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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Preventing migraines without weight gain
From Shape, 8/1/04

The drug Topamax (topiramate), which is approved for epilepsy, also can prevent migraines and reduce the need for "emergency" pain medication, according to a study published in the Journal of the American Medical Association. And unlike some other migraine-prevention drugs, including Depakote (valproic acid) and tricyclic anti-depressants such as Elavil (amitriptyline) and Pamelor (nortriptyline), it doesn't cause weight gain. "Topiramate can reduce the number and severity of migraine headaches," says lead author Jan Lewis Brandes, M.D., a neurologist in Nashville, Tenn. "However, it will not replace the medications taken to stop or abort [a headache]."

Lewis tracked 468 patients, mostly women, who'd had chronic migraines for at least six months. People who took 100 milligrams a day of Topamax reported their migraines dropped from an average of nearly six per month to 3.5; those who took 200 milligrams a day suffered three migraines a month compared with five. Side effects include fatigue and nausea, but also weight loss: Subjects who took Topamax lost 3-4 percent of their body weight, while people on other migraine-prevention drugs sometimes gain as many as 40 pounds.--K.D.

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group

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