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RЕVIЕWING DRUG RЕSЕАRСH ОN DRUG THЕRАРY: АMITRIРTYLINЕ 1 Essay Example

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Reviewing Drug Research on Drug Therapy: Amitriрtylinе

Introduction

Amitriptyline is a tricyclic antidepressant, a term used to describe a group of antidepressants with characteristics similar to those of amitriptyline. The arrow amitriptyline drugs contain amitriptyline hydrochloride. Its impact on the balance of the chemical composition of the brain to resume normalcy makes it suitable for the treatment of depression. The paper discusses the pros and cons of the use of amitriptyline and the reason why the conclusive recommendation is relevant. The discussions consider the positive impact as experienced by actual patients, the negative impact depending on the nature of the subscription, and finally settling on the most rational conclusion.in relation to the use of amitriptyline among inmates.

This report is about the use of drug therapy for the treatment of mental illnesses among inmates. It consists of the analysis and critique of the use of amitriptyline for the treatment of problems such as depressive disorders and the rationale behind its recommendation or lack of recommendation thereof. Since its synthesis and introduction in pharmacies in the United States in 1960 and 1961 respectively, amitriptyline is used often to alleviate depression. It is accurate to say that amitriptyline was the first drug used for the treatment of depression of its type[ CITATION Leu12 l 1033 ].

Discussion

Although medications are not always the first alternative for the treatment of depressive disorders among the patients, there are cases that only improve upon the administrative of antidepressant drugs. Anti-depressant drugs can be selected from a variety of treatments such as serotonin reuptake inhibitors (SSRIs), atypical antidepressants, monoamine oxidase inhibitors (MAOIs), neropinephrine and dopamine reuptake inhibitors (NDRIs), and atypical antidepressants. Amitriptyline is a member of the atypical antidepressants. Although their effect is more or less similar to that of other anti-depressants, they are usually only used upon the failure of the observation of positive effects of other antidepressants.

The functioning of amitriptyline involves a direct effect on brain chemicals thus instantly affecting the moods of the patient. One of the most common problem that faces inmates is depression and other psychological disorders. The cases of mental disorders are more common in mental institutions than any other single population. The move to de-institutionalize people with mental illness in the 1970s is the reason for the large number of institutionalized mental inmates.

The cons of the use of amitriptyline

The immediate shift from the MAOIs to amitriptyline is prone to adverse effects on the patient including instances of severe symptoms associated with the drug and sudden death upon an overdose. The other cons include the possibility of allergic reactions to the ingestion of amitriptyline among some patients. It is also not safe for patients that recently had myocardial infarctions to take the medication since there is a high possibility of adverse effects in relation to the same. It is common for patients to get suicidal upon the initiation of the treatment which makes it essential to combine the treatment with psychotherapy.

With the frequent transfers that occur in mental institutions, it is common for the disruption of the medical care of inmates to be interrupted. Many are the cases that the medication is not followed up which leads to the likelihood of the administration of amitriptyline immediately after the ingestion of a different subscription which is likely to result in adverse reactions[ CITATION Jac01 l 1033 ].

Amitriptyline is also not suitable for patients with medical conditions such as diabetes and cardiovascular complications are not advised to take amitriptyline for medication. Amitriptyline is also not suitable for treatment among patients with bipolar disorders and schizophrenia. The same applies for women that are breastfeeding or pregnant.

It is recommended that inmates get anti-depressant subscriptions because of the lack of enough therapists to take them through regular therapy and only resort to drugs as the last option[ CITATION Jac01 l 1033 ]. It is for that reason that the choice of the drugs given must be evaluated for safety and suitability across large populations without adversities. It is not medically safe to subscribe amitriptyline to children under the age of twelve. When subscribed to teenagers, an accompanying supervisor is essential to prevent the instances of abuse.

The disadvantages that come with the administration of drugs for depressive disorders include the possibility of abuse even among those to whom the drugs are subscribed. The most vulnerable populations to the abuse of drugs used for the treatment of mental disorders include patients with a history of drug abuse and people living in controlled environments. Prisons constitute controlled environments for disciplinary of retention purposes. In such instances, the use of depressive symptoms medication should include the accompaniment of addiction specialists among other therapists to monitor the impact of the drugs and detect signs of dangerous and self-destructive behaviour[ CITATION Eli14 l 1033 ].

