Elavil (amitriptyline-HCl) is one of a group of drugs known as tricyclic antidepressants because of their chemical structure (NIMH, 2002). The chemical formula for Elavil is
3-(10, 11)-dihydro-5H-dibenzo[a,d]cycloheptene-5-ylidine)-N,N-dimethyl-1-propanamine hydrochloride, with the empirical formula of C20H23N.HCl (PhysicianÆs Desk Reference, 1999). It is a white, odorless crystalline compound, which is soluble in water. Elavil is available in tablet form, and also as a sterile solution for intramuscular injection.
The exact action of Elavil in man is not known, but it inhibits the action of the cell membrane pump responsible for the uptake of norepinephrine and serotonin in adrenergic and serotonergic neurons (PhysicianÆs Desk Reference, 1999). This may cause prolongation or potentiation of neuronal activity because these neurotransmitters are important in the termination of neuronal transmitting activity. This mechanism is believed to give Elavil its antidepressant activity. Elavil also alleviates the anxiety associated with depression because of its sedative action (Long, 2003).
From the early 1960s through the 1980s, tricyclic antidepressants constituted the first line of approach in treating depression (NIMH, 2002). Elavil is one of a family of tricyclic antidepressants which affect the neurotransmitters norepinephrine and serotonin. While these drugs remain just as effective as newer ones used in the treatment of depression, they have gone out of favor because of their unpleasant side effects, and are now used only as second-line or third-line treatment for depression. Elavil is used in depressive states caused by psychotic or endogenous illness, and in some cases of neurotic depression (Long, 2003). It is not used in patients with mild depressive states or depressive reactions.
The most common side effects of Elavil include sedation, mild constipation, headache, fatigue, nausea, and dry mouth (...