Tryptomer

Tryptomer (Amitriptyline Hydrochloride) is one of the main representatives of tricyclic antidepressants. Tryptomer (Amitriptyline Hydrochloride) is a drug mainly used to treat a number of mental illnesses: depressive and anxiety disorders, less often attention deficit disorder and hyperactivity disorder and bipolar disorder. Other indications include the prevention of migraine, the treatment of neuropathic pain such as fibromyalgia and postherpetic neuralgia, and less often insomnia. The drug belongs to the class of tricyclic antidepressants (TCA), and its exact mechanism of action is unclear.

Tryptomer (Amitriptyline Hydrochloride) prescribed per os (during or after meals).

The initial daily dose for oral administration is 50-75 mg (25 mg in 2-3 doses), then the dose is gradually increased by 25-50 mg to obtain the desired anti-depressant effect. The optimal daily therapeutic dose is 150-200 mg (the maximum part of the dose is taken at night). In severe depressions resistant to therapy, the dose is increased to 300 mg or more, up to the maximum tolerated dose (the maximum dose for outpatients - 150 mg per day).

After a stable antidepressant effect is obtained, after 2-4 weeks, the doses are gradually and slowly reduced. In the case of signs of depression with a decrease in dose, you must return to the previous dose.

In elderly patients with mild disorders, in outpatient practice, the doses are 25-50-100 mg maximum, in divided doses or 1 time per day for the night.

In case of enuresis in children over 6 years old - 12.5–25 mg at bedtime (the dose should not exceed 2.5 mg / kg of the child’s body weight).

For the prevention of migraine, with chronic pain of a neurogenic nature (including prolonged headaches) from 12.5-25 mg to 100 mg per day.

The main side effects are associated with a pronounced anticholinergic effect. Often (especially at the beginning of therapy and with increasing doses) there are dry mouth, dilated pupils, disturbed accommodation of the eyes (lack of clarity and blurred vision near, inability to focus the eyes at close range - for example, when reading and embroidering), constipation, sometimes severe, up to development of paresis or complete atony (paralysis) of the intestine, and acute dynamic obstruction of the intestine.

At higher doses, there may be difficulty and delay of urination up to complete atony of the bladder. Hand tremor also appears at higher doses and is associated with stimulation of the peripheral beta-adrenergic system (removed by beta-blockers). Also often observed (especially at the beginning of therapy) a feeling of intoxication (the so-called "anticholinergic intoxication", similar to intoxication from cyclodol or atropine), drowsiness, lethargy, apathy due to excessive sedation, dizziness.

In some cases (mainly in older people) delirium may develop.

Amitriptyline in doses above 150 mg per day reduces the threshold of seizure activity, so you should consider the possibility of convulsive seizures in patients with those in history and in patients who are prone to this because of age or injury.

Treatment with amitriptyline in old age should be carried out under close supervision, with the use of minimum doses of the drug and their gradual increase, in order to avoid the development of delirious disorders, hypomania and other complications.

Patients with a depressive phase of a manic-depressive psychosis may enter a manic stage.

While taking amitriptyline alcohol is prohibited.