However, despite the cons, with the relevant patient education, the inmates should be in a position to speak out in case of the previous treatment with amitriptyline in cases where the new medical practitioners subscribe new drugs for them[ CITATION Bon12 l 1033 ].

The impact of amitriptyline in the relaxation of muscles and the alleviation of chronic pain related to depressive disorders and other psychological disorders makes it a relevant alternative over other medications. Although the side effects are uncomfortable at the beginning of the medication, they wear out after a week or so. Afterwards, depending on the health status of the individual, they can be continued or discontinued upon the orders of the doctor[ CITATION Sør05 l 1033 ].

TCAs such as amitriptyline alleviate pain in 4 out of every 5 patients to whom it is subscribed. On the other hand, SSRIs help 1 in every 7 of its patients. In terms of fast and effective results among the right candidates, amitriptyline works best. The link between pain and antidepressants is relevant based on the fact that physical pain could be as a result of psychological or biological factors among people with depressive symptoms[ CITATION Ais09 l 1033 ].

The fact that the administration of TCAs in conjunction with SSRIs requires expert knowledge gives assurance that any TCA subscription is effective and relevant to the case. The fast effect experienced by the treatment using TCAs makes them effective among inmates who do not have the luxury of lengthy therapy. The most common forms of chronic neuropathic pains experienced by patients with depressive symptoms are such as major depressive disorders[ CITATION PKG07 l 1033 m Kri10].

The Pros of amitriptyline

A research is done to compare amitriptyline, placebo, and no treatment as approaches of depressive disorders among adults. The study collects dichotomous data that with the calculation of an odds ratio of a ninety five confidence interval. The study consists of 3509 participants and 39 trials and runs through a span of twelve weeks. The results show amitriptyline as more effective than amitriptyline in the treatment of depressive disorders. In relation to the withdrawal of patients from the treatment for the anti-depressive disorders, the number of those that withdraw from amitriptyline are fewer as compared to those that withdraw from placebo.

A study based in the US and Canada that consists of the subscription of SSRIs and TCAs. Various reports report that all anti-depressants have side effects and those of SSRIs are significantly similar to those of TCAs. Despite the side effects of the intake of TCAs such as amitriptyline, [ CITATION Rob09 l 1033 ].

Although the tricyclic antidepressants do not have any effect on the reuptake of dopamine, their indirect action of the, the dopaminergic reaction, with the effect of dopamine D2 Receptors desensitization constitutes how they work. Amitriptyline results in an overall balanced inhibition against components such as the uptake of adrenaline and serotonin[ CITATION Sør05 l 1033 ].

Depressive disorders are triggered by various factors such as the physical environment or internal chemical imbalances. The ac of the treatment of clinical depression may lead to disability and in severe cases, death. Types of depressive disorders differ and could be episodic and vary in its degree of severity. Depending on the approach taken for the treatment of depressive disorders, the person may get back to normal or get worse and become violent and in worse instances commit or attempt suicide. This is the situation in correctional institutions where people are locked in for long periods. Such locking of people in triggers depressive symptoms[ CITATION Pet04 l 1033 ].

Like most TCAs amitriptyline is mostly dosed once daily in addition to its inexpensive cost. Although the side effects (dry eyes, dry mouth, blurry vision, constipation, and urinary retention among others) are among the most common cause of the discontinuation of the use of amitriptyline, starting off with lower doses then increasing the dosage to match the depressive symptoms.

Recommendations

Amitriptyline prolongs the activity of serotonin and noradrenaline neurotransmitters released by the brain. The results include prolonged enlightened moods and because the moods are lightened which relieves the depression. The accompanying sedative effect and the affect it has on anxiety disorders, insomnia, and agitation. Although not always the first option because of the risks involved in possible overdoses and abuse, when used it is effective and radical. The overall advantage is that the behaviour of the patient is monitored and adjusted because of the elevation of their moods.

