Treatment of depression with Amitriptyline: reviews, dosage and dosage regimen

Amitriptyline instructions for use are classified as tricyclic antidepressants.
These are some of the strongest drugs at a fairly reasonable price. But today, experts are divided on the possibility of recommending this drug in the first line of therapy. Due to the presence of a large number of side effects of tricyclic antidepressants, their poor tolerability profile, and violation of the rules for taking medications by patients, which leads to an increase in morbidity and sometimes death, many experts, including international ones, pay more attention to the drugs new generation. They are comparable in effect to Amitriptyline, but have fewer side effects. Nevertheless, Amitriptyline is used quite successfully in psychiatric practice.

What does amitriptyline help with?

For depression, panic attacks, anxiety and so on. It is part of a large group of tricyclic antidepressants that are quite powerful, but only if the dosage is adequate. They love to give it in hospitals, since it gives an effect almost immediately due to the fact that the anti-anxiety and hypnotic effects appear after the first dose. Antidepressive drugs develop gradually and can be counted on only after three weeks.

Amitriptyline is also often used for chronic pain. They even treat ulcers! True, treatment can only begin when the acute period has passed. I can also say with confidence that the drug perfectly fights pain in the intestines, especially if they are caused by such a nasty diagnosis as irritable bowel syndrome. Amitriptyline also helps with migraines (it really helps, it’s been tested!). For all these illnesses, smaller doses are usually taken than for depression.

Contraindications

The main area of application of the drug is diseases of the psyche and central nervous system. These include, first of all:

depression of various origins, primarily endogenous;
anxiety states;
psychoses;
schizophrenia;
neurogenic pain syndrome;
sleep disorders;
alcohol withdrawal;
behavioral disorders, including in children;
phobias;
epilepsy;
Bulimia nervosa (excessive appetite due to nervousness);
chronic pain syndrome (migraine, rheumatism, cancer, neuralgia and neuropathy);
migraine prevention;
peptic ulcer of the stomach and duodenum;
neurogenic urinary incontinence (except for cases with bladder hypotension).

For depression, the drug can be used as monotherapy; for other diseases, amitriptyline is most often used as part of complex therapy

Amitriptyline is contraindicated in:

severe forms of heart and kidney failure;
decompensated heart defects;
severe hypertension;
acute or subacute forms of myocardial infarction;
acute intoxication with alcohol, sleeping pills, analgesics and psychoactive substances;
angle-closure glaucoma;
atrioventricular block, stage 2;
under 6 years of age;
while taking MAO inhibitors.

During pregnancy, the drug can be prescribed only if there is no other alternative, after the doctor has weighed the pros and cons. Experiments on animals have shown that the drug has a teratogenic effect. Newborns born to women who took the drug during pregnancy may suffer from increased sleepiness or tearfulness for some time.

The drug, in addition, is contraindicated for people driving vehicles and performing work that requires concentration.

The drug is prescribed with caution when:

problems with the cardiovascular system (in particular, coronary heart disease, arrhythmia, heart failure),
chronic alcoholism,
bronchial asthma,
decreased intestinal motor function,
presence of a convulsive symptom in the anamnesis,
manic-depressive psychoses,
strokes,
renal and hepatic pathologies,
urinary retention and bladder hypotension,
thyrotoxicosis,
epilepsy,
prostatic hyperplasia.

Treatment of patients with severe endogenous depression and a high risk of suicidal behavior should be carried out only in a hospital setting.

Manufacturer

Personally, I (and everyone else too) have encountered three different amitriptylines - Denmark (Amitriptyline Nycomed), Slovenia and Russia. Some say they don’t feel the difference, others say that only Slovenian is good. From personal experience I can say that I like Amitriptyline Nycomed the most - that’s what I’m taking now. It acts more delicately; I didn’t notice any effect like “I got hit on the head with a dust bag.” Of course, it is more expensive than the domestic one, but people, it still costs 55 rubles for 50 25 mg tablets! It's practically free! By the way, some are beginning to doubt a drug with such a cost, but I tell you with all responsibility - do not doubt it! It works, and how.

Drugs with similar effects

Amitriptyline – INN (that is, international nonproprietary name). Patented products containing Amitriptyline as an active ingredient include:

Saroten Retard,
Elivel,
Damile Maleinat,
Amitriptyline-Grindeks,
Vero-Amitriptyline,
Amitriptyline Nycomend.

