Amitriptyline chemical structure
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Elavil

Amitriptyline hydrochloride (sold as Elavil®, Tryptanol®, Endep®) is a tricyclic antidepressant drug. It is a white, odorless, crystalline compound which is freely soluble in water and usually dispensed in tablet form. The empirical formula of its hydrochloride salt is C20H23N·HCl. more...

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Mechanism of Action

Amitriptyline affects serotonin and noradrenaline reuptake almost equally.

Uses

Approved

Amitriptyline is approved for the treatment of endogenous depression and involutional melancholia (depression of late life, which is no longer seen as a disease in its own right), and reactive depression and for depression secondary to alcoholism and schizophrenia.

Unapproved/Off-Label/Investigational

Amitriptyline may be prescribed for other conditions such chronic pain, postherpetic neuralgia (persistent pain following a shingles attack), fibromyalgia, interstitial cystitis, or irritable bowel syndrome.

A randomized controlled trial published in June of 2005 found that amitriptyline was effective in functional dyspepsia refractory to famotidine and mosapride combination therapy.

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Live healthy
From Shape, 10/1/04 by Sharon Cohen

One funny workout

Laughing hard for just 20 seconds doubles your heart rate for about a minute afterward, research at Stanford University in California shows. That's the same result you'd get from 15 minutes on a stationary bicycle or 10 minutes of strenuous rowing (though you won't burn as many calories). Laughter can be an effective "mini-workout," says psychiatrist William F. Fry, M.D., a leading researcher on laughter's health benefits. Laughing exercises not just your heart and lungs, Fry says, but the muscles in your chest, abdomen, shoulders, neck, face and scalp as well.

--Lauriana Hayward

the sedentary American

On average, leisure-time physical activity makes up just 5 percent of Americans' total daily energy expenditure. And 86 percent of people do no exercise at all, University of California, Berkeley, research on 4,185 women and 3,330 men found. The top three ways people 18 and older expended energy were driving (11 percent of daily activity), doing office work (9 percent), and watching television or movies (8.6 percent). In comparison, the top leisure-time physical activities were moderate walking (1 percent), swimming (0.8 percent) and aerobic exercise (0.6 percent).

But contrary to the conventional wisdom, the reason we don't exercise more isn't lack of time: Americans watch an average of two hours and 50 minutes of television a day, says study leader Linda Dong, M.P.H., a professor at the University of Washington in Seattle.

--Carol Potera

prescription protection

Ask your doctor to write the reason for your prescription on the slip she gives you. That's because a drug is sometimes prescribed "off label," meaning a doctor is prescribing it for a condition other than the one for which the U.S. Food and Drug Administration has approved the medication. Off-label use is legal but can confuse you and your pharmacist if your doctor doesn't specify why she's ordering a drug, according to the Institute for Safe Medication Practices. Case in point: When one woman's doctor prescribed Elavil (amitriptyline) for neck pain without explaining that the anti-depressant is used off-label for nerve pain, the patient wrongly concluded that her doctor thought her pain was "all in her head." Specifying the reason also may help avoid pharmacy mix-ups with similarly named medications--just in case your doctor has bad handwriting.

--Kathleen Doheny

impressive back-pain relief

Acupressure might help your lower-back pain more than physical therapy, a new study suggests. After six sessions of either type of treatment for four weeks, people who'd gotten acupressure had half as much lower-back pain as those who'd received physical therapy. Six months after treatment ended, the acupressure group had one-third as much pain as the physical-therapy group and half as much as they reported at the four-week mark. To find a qualified acupressure practitioner, go to aomalliance.com or amtamassage.org. The research was reported in Preventive Medicine.

--K.D.

Edited by Sharon Cohen and Kim Acosta

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group

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