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Indications - Amitriptyline Hydrochloride is indicated in- Depressive Illness: particularly where sedation is required. Nocturnal Enuresis in children. Prophylaxis of Migraine. Tension Headache. Chronic Pain.

Dosage & Administration - Depression: Initially 75 mg (Elderly and Adolescents 30-75 mg) daily in divided doses or as a single dose at bedtime increased gradually as necessary to 150-200 mg; Child under 16 years not recommended for depression. Nocturnal Enuresis: Child 7-10 years: 10-20 mg, 11-16 years: 25-50 mg at night; max. period of treatment (including gradual withdrawal) 3 months-full physical examination before the further course. Prophylaxis of Migraine: 100 mg daily. Tension Headache: 10-25 mg three times daily.

Side Effects - Anticholinergic: Excessive perspiration, dry mouth, blurred vision, hyperpyrexia, urinary retention and urinary tract dilatation. Cardiovascular reactions: Hypotension, syncope, postural hypotension, hypertension, tachycardia, palpitations, myocardial infarction, etc. CNS and Neuromuscular: Confusional states, disturbed concentration, disorientation, delusions, etc. Allergic: Skin rash, urticaria, photosensitization, etc. Haematological: Bone-marrow depression. Gastrointestinal: Nausea, epigastric distress, vomiting, anorexia, stomatitis, unpleasant taste, weight loss, diarrhoea, constipation, etc. Endocrine: Testicular swelling, gynaecomastia, breast enlargement, galactorrhoea, etc.

Contraindications - Amitriptyline is contraindicated in myocardial infarction, arrythmias, particularly heart block of any degree, mania and severe liver disease. Initially, sedation may affect the ability to drive or operate machinery.

Others - Pregnancy & Lactation Pregnancy Category C. Amitriptyline has been shown to cross the placenta. Amitriptyline should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus. Amitriptyline is excreted into breast milk. Because of the potential for serious adverse reactions in nursing infants from Amitriptyline, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.