The latter is quite common. For Amitriptyline Nycomed 25 mg, the instructions for use are similar to those for regular domestic Amitriptyline; it costs approximately 53 rubles per package. Prescription drug. Prescriptions for such drugs are written using Latin. For Amitriptyline, the recipe in Latin will look like this:

Amitriptyline

Rp.: Tab. Amitriptylini 0.025 No. 20

DS 2 tab. 4 times a day after meals to treat depression.

Dosage

Amitriptyline is available in two dosages - 10 and 25 mg. The minimum therapeutic dose is 75 mg per day. The antidepressant effect of the drug is revealed at a dosage of at least 150 mg per day - that’s 6 tablets of 25 mg. They can be distributed approximately like this - 2-2-2 (morning-afternoon-evening), 3-3 (morning-evening), 1-1-4 (morning-afternoon-night). The instructions allow you to drink most of the dose at night, since the drug has quite severe side effects (especially at the beginning of use), but then I drank it and lay down, fell asleep, did not feel anything.

I’ll say right away that doctors outside hospitals avoid prescribing normal doses of amitriptyline. I don’t know why - are they afraid that the patient won’t reach them later and will fall somewhere along the way? The last time I said that I usually take three tablets a day (that is, those same 75 mg), they asked me “isn’t that too much?” This speaks well of the professionalism of doctors in mental health centers, since lower dosages simply will not have the desired effect. Or do they simply hope that with a small dosage the patient will receive an anti-anxiety effect, and no more is needed?

In small doses, according to both patients and researchers, only a sedative and hypnotic effect predominates. I use this regularly, and it usually takes me two weeks on 50 mg to get back to normal. But if you need a serious effect, then you can’t do without serious doses.

You should start taking it with a minimum dosage, because if you immediately take a 25 mg tablet, you will be knocked out so much that you will not want to continue. Half, and even that - for the night. Every 3-4 days, add half a dose until you reach 75 mg per day. Sit on this dose and let your body get used to it. Then you can add one tablet a week to the desired dosage - let me remind you, it should be no less than 100-150 mg. As soon as you reach the desired dose, you can count down 3 weeks. There is no desired effect - raise it again. At home, I do not recommend drinking more than 150 mg, so if you decide to do this, then either consult a doctor or go to the hospital.

Why do I describe the initial and subsequent dosages this way? Because even though amitriptyline is a well-studied drug, many doctors make quite serious mistakes. Either they immediately prescribe large doses, or initially they do not want to go to even the minimum therapeutic level. But, in any case, I always recommend that all dosage changes be coordinated with your doctor, and if you do something on your own, it is only at your own peril and risk.

And remember that taking beta blockers (such as, for example, anaprilin) significantly increases the concentration of amitriptyline in the blood, so the dosage should be minimal (best of all - two times lower than required).

Description

From a chemical point of view, amitriptyline belongs to the category of tricyclic antidepressants.
This class of drugs received this name because of their characteristic molecule shape, consisting of three carbon rings. The principle of action of amitriptyline is based on inhibition of the reuptake of various neurotransmitters, such as dopamine, norepinephrine and serotonin. This means that the drug prevents nerve cells from retaining these neurotransmitters at the time of impulse transmission. Due to this, the total amount of neurotransmitters in the area of synaptic connections between neurons increases. As a result, neural connections become more stable, and the functioning of the body’s adrenergic and serotonin systems is normalized.

Why is this so important in the case of depression? It's no secret that depression is not just blues or a bad mood. This is a serious disease of the nervous system, in which neural connections do not function properly, and in the nervous system there is a lack of various neurotransmitters and a disruption in the transmission of impulses between individual parts of the central nervous system. And this disease can be cured only by taking special medications, which include amitriptyline.

This drug has not only an antidepressant effect. It also provides:

moderate analgesic effect of central origin,
anticholinergic (central and peripheral),
antihistamine,
alpha adrenergic blocking agent
antiarrhythmic (due to slowing ventricular conduction),
sedative (calming),
anxiolytic (anti-anxiety) effect.

In addition, amitriptyline causes a decrease in appetite. Thanks to all these properties, the positive effect of the drug is manifested not only in mental disorders. Also the drug:

helps reduce pain,
has an antiulcer effect (due to blocking histamine receptors in the parietal cells of the stomach),
helps normalize urination (due to the anticholinergic effect and increased bladder distension).

The drug does not inhibit MAO. During general anesthesia, it reduces body temperature and blood pressure.

