Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Endep (Elavil: This brand name drug is no longer available in the U.S.)
DRUG CLASS AND MECHANISM: Amitriptyline is an antidepressant drug. Depression
is an all-pervasive sense of sadness and gloom. It is believed that in some
patients with depression, abnormal levels of neurotransmitters (chemicals that
nerves use to communicate with each other) may relate to their depression.
Amitriptyline elevates mood by raising the level of neurotransmitters in nerves
of the brain. Amitriptyline was approved by the FDA in May 1983.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 25, 50, 75, 100, and 150mg.
STORAGE: Amitriptyline should be stored at room temperature in a tight, light
resistant container. Avoid storage at temperatures above 30°C (86°F).
PRESCRIBED FOR: Amitriptyline is used to elevate the mood of patients with
depression.
DOSING: Amitriptyline may be taken with or without food. The recommended
adult dose is 40-150 mg daily in divided doses. The lowest effective dose should
be used.
DRUG INTERACTIONS: Amitriptyline should not be used with monoamine oxidase
inhibiting drugs. High fever, convulsions and even death can occur when these
two drugs are used together. Epinephrine should not be used with amitriptyline,
since together they can cause severe high blood pressure. Alcohol blocks the
antidepressant action of amitriptyline but increases its sedative effect.
Cimetidine (Tagamet) can increase blood levels of amitriptyline and its side
effects.
PREGNANCY: Safety in pregnancy and children is not established.
NURSING MOTHERS: Amitriptyline is secreted in
human milk and potentially can
adversely affect the nursing infant.
SIDE EFFECTS: Sometimes troublesome side effects include fast heart rate,
blurred vision, urinary retention, dry mouth, constipation, weight gain or loss,
and low blood pressure on standing. Rash, hives,
seizures, and hepatitis are
rare side effects.
Amitriptyline is used with caution in patients with seizures since it can
increase the risk of seizures. Amitriptyline is used with caution in patients
with prostate enlargement because of the risk of increasing retention of urine
due to the inability to urinate. Amitriptyline can cause elevated pressure in
the eyes of certain patients with glaucoma.
Antidepressants increased the risk of suicidal thinking and behavior in
short-term studies in children and adolescents with depression and other
psychiatric disorders. Anyone considering the use of amitriptyline or any other
antidepressant in a child or adolescent must balance this risk with the clinical
need. Patients who are started on therapy should be closely observed for
clinical worsening, suicidal thinking or behavior, and unusual changes in
behavior.
If amitriptyline is discontinued abruptly, dizziness, headache, nausea, and
restlessness may occur. Withdrawal symptoms may occur when even a few doses are
missed. Therefore, it is recommended that the dose of antidepressant be reduced
gradually when therapy is discontinued.
Shingles (herpes zoster) is a skin rash caused by the same virus that causes chickenpox. Under certain circumstances, such as emotional stress, immune deficiency, or with cancer, the virus re-activates causing shingles. Shingles are catching and can spread from an infected person to others who have not had chickenpox. There are a variety of treatments for shingles.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Hives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an
allergic reaction. The allergy may be to food or medications, but usually the
cause of the allergy (the allergen) is unknown.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
IBS (irritable bowel syndrome) is a common gastrointestinal disorder involving abnormal gut contractions (motility) characterized by abdominal pain,
bloating, mucous in stools, and irregular bowel habits with alternating diarrhea
and constipation, symptoms that tend to be chronic and to wax and wane over the
years. Treatment options include medication and lifestyle changes such as diet, exercise, and stress management to control symptoms. Also called spastic colitis, mucus colitis, nervous colon syndrome.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Shingles is caused by the same virus that causes
chickenpox
and can be spread to people who have not had chickenpox.
Shingles, also known as Herpes zoster, is not related to
the sexually transmitted herpes virus disease called herpes genitalis.
Shingles may cause pain that can continue after the rash
disappears.
Steroids and antiviral drugs can help prevent long-term
pain after shingles if they are started within the first two days of the
appearance of the rash.
A vaccine is available for people over 60 years of age to reduce the incidence and severity of shingles.
What is shingles? What causes shingles?
Shingles is a skin rash caused by the same virus that causes chickenpox. This
virus is called the Varicella zoster virus (VZV)
and belongs to the herpes family of viruses.
After an indivi...
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