Amitriptyline oxide, a drug belonging to the tricyclic antidepressant group, is used to treat depression, anxiety, and chronic sleep disorders. It is commercially available as the active ingredient amitriptyline oxide 2-water under the names Equilibrin and Amioxid-neuraxpharm.
What is amitriptyline oxide?
Amitriptyline oxide, a drug belonging to the tricyclic antidepressant group, is used to treat depression, anxiety, and chronic sleep disorders. Amitriptyline oxide is a mood-lifting drug of the tricyclic antidepressants. It calms and relieves anxiety and is prescribed especially for anxiety disorders, depression, and chronic sleep disorders. In addition, amitriptyline oxide is effective against certain chronic pain, such as neuropathic pain. The active ingredient is contained in the drugs Equilibrin and Amioxid-neuraxpharm. Both brands are sold as 30 mg, 60 mg, 90 mg and 120 mg tablets. The active strength and dose are determined by the treating physician. Because of its numerous possible side effects, amitriptyline oxide should be prescribed with particular care, and the patient should be examined regularly for adverse effects.
Pharmacologic Effects
The mode of action of amitriptyline oxide is based on inhibition of the reuptake of the neurotransmitters norepinephrine and serotonin into the presynaptic neuron. This blocks their uptake into the brain cells. This increases the concentration of the two neurotransmitters at the contact points to the cranial nerves. Norepinephrine and serotonin are subsequently again present in sufficient quantities for signal transmission. This eliminates the cause of the symptoms of depression, which are caused by the lack of norepinephrine and serotonin and the resulting insufficient signal transmission. The use of amitriptyline oxide elevates mood and reduces anxiety. Patients sleep better again. A decrease in suicidal thoughts or a risk of suicide can be expected. Nevertheless, it is urgent to note: Amitriptyline oxide requires some time to develop its desired effect after starting to take it. Patients at risk of suicide or otherwise harming themselves should therefore continue to be monitored particularly closely even after starting therapy with amitriptyline oxide. There may even be a temporary increase in depression and suicidal intentions at the start of treatment! Also, the dose may need to be adjusted. In principle, it must also be remembered that amitriptyline oxide can be potentially lethal, so that suicidal patients must always be given only the smallest possible amount of amitriptyline oxide. Amitriptyline oxide is administered on and off at the start and end of treatment.
Medicinal use and application
The prescription of amitriptyline oxide is indicated for mental impairments that focus on depressed moods or anxiety. In particular, depression associated with anxiety and agitation are typical occasions for therapy with amitriptyline oxide. The drug exerts a calming influence and alleviates nervousness, so that patients with chronic sleep disorders sleep better again. The most favorable time of day to take amitriptyline oxide is therefore towards evening. Amitriptyline oxide should not be taken or discontinued abruptly, but should be phased in and out at the start and end of therapy. At the beginning of treatment, the patient should be monitored closely. In particular, individuals with suicidal ideation and self-injury tendencies should be monitored closely. Amitriptyline oxide takes a while to achieve its desired effect and may even temporarily increase existing depression or suicidal tendencies at the start of treatment. Therefore, individuals affected by this should receive amitriptyline oxide only in the smallest possible amount, as the drug can be lethal in sufficiently high amounts. The patient should be advised to seek medical contact immediately if suicidal thoughts arise and to go to a hospital if necessary.
Risks and side effects
A variety of side effects may occur during therapy with amitriptyline oxide. Very commonly, there are:
- Inner restlessness and lack of concentration
- Ataxia
- Taste disorders
- Mydriasis
- Micturition disorders
- Hyponatremia
- Increased thirst
- Skin rash
- Impotence
- Loss of libido
- in older persons to delirious symptoms
Common side effects also include:
- Fatigue, drowsiness
- Headache
- Dizziness, accommodation disorders, tremor.
- Aggression
- Speech disorders
- Dry mouth or nasal congestion
- Sweating
- Tachycardia, cardiac arrhythmia
- Hypotension
- Orthostatic dysregulation
- Constipation
- Passive increase in liver enzyme activity
- Weight gain
Other extremely diverse side effects can occur, although less frequently, so regular visits to the doctor are recommended. Contraindicated amitriptyline oxide in individuals with prostate enlargement with bladder emptying disorder, flaccid bowel, glaucoma, myocardial insufficiency, cardiac arrhythmias, liver dysfunction, and elderly patients with brain-organic psychosyndrome. Also excluded from amitriptyline oxide therapy are pregnant and breastfeeding women. Children and adolescents younger than 16 years are eligible for therapy with reservations.