Amitriptyline does not have an immediate effect. It takes some time, at least 2-3 weeks, for its therapeutic effects to appear.

The effect of the drug largely depends on the dose. At small doses, below the therapeutic threshold, the drug has only a mild sedative effect, and there is no antidepressant effect. As the dose increases, an antidepressant effect appears, while the sedative effect gives way to a stimulating one.

In general, compared to other tricyclic antidepressants, the sedative properties of the drug predominate. Due to this, side effects typical of antidepressants with a stimulant effect, such as delusions and hallucinations, are not typical for amitriptyline.

The drug is especially effective for anxiety and depression. Treatment with amitriptyline in such cases successfully relieves not only depression itself, but also anxiety, psychomotor agitation (agitation), internal tension and fear, and normalizes sleep.

Duration of admission

You need to take amitriptyline in the required dosage for six months (counting from the complete disappearance of symptoms). Then you can reduce the dosage - very, very gradually, half a week, otherwise withdrawal symptoms will set in. It is not as strong as the same Paxil, but for some it can give indescribable sensations. I always lowered smoothly, so I didn’t feel anything like that.

When you reduce it to 2-3 tablets a day, sit on this dose longer, do not reduce it completely. This is a maintenance dose; it can be taken for a year or several years. If you are not undergoing psychotherapy, then you may have to take this dose for the rest of your life. My depression usually returns after about a month if I took the pills for a long time, and after two weeks if the course was short. Therefore, it is best not to reduce it to zero, leave the minimum dose. I now have one tablet a day, that’s enough for now.

Analogs

Analogues of the drug amitriptyline nycomed are products containing Amitriptilin in their composition. For example, Amizol, Amirol, Elivel, Vero-Amitriptyline. All of the products listed are manufactured by different manufacturers. Medicines containing tricyclic antidepressants are sold in pharmacies strictly according to prescription.

Side effects

Ooooh, this is just a huge field for writing Talmuds. Any antidepressant will have side effects, but some people call amitriptyline just a beastly drug in this regard. Well, it's actually not that scary. So what can you have?

Dry mouth . This is the first thing even a doctor will tell you. Some say that it is difficult to even speak; the tongue cannot move in the mouth. I didn’t experience this even at high dosages. I don't know what's wrong with me.

Tachycardia . The resting pulse can be up to 120 beats per minute. During my first course, I was afraid of this side effect, but gradually everything calmed down for me. The maximum can be 90-100 strokes. By the way, in general, amitriptyline is considered cardiotoxic, that is, it can cause heart failure. But this only applies to high doses and long periods of use. But, in any case, it is better to do an ECG every six months.

Pupil dilation . Everyone close to you may mistake you for a drug addict (wear dark glasses, ha ha!). But gradually it will pass. Personally, I didn’t have this.

Constipation. This can be a real problem if you don't immediately grab this side by the tail. If you have a penchant for this matter, then it is best to start consuming more fiber. And if this does not help, then there is an excellent drug called Duphalac, which you can take for a long time.

Weakness, lethargy . It will probably be at the beginning of the reception. We take the main dose at night and wait for the body to adapt. Gradually everything will pass.

Decreased cognitive abilities . The pot stops cooking. This also happens at the beginning of treatment. Personally, he always cooks for me, but not everyone is like me. You have to endure this. Naturally, you don’t need to start taking amitriptyline before important exams or projects, otherwise you’ll fail everything.

Weight gain . This is the main side effect of amitriptyline for me! I usually gain from 10 to 25 kg per cycle, and that's a lot! My doctor tried to put me on a diet that prohibited almost everything. It didn’t work, there were breakdowns, and because of them I gained even more than I could have. So now I just “surrender to the will of the waves” and eat. But at the same time, I try to walk and play sports to minimize the harm.

Overdose

If the dose of Amitriptyline prescribed by the doctor is not followed, there is a high risk of overdose, which is manifested by the following symptoms:

increased body temperature;
drowsiness;
disorientation;
confusion of thinking;
dilated pupils;
shortness of breath;
muscle stiffness;
overly excited state;
hallucinations;
convulsive seizures;
severe vomiting;
respiratory depression;
comatose state;
arrhythmia;
heart failure;
hypotension.

In case of overdose, immediately rinse the stomach and, if necessary, induce vomiting to more quickly cleanse the body. At the discretion of the doctor, symptomatic therapy is prescribed.

