Elavil

ORIGINAL USES (ON-LABEL)

Depression.

NEWLY DISCOVERED USES (OFF-LABEL)

Chronic fatigue syndrome, chronic nausea and vomiting, chronic neuropathic pain, diabetic neuropathy, dyspepsia, fibromyalgia, interstitial cystitis, irritable bowel syndrome, migraine prevention, multiple sclerosis, panic disorder, post-herpetic neuralgia, post-traumatic stress disorder, pruritus, urticaria, vulvodynia.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Elavil.

Older adults are especially liable to certain side effects of Elavil, including rapid heartbeat, constipation, dry mouth, blurred vision, sedation, and confusion, and are in greater danger of sustaining a fall.

Blurred vision, bone marrow depression, bowel problems, breast enlargement (in males and females), constipation, dry mouth, hair loss, heart attack, high body temperature, problems urinating, rash, seizure, stroke, swelling of the testicles, water retention

Headache, nausea, vague feeling of bodily discomfort

Dream and sleep disturbances, irritability, restlessness

These side effects do not signify an addiction to the drug.

DESCRIPTION

Amitriptyline tablets belong to a class of drugs called tricyclic antidepressants (TCAs), used in the treatment of symptoms of mental depression, including anxiety. Elavil is thought to improve mood by raising the level of neurotransmitters (the brain messenger chemicals norepinephrine and serotonin) thereby improving anxiety with its sedative effects. Side effects of amitriptyline include dry mouth, mild drowsiness, photosensitivity, urinary retention, tinnitus (ringing in the ears), and confusion. It should be taken at night due to its sedative effects. It may take up to two to three weeks to take effect.

Why should Elavil not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Elavil or similar drugs such as desipramine and imipramine, you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced.

Do not take Elavil while taking other drugs known as MAO inhibitors. Drugs in this category include the antidepressants phenelzine and tranylcypromine.

Unless you are directed to do so by your doctor, do not take this medication if you are recovering from a heart attack.

Overdosage

An overdose of Elavil can prove fatal. If you suspect an overdose, seek medical attention immediately.

Abnormally low blood pressure, confusion, convulsions, dilated pupils and other eye problems, disturbed concentration, drowsiness, hallucinations, impaired heart function, rapid or irregular heartbeat, reduced body temperature, stupor, unresponsiveness or coma

Agitation, extremely high body temperature, overactive reflexes, rigid muscles, vomiting

Precautions

Schizophrenic patients may develop increased symptoms of psychosis; patients with paranoid symptomatology may have an exaggeration of such symptoms. Depressed patients, particularly those with known manic-depressive illness, may experience a shift to mania or hypomania. In these circumstances the dose of amitriptyline may be reduced or a major tranquilizer such as perphenazine may be administered concurrently.

The possibility of suicide in depressed patients remains until significant remission occurs. Potentially suicidal patients should not have access to large quantities of this drug. Prescriptions should be written for the smallest amount feasible.

Concurrent administration of Amitriptyline and electroshock therapy may increase the hazards associated with such therapy. Such treatment should be limited to patients for whom it is essential.

When possible, the drug should be discontinued several days before elective surgery.

Both elevation and lowering of blood sugar levels have been reported. Amitriptyline should be used with caution in patients with impaired liver function.