any somatic illness, and the patient loses time looking for an answer and begins to visit general practitioners or therapists, who make the diagnosis on time in only 5% of cases. It happens because of hidden symptoms for numerous diseases resulting from which other drugs may be prescribed. Patients undergo multiple examinations, spend a lot of time and money on visits to various specialists, and have no improvement in their condition. From here begins a vicious circle. They begin to fall even more into a state of depression since they believe that they have an incurable disease and cannot be cured. Patients most often come to a psychiatrist with severe and chronic manifestations of this condition.