Amitriptyline and anesthesia

The instructions for the drug say that if you take it, you need to inform the doctor who is going to give you anesthesia - both local and general (for example, this could be a dentist). But in practice, you will get a perplexed face and complete ignorance of what amitriptyline is and how dangerous it can be during anesthesia. I was very interested in this issue and this is what I found out. If you are taking medium or high doses of amitriptyline, it is best to avoid anesthesia altogether at this point. If you can’t do without this, then this should be the minimum possible dose of anesthetic for a short time. It's best to do everything in a clinic, where they have everything you need in case you pass out. In general, it is better if the clinic is not very far from the hospital. Scary? So do I. So it is best not to mix amitriptyline with anesthesia. Well, at low doses you can, of course, but also with caution.

What is Amitriptyline?

The medicine should be taken orally after meals with plenty of water.

Amitriptyline is one of the most prominent representatives of the first generation of antidepressants. It has a direct effect on the nerve cells of the brain, allowing you to suppress anxiety and reduce the severity of depressive conditions.

Important! Unlike a number of analogues, Amitriptyline does not cause hallucinations, and therefore it is often prescribed for migraines and chronic headaches.

The medicine is available in tablet form and as a solution for injection. The tablets are small in size, round in shape and covered with a white coating. The solution appears as a clear liquid that is either colorless or faintly colored.

This drug has a pronounced sedative effect, which is why it is often used to treat depressive conditions. It helps reduce severe emotional arousal and anxiety. In addition, the drug has the following properties:

antihistamine;
thymoleptic;
antiserotonin;
analgesic;
anxiolytic;
antiulcer;
M-anticholinergic.

Amitriptyline is also used to lower body temperature and blood pressure during general anesthesia.

The effect of taking the drug occurs no earlier than two weeks after the start of its use.

Amitriptyline is strictly contraindicated during pregnancy

The advisability of taking this drug arises in the following cases:

The patient was diagnosed with severe depression. Symptoms of sleep disturbance, emotional overexcitation and anxiety are observed. We can talk about depression caused by mental trauma, alcoholism or organic brain damage.
Disorders of mental activity that occur against the background of the development of schizophrenia. Amitriptyline is often used in the treatment of depressive conditions in schizophrenic patients.
Mixed emotional disturbances. If the complication of the patient’s mental state was caused by several factors, then this remedy also helps to stabilize the patient’s well-being.
Attention disorders, the patient’s inability to carry out any active activity.
Bulimia, which is of a nervous nature.
Nocturnal enuresis.
Chronic pain observed in cancer patients, rheumatic diseases and migraines. Amitriptyline is also prescribed to patients with postherpetic neuralgia, atypical pain in the heart area and neuropathies of various origins.
Peptic ulcer of the duodenum and stomach.

This drug has a fairly wide list of contraindications, and therefore its use should be carried out exclusively under the supervision of a doctor.

It is prohibited to take Amitriptyline if you have the following diseases and conditions:

Myocardial infarction, which is in an acute form or subacute period of development.
Serious problems in the functioning of the heart muscle. We are talking about intraventricular conduction disorders, atrioventricular blockades, etc. The drug should be used with caution in patients with coronary heart disease and arrhythmias.
Acute alcohol intoxication.
Thyroid diseases.
Angle-closure glaucoma.
Pregnancy. Prescribing this drug during the 1st and 3rd trimesters is strictly prohibited. In case of emergency, Amitriptyline is taken under medical supervision.
Breast-feeding. If Amitriptyline therapy is absolutely necessary, breastfeeding should be discontinued.
The presence of acute intoxication with hypnotics, analgesics and psychoactive drugs.

Amitriptyline is not prescribed to children under 6 years of age.

Side effects

When taking the drug, tachycardia and heart rhythm disturbances may occur.

When taking this drug, it is necessary to take into account a number of possible side effects, which manifest themselves as follows:

Confusion, weakness and dizziness, fainting.
Heart rhythm disturbances, tachycardia.
Urinary retention, constipation, development of paralytic intestinal obstruction.
Minor weight gain.

Due to the large number of side effects, many doctors use inappropriately low dosages of Amitriptyline in treatment, which results in a significant reduction in the effectiveness of treatment.

In case of overdose, this drug can lead to the development of severe poisoning. Therefore, it is often acquired by people with suicidal tendencies. The doctor’s task in this case is to timely recognize such a patient and prevent death.

