Amitriptyline

Amitriptyline is one of the first antidepressants that has been on the market since the early 1960s. It is mainly given for depression that accompanies anxiety disorders. Another area of ​​application is pain therapy.

What is amitriptyline?

The antidepressant amitriptyline was first produced in 1960 and launched two years later. Until the introduction of the serotonin reuptake inhibitors, amitriptyline was the most prescribed antidepressant worldwide.

And even today this active ingredient is still one of the psychotropic drugs that are most frequently prescribed in Germany. Amitriptyline is a tricyclic antidepressant that has a characteristic chemical structure with three fused rings. The preparation, which is known as a mood enhancer, is prescribed primarily for psychological complaints in which fears or a bad mood are in the foreground.

Amitriptyline also has a dampening effect on the psychomotor system of the patient. The preparation is therefore also administered in the case of sleep disorders, which are often among the symptoms of depression.

Pharmacological effect

Like all tricyclic antidepressants, amitriptyline also affects the metabolism of the brain by inhibiting the re-uptake of the messenger substances noradrenaline, dopamine and serotonin in the nerve cells.

This is supposed to compensate for the lack of messenger substances, which is characteristic of depressed patients. The messenger substances play an important role in the brain metabolism in that they control all nerve reactions. The messenger substances are usually located in small vesicles at the ends of the neurons, where they are released as soon as the nerve is excited. As a result, the messenger substances reach the receptors of other nerve cells and pass on the stimulus. The messenger substances are then broken down by enzymes or returned to the original storage facility via a special transport system.

Amitriptyline occupies the receptors of the messenger substances, whereby the brain metabolism is changed. In addition, the active ingredient prevents the messenger substances from being transported back. This allows them to stay longer at the site of action, which increases their effectiveness. In this way, amitriptyline can relieve tension and anxiety and relieve depressive moods.

The condition of chronic pain patients can also be improved. Here, too, the cause is often a disturbed processing of pain signals in the brain, with the messenger substance serotonin playing a key role.

Medical application & use

Various preparations with the active ingredient amitriptyline can be administered against all forms of depression because of their mood-enhancing effect. They are preferred for forms of depression that are associated with feelings of restlessness and fear.

Because it is often difficult to clarify which symptom is the cause and which is the consequence, especially in the case of mental illnesses, amitriptyline is also administered for anxiety disorders. Because these can have a negative effect on mood, which shows symptoms that can also be associated with depression. Because the preparation generally has a calming effect, amitriptyline is also used for pathological and chronic sleep disorders. Because of the calming effect that the preparation shows in all indications, it should always be taken in the evening.

Another area of ​​application for amitriptyline is chronic pain. Because in many cases these also have a psychological component. The active ingredient covers a relatively wide range of pain, from mild to very severe pain. Typical examples of applications in pain patients are the treatment of headaches in migraine patients or the pain in the musculoskeletal system from which fibromyalgia patients suffer.

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Risks & side effects

Patients given the preparation very often complain of side effects such as dry mouth, dizziness, tiredness, disorders of the cardiovascular system, headache, irritability, speech disorders and weight gain. A feeling of thirst, inner restlessness, taste disturbances or lack of concentration are just as common side effects as a loss of libido.

Occasionally, side effects such as high blood pressure, diarrhea or changes in the blood count may occur. In addition, there are a number of other possible side effects. Therefore, the approximately two-week adjustment to the preparation should take place under medical supervision.

Because if the side effects are too severe, you may have to switch to another preparation. In addition, the side effects should largely subside as soon as the recruitment phase is completed. Weaning should also be done slowly and gradually when discontinuing the preparation.