Amitriptyline should be used in small doses, monitored closely to prevent cases off relapse into drug abuse or an overdose and the adversities related to an overdose. It is also best to administer it in small portions at the beginning then advance to the full dosage with time to check for the symptoms and avoid instances of severely adverse symptoms. Severely adverse symptoms are among the top reasons for the discontinuation of the use of the drugs among many patients for the lack off the patience to wait for the body to acclimate.

Amitriptyline helps in the treatment of the neuropathic pain because it is required in much lower doses when prescribed for the problems mentioned above as opposed to its use in depression. The dangers of overdose are severe as are the administration to people with a history of cardiovascular disorders. The overall recommendation is care in the administration of the same.

According to The Pharmaceutical Society (2011), amitriptyline is a good alternative for its use in prisons given the close examinations that accompany the subscription of drugs in prison and the strict rules that prison. The daily dosing of one time per day helps in that the therapist or medical practitioner in charge of the treatment of neuropathic pain and depression among various people including inmates because of their effectiveness without the need for combination with other treatments. Some of the side effects of drugs used for the treatment of depression and neuropathic pain have side effects such as violence. Such include various categories such as SSRIs. TCAs such as amitriptyline help in the addressing the violence exhibited within enclosed places such as prison as a result of depression because of their sedative effects[ CITATION The112 l 1033 ].

Although there is a valid history of low tolerance of amitriptyline among many patients, their effects are fast and strong and essential for use within institutions such as prisons. Since most cases of depressive disorders are seldom acute, the treatment of such through therapy sit-downs and procedures is advised before the subscription of medication. Amitriptyline works on the nerve cells of the brain. Despite the limitations that come with the people that are eligible for the use of the drug,

The treatment of chronic neuropathic pain requires instant treatment. Most inmates do not get continuous treatment of their depression which makes them likely to have drugs smuggled into their prison for the sake of the relaxation effect. Antidepressants are administered when usual therapy fails in the alleviation of symptoms related to mental problems. As a result of the few therapists that are available for the people in the mental institutions, the careful administration of medication for the treatment of depressive symptoms is essential. Depending on the eligibility, the faster the healing effect, the better the medication preference.

Conclusion

According the research, amitriptyline is an effective drug when used for depression and digressive disorders. It has multiple effects on the on the patients as it also treats neuropathic pain and insomnia which are also symptoms of depression. It has a high risk upon an overdose where death is can be a side effect in severe cases. However, it consists of one daily dose which makes it easy to monitor since the patient can receive a pill every time upon a visit to the therapist. Its sedative effect is especially helpful I the alleviation of the violent emotions that are occasionally experienced among patients upon the initiation of the intake of the drugs. Care is the key factor in the use of amitriptyline for the treatment of depression and neuropathic pain.

References

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Bond DJ, H. G. (2012). The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention-deficit/hyperactivity disorder. Ann Clin Psychiatry, 23-37.

Bowen, R. A., Rogers, A., & Shaw, J. (2009). Medication management and practices in prison for people with mental health problems: a qualitative study. Int J Ment Health Syst.

Consumer Medicine Information. (n.d.).

Ellis, P. (2004). Australian and New Zealand clinical practice guidelines for the treatment of depression. CPGs for Treatment of Depression, 390-409.

Evans, E. A., & Sullivan, M. A. (2014). Abuse and misuse of antidepressants. Substance Abuse and Rehabilitation, 107–120. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140701/

Gillman, P. K. (2007). Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. British Journal of Pharmacology, 737–748. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014120/

Jefferies, K. (2010). Treatment of Neuropathic Pain. Kristen Jefferies, 425-432.

Leucht C, H. M. (2012). Amitriptyline versus placebo for major depressive disorder (Review). Cochrane Database of Systematic Reviews, 1-149.

Moultry, A. M. (2009). The Use of Antidepressants for Chronic Pain. US Pharmacist, 26-34.

Sindrup, S. H., Otto, M., Finnerup, N. B., & Jensen, T. S. (2005). Antidepressants in the Treatment of Neuropathic Pain. BCDT, 399–409. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2005.pto_96696601.x/full

The Pharmaceutical Society. (2011). Safer Prescribing in Prisons. RCGP, 17-21. Retrieved from file:///C:/Users/Hp/Downloads/UK51_Safer_Prescribing_in_Prison%20(2011).pdf