This drug can treat the following disorders:

depression;
nocturnal bulimia;
worry and anxiety;
mental disorders, etc.

To assess the effectiveness of this drug in the fight against depression, one should consider the mechanism of its effect on the body. With the development of depression, a sharp decrease in norepinephrine and serotonin is observed in the patient’s body. This happens because they begin to flow to the brain cells.

The high effectiveness of Amitriptyline in the treatment of depression lies in improving the patient’s mood due to the release of norepinephrine and serotonin from the brain structures. As a result, symptoms of depression are alleviated. If the absorption of neurotransmitters in cells occurs repeatedly, then this no longer affects a person’s mood.

Reviews from doctors

Doctors usually highly praise this drug as one of the most studied. There are a lot of studies on it, where the dosage and effect are discussed in detail. In addition, there is one more nuance. Many people who suffer from depression and/or panic attacks are unable to work. That's why they don't have much money. Now think about what is better - a drug for 5 thousand for a month (antidepressants are expensive nowadays) or for 200 rubles?

If the doctor has worked with neuroses and borderline conditions, then he will know the drug inside and out. That is, everything that I wrote above, he will keep in mind when prescribing amitriptyline to you. If it didn’t work, then don’t hesitate to help him, talk about increasing the dose if he tries to give you a low one, and don’t take the whole pill at once if you are prescribed to start with 75 mg per day.

Instructions for use of the drug

The instructions for use of Amitriptyline explain in detail what disease the medication should be used for, and patient reviews indicate a high degree of effectiveness of the drug.

Indications for use

According to the instructions, the drug is prescribed for the treatment of depressive states of involutional, reactive, endogenous, medicinal nature. It is recommended to use the medication in cases of depressive conditions due to alcohol abuse, damage to brain tissue, which is accompanied by sleep disturbances and the appearance of anxiety.

Indications for prescribing the drug are:

Schizophrenic psychoses.
Emotional mixed disorders.
Behavioral disorders.
Nocturnal enuresis.
Bulimia nervosa.
Chronic pain - migraine, atypical facial pain, pain in cancer patients, post-traumatic and diabetic neuropathy, rheumatic pain, postherpetic neuralgia.

The medication can be prescribed for the treatment of diseases of the gastrointestinal tract, if there is a need to relieve headaches and for the prevention of migraines.

Method of use

The antidepressant Amitriptyline must be swallowed without chewing. The initial dose of the drug used in treatment is 25-50 mg, the medication should be taken at night. Over the course of 5-6 days, the dosage is increased to a level of 150-200 mg per day, this dosage should be divided into three doses per day.

The instructions for use recommend increasing the dosage of the drug to 300 mg per day within 2 weeks, if no improvement in the patient’s condition is observed within 2 weeks. When the symptoms of depression disappear, the dose of the medication is reduced to 50-100 mg per day.

If the patient's condition does not improve within 3-4 weeks of treatment, further therapy is considered inappropriate.

When treating elderly patients with minor impairments, the drug is prescribed in a dosage of 30-100 milligrams per day. The drug is taken at night. If signs of improvement appear, the dose of the medication is reduced to a dosage of 25-50 mg per day.

For intravenous or intramuscular administration, a dose of 20-40 mg is used 4 times a day. The course of therapy lasts from 6 to 8 months.

The medication for the occurrence of neurological pain and for the prevention of migraine is taken at a dose of 12.5-100 mg per day.

In the presence of childhood enuresis, patients from 6 to 10 years old are prescribed 10-20 mg of the drug per day, the medicine should be taken at night, and patients from 11 to 16 years old are required to take the medication at the rate of 1-5 mg per kg per day.

Contraindications of the drug

When prescribing a drug for therapy, one should take into account the patient's possible contraindications to the use of Amitriptyline.

The main contraindications are:

myocardial conduction disorders;
severe hypertension;
acute kidney and liver diseases;
bladder atony;
prostatic hypertrophy;
paralytic ileus;
pregnancy and lactation;
age up to 6 years.

It is also prohibited to prescribe the drug if the patient is found to have hypersensitivity to the main or auxiliary components of the drug.

Side effects

While taking the medication, the patient may experience a whole range of side effects and unwanted reactions. The use of the drug may cause blurred vision, impaired urination, dry mouth, increased intraocular pressure, increased body temperature, intestinal obstruction and constipation.

Most often, side effects disappear on their own when the dosage of the drug is reduced or after the body gets used to the drug.

