Buy Amitriptyline (Elavil) Cas 50-48-6

Amitriptyline, formerly sold under the brand name Elavil among others, is a tricyclic antidepressant primarily used to treat major depressive disorder, and a variety of pain syndromes such as neuropathic pain, fibromyalgia, migraine and tension headaches.^[11] Due to the frequency and prominence of side effects, amitriptyline is generally considered a second-line therapy for these indications.^{[12][13][14][15]}

The most common side effects are dry mouth, drowsiness, dizziness, constipation, and weight gain. Glaucoma, liver toxicity and abnormal heart rhythms are rare but serious side effects. Blood levels of amitriptyline vary significantly from one person to another,^[16] and amitriptyline interacts with many other medications potentially aggravating its side effects.

Amitriptyline was discovered in the late 1950s by scientists at Merck and approved by the US Food and Drug Administration (FDA) in 1961.^[17] It is on the World Health Organization’s List of Essential Medicines.^[18] It is available as a generic medication.^[19] In 2023, it was the 90th most commonly prescribed medication in the United States, with more than 7 million prescriptions.^[20][21]

Amitriptyline is indicated for the treatment of major depressive disorder, neuropathic pain, and for the prevention of migraine and chronic tension headache. It can be used for the treatment of nocturnal enuresis in children older than 6 after other treatments have failed.^[11]

Amitriptyline is effective for depression,^[22] but it is rarely used as a first-line antidepressant due to its higher toxicity in overdose and generally poorer tolerability.^[23] It can be tried for depression as a second-line therapy, after the failure of other treatments.^[12] For treatment-resistant adolescent depression^[24] or for cancer-related depression^[25] amitriptyline is no better than placebo; however, the number of treated patients in both studies was small. It is sometimes used for the treatment of depression in Parkinson’s disease,^[26] but supporting evidence for its effectiveness in that respect is lacking.^[27]

Amitriptyline alleviates painful diabetic neuropathy. It is recommended by a variety of guidelines as a first or second-line treatment.^[13] It is as effective for this indication as gabapentin or pregabalin but less well tolerated.^[28] Amitriptyline is as effective at relieving pain as duloxetine. Combination treatment of amitriptyline and pregabalin offers additional pain relief for people whose pain is not adequately controlled with one medication and is usually safe.^[29][30] Amitriptyline in certain formulations may also induce the level of sciatic-nerve blockade needed for local anesthesia therein.^[31] Here, it has been demonstrated to be of superior potency to bupivacaine, a customary long-acting local anesthetic.

Low doses of amitriptyline moderately improve sleep disturbances and reduce pain and fatigue associated with fibromyalgia.^[32] It is recommended for fibromyalgia accompanied by depression by Association of the Scientific Medical Societies in Germany^[32] and as a second-line option for fibromyalgia, with exercise being the first line option, by European League Against Rheumatism.^[14] Combinations of amitriptyline and fluoxetine or melatonin may reduce fibromyalgia pain better than either medication alone.^[33]