amitriptyline
Last reviewed 01/2023
Amitriptyline is a tricyclic antidepressant with sedative properties.
Dose of 75-200 mg per day in divided doses - starting dose is 50-75 mg per day in adults; 25-50mg in elderly and adolescents - which should be increased gently over 10 days. The usual maximum effective prescribed dose is 150 mg per day.
Especially useful for depression with anxiety, and particularly those with endogenous features, e.g. early morning wakening, diurnal mood variation, severe mood changes, weight loss. It is the tricyclic antidepressant of preference for sedation, and is best given as a once nightly dose. There is little advantage in using commercial sustained-release preparations.
The patient should be advised to expect a 10-14 day delay before the onset of therapeutic action at each dose level, and that side effects may make them feel worse before improvement begins.
The summary of product characteristics should be consulted before prescribing this drug.