Additionally, the following may be observed:

Weakness, drowsiness and fatigue.
Ataxia.
Insomnia.
Dizziness.
Nightmares.
Confusion and irritability.
Tremor.
Motor agitation, hallucinations, impaired attention.
Paresthesia.
Cramps.
Arrhythmia and tachycardia.
Nausea, heartburn, stomatitis, vomiting, change in tongue color, epigastric discomfort.
Anorexia.
Increased activity of liver enzymes, diarrhea, jaundice.
Galactorrhea.
Changes in potency, libido, testicular swelling.
Hives, itching, purpura.
Hair loss.
Enlarged lymph nodes.

In the event of an overdose, the body may react differently, depending on the physiology.

If a dosage of more than 500 mg enters the body of an adult, the patient experiences the development of moderate or severe intoxication. If 1200 mg enters the body, death may occur.

Patient reviews

I read quite a lot of them, both in preparation for this material and before. Everyone writes that the drug is effective. Seriously, I have not seen a single review saying that amitriptyline did not help him. However, everyone agrees that its side effects are simply terrible. Also, many still return to amitriptyline, even after trying other drugs. Personally, I consider it the best for myself.

Also, many write that at a dosage of up to 150 mg per day, it knocks you out, and if it’s higher, then, on the contrary, you start to catch vigor. Here I can say that personally it knocks me out only at the very beginning, and then at any dosage - no. I am quite cheerful and can work.

Indications

Amitriptyline Nycomed is used in the same cases as amitriptyline from other companies, with the exception of those when an injection form of the drug is required. Indications for its use are:

Clinical depression and symptomatic decreased mood due to organic pathology;
Anxiety and anxiety-phobic disorders;
Schizoaffective disorder with a depressive component;
Symptomatic insomnia;
Bedwetting in children;
Pain caused by any pathological condition;
Psychogenic anorexia or bulimia.

Reviews of the drug "Melipramin" and its comparison with other analogues

Patients have a good opinion about the effectiveness of this drug. It is especially good, according to patients, that this medicine helps against panic attacks. The side effects of this drug, like almost all other antidepressants, are quite serious. But basically, the drug “Melipramin” has a negative effect on the patient’s body, judging by the reviews, only in the first days after the start of treatment. Then the side effects become less noticeable and may even disappear.

As for the harmful effects on the body, most often, as patients note, this drug causes drowsiness, decreased libido and pain in the heart. Other unpleasant side effects may occur during treatment with this drug.

The drug Melipramin differs from the analogues discussed above and many other antidepressants in that, among other things, it also has a strong activating effect on patients. Therefore, doctors usually recommend taking this remedy only in the first half of the day. In comparison with the Amitriptyline analogues discussed above, this drug is also more “heavy”.

Release form

Nortriptyline is produced by different companies in the form of dragees, capsules and tablets. The medicine is packaged in bottles of 100 tablets and capsules or in blisters of 10 tablets. The dosage of the drug is 10 mg or 25 mg of Nortriptyline in one tablet, capsule or dragee. Excipients depend on the release form.

Composition and active substance

Amitriptyline contains:

Amitriptyline tablets

1 tablet contains

Active substance: amitriptyline hydrochloride 10, 25 or 50 mg.

Excipients: core - lactose monohydrate, gelatin, colloidal silicon dioxide, calcium stearate, corn starch, talc. Shell - macrogol, dimethicone SE-2, Sepifilm 3048 Yellow (microcrystalline cellulose, hypromellose polyoxyl 40 stearate, titanium dioxide, quinoline yellow).

Amitriptyline solution for intramuscular administration

1 ml of solution contains:

Active substance: amitriptyline hydrochloride 10 mg.

Excipients: glucose, benzethonium chloride, sodium chloride, water for injection.

How to restore sleep after binge drinking

To find out how to fall asleep after binge drinking, you need to contact a qualified specialist. It will not be possible to quickly establish sleep, because... First you need to remove harmful toxins from the body, and this takes about 4 days.

We invite you to read: Alcoholism as a manifestation of deviant behavior

Taking sedatives should only be done under the supervision of a physician. Under no circumstances should you take Valocordin or Corvalol 2-3 hours after drinking alcohol-containing drinks, because their toxicity increases and can cause liver damage.

