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Amitriptyline, sold under the brand name Elavil, among others is the most widely used tricyclic antidepressant (TCA). It is used to treat a number of mental disorders, including major depressive disorder and anxiety, and less commonly psychosis, attention deficit hyperactivity disorder, and bipolar disorder. Other uses include prevention of migraines, postherpetic neuralgia, neuropathic pain such as fibromyalgia, and less commonly insomnia.〔(【引用サイトリンク】url=http://www.drugs.com/monograph/amitriptyline-hydrochloride.html )〕 Side effects may include seizures, an increased risk of suicide in those less than 25 years of age, urinary retention, and a number of heart issues. They should not be taken with MAO inhibitors or cisapride.〔 In the United States and Australia, they are pregnancy category C which means that may cause problems during pregnancy. Use during breastfeeding does not appear to be a problem. Amitriptyline is chemically basic and is in the form of hydrochloride salt (pKa 9.4) in the market.〔A.S. Yazdi, N. Razavi, S.R. Yazdinejad. Separation and determination of amitriptyline and nortriptyline by dispersive liquid–liquid microextraction combined with gas chromatography flame ionization detection. Talanta, 75 (2008), pp. 1293–1299〕 It was originally developed by Merck, first synthesized in 1960 and first approved by the US Food and Drug Administration (FDA) on 7 April 1961. It is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system. ==Medical uses== Amitriptyline is used for a number of medical conditions including major depressive disorder (MDD) which is its only FDA-labeled indication.〔 This is also a TGA- and MHRA-labelled indication.〔〔 Some evidence suggests amitriptyline may have superior efficacy compared to other antidepressants, including the selective serotonin reuptake inhibitors (SSRIs), although it is rarely used as a first-line antidepressant nowadays due to its high degree of toxicity in overdose and generally poorer tolerability than the newer antidepressants such as the SSRIs and serotonin-norepinephrine reuptake inhibitors.〔 It is TGA-labeled for migraine prophylaxis, also in cases of neuropathic pain disorders,〔 fibromyalgia and nocturnal enuresis. Amitriptyline is a popular off-label treatment for irritable bowel syndrome (IBS). Although it is most frequently reserved for severe cases of abdominal pain in patients with IBS because it needs to be taken regularly to work and has a generally poor tolerability profile, although a firm evidence base supports its efficacy in this indication.〔 Amitriptyline can also be used as an anticholinergic drug in the treatment of early-stage Parkinson's disease if depression also needs to be treated.〔(Parkinson's disease ). Merck Sharp & Dohme Corp. August 2007. Retrieved on 2013-12-22.〕 Amitriptyline is the most widely researched agent for prevention of frequent tension headaches. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「amitriptyline」の詳細全文を読む スポンサード リンク
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