A contrast shower will help you cheer up. After 10 minutes, a person may feel significant relief. When intoxicated, the water balance is disturbed, so you need to consume more fluids. The more water enters the body, the more alcohol breakdown products leave in the urine.

Drinks that can help include water, mineral water, kefir, milk, kvass. Activated carbon also effectively relieves intoxication. The dosage is calculated in the ratio of 1 tablet: 10 kg. Activated carbon is a powerful absorbent, but it is better not to overdo it, because... Diarrhea and hypovitaminosis are observed as a side effect.

Pharmacological properties

Pharmacodynamics

Amitriptyline is a tricyclic antidepressant from the group of non-selective monoamine reuptake inhibitors. It has a strong sedative and thymoanaleptic (antidepressive) effect.

Amitriptyline increases the content of serotonin and norepinephrine in the synaptic cleft in the central nervous system by inhibiting the reuptake of these neurotransmitters by the membranes of presynaptic neurons.

Amitriptyline blocks H1-histamine receptors, α1-adrenergic receptors and M1- and M2-muscarinic cholinergic receptors. According to the monoamine hypothesis, there is a correlation between the function of serotonin and norepinephrine in brain synapses and a person’s emotional tone.

A clear relationship between the plasma concentration of amitriptyline and the clinical effect of the drug has not been established, but at concentrations of the active substance in the range of 100–260 μg/l, the optimal clinical effect of amitriptyline is apparently achieved.

A significant decrease in depression occurs later than the equilibrium plasma concentration of the drug. This occurs after approximately 2–6 weeks of therapy.

Amitriptyline also has a quinidine-like effect on the innervation of the heart by the autonomic nervous system.

Pharmacokinetics

The drug is quickly and completely absorbed from the digestive tract after oral administration. Peak plasma concentrations occur 2–6 hours after oral administration of amitriptyline.

Plasma concentrations vary significantly between patients. Bioavailability is about 50%. Approximately 95% of amitriptyline is bound to plasma proteins. It takes 4 hours to reach the maximum concentration, and equilibrium concentration is observed approximately one week after the start of therapy. The volume of distribution averages 1085 l/kg. Amitriptyline and its active metabolite cross the placental barrier and are excreted in breast milk.

Metabolism of the drug occurs in the liver. About 50% of amitriptyline undergoes first-pass effects through the liver. Under the influence of cytochrome P450, N-demethylation of the substance occurs with the formation of nortriptyline (an active metabolite). Subsequently, amitriptyline and nortriptyline are hydroxylated to form active hydroxy and 10-hydroxy metabolites (amitriptyline metabolites) and 10-hydroxynortriptyline (nortriptyline metabolite). As a result of conjugation with glucuronic acid, inactive metabolites are formed. The main factor determining renal clearance and plasma concentration of the drug is the rate of hydroxylation. In some people, due to genetic characteristics, the hydroxylation process is slowed down. The half-life of amitriptyline and nortriptyline from blood plasma increases in patients with impaired liver function.

The half-life ranges from 9 to 46 hours for amitriptyline and from 18 to 95 hours for nortriptyline. The main part of the drug is excreted through the intestines and kidneys in the form of metabolites. Only a small amount of amitriptyline is excreted unchanged. In patients with impaired renal function, the elimination of metabolites slows down, but the rate of metabolism itself remains unchanged. Since the binding of amitriptyline to plasma proteins is very high, dialysis is ineffective.

Special Terms of Use

If the use of a solution is prescribed, administration is performed only in a hospital setting and under constant medical supervision. In the first days of treatment in any form, the patient must strictly adhere to bed rest.
Blood pressure levels are monitored before use.
Ethanol must be completely abandoned during the entire period of use; this combination is dangerous for the patient’s life.
It is necessary to stop using the medication in treatment gradually, systematically reducing the daily dosage
. With abrupt cessation of use, a large percentage of patients experience a pronounced “withdrawal syndrome” that can lead to a new and severe depressive attack.
When taking it, it is necessary to monitor the potential for the development of manic states, which can often be observed with cyclical and affective depressive disorders.

Important!

With long-term use of amitriptyline, the development of caries and damage to the mucous membranes of the gastrointestinal tract is noted.

Why does insomnia occur after binge drinking?

Excessive ingestion of ethyl alcohol into the body begins to lead to disruption of the nervous system, liver, and disruption of circadian rhythms. For complete restoration of the body, it is necessary that during the night the process of sleep moves from the slow phase to the fast phase 3-4 times.

The appearance of energy and restoration of organ functions occurs during the slow phase of sleep. During this period, melatonin production and cerebrospinal fluid synthesis occur. With alcoholism, these phases are significantly reduced. Sleep becomes intermittent, which is why the body does not have time to perform all functions aimed at recovery. A person wakes up even from a slight noise or rustle. Due to alcohol poisoning and intoxication, the following begins:

headache;
hypertension;
hallucinations of vision and hearing;
feeling tired.

If there are chronic pathologies in the body, then they can worsen from alcoholic insomnia.

How to quickly fall asleep with a hangover

How to sleep with a hangover? This is not an idle question, but one of the ways to treat the cruel consequences of excessive alcohol consumption.

Insomnia from a hangover is quite understandable from a physiological point of view, but you still need to fall asleep, and for this you should take appropriate measures.

Very often you can hear an exclamation from a suffering person: “I can’t sleep.” Therefore, experts give useful recommendations on how to cope with the problem.

The essence of the problem

Why do many people experience insomnia during a severe hangover? It is generally accepted that this phenomenon is caused by hypersympathicotonia, which consists of an excessively increased tone of the nervous system in general and the zone that ensures normal sleep in particular.

This excited state is especially clearly manifested in alcoholics and people in the process of long-term drinking. In such cases, the drinker practically does not recover from the state of increased nervous tone, which causes chronic insomnia.

And how can you fall asleep when the period of one excitation is overlapped by a new effect on the nerve centers in the cerebral cortex.

A unique remedy has been found that causes AVOIDANCE to alcohol! You can overcome alcoholism in just a week!

In what cases is it prescribed

Indications for the use of Amitripilin are, for example, diseases such as:

depression;
fears and phobias;
anorexia and bulimia;
migraine.

Sometimes this remedy is also prescribed for children with enuresis.

This rather strong medicine should be prescribed exclusively by the attending physician. It actually has a lot of side effects. Patients taking the drug "Amitriptyline" often experience:

impaired focusing of vision;
constipation and intestinal obstruction;
lethargy and drowsiness;
dizziness and low blood pressure;
tachycardia;
weakness;
decreased libido.

Also, people undergoing a course using this remedy may experience fainting.

This drug also has quite a lot of contraindications. For example, it is not prescribed to patients if they have problems such as:

intestinal obstruction;
blood diseases;
glaucoma;
bladder diseases.

This medicine is prescribed with caution for schizophrenia, bronchial asthma, epilepsy and some other diseases.

How does it affect blood pressure?

Before you start using the drug, you need to check your blood pressure. For those who suffer from hypotension or slight drops in blood pressure, Amitriptyline reduces blood pressure even more. Thus, you need to be careful as interactions with other drugs may cause blood pressure problems.

Does amitriptyline increase blood pressure?

In some cases, the drug can increase blood pressure, increase heart rate, and even cause a hypertensive crisis.

When using Amitriptyline simultaneously with other medications, blood pressure may either increase or decrease.

Drug interactions

As a rule, when using Amitriptyline simultaneously with other drugs that have a depressant effect on the central nervous system, as well as with alcohol, an excessive increase in depression of the central nervous system is possible. The effect of alcohol increases. In addition, hypotensive effects and respiratory depression may be observed. If you take the medicine together with other drugs that have anticholinergic activity, the anticholinergic effect may be enhanced. Taking the drug "Amitriptyline" with symptomatic medications enhances their effect on the heart and cardiovascular system as a whole. Because of this, the risk of developing various rhythm disturbances, arterial hypertension (severe forms), and tachycardia increases. Taking with guanethidine and clonidine reduces the hypotensive effect of these drugs. Use together with barbiturates: with quinidine - slowing down the metabolism of the drug "Amitriptyline", with carbozepine - a significant decrease in the effect of the drug due to a strong acceleration of its metabolism. Simultaneous use with cimetidine also slows down the metabolism of Amitriptyline, and also increases its concentration in plasma and increases the risk of toxic effects.

Recommendations for eliminating withdrawal symptoms

If withdrawal occurs, symptomatic therapy is required, which is based on the use of mild herbal sedatives. In severe cases, the prescription of tranquilizers is justified. Trying to cope with the symptoms of the syndrome on your own is not recommended, as this provokes a worsening of the condition. The main way to treat such consequences of using antidepressants is psychotherapy. It is a fundamental method of combating cognitive impairment and helps to stop using potent drugs.