Amitriptyline

Category: pharmacological

Aliases: Elavil

Pharmacological Mechanism

Tertiary-amine TCA — strong serotonin + norepinephrine reuptake inhibition + H1 + muscarinic + α1 antagonism. Now used mainly off-label for chronic pain, migraine prophylaxis, neuropathic pain at low doses (10–50 mg). High anticholinergic burden in elderly.

Half-Life (t½)

PO: 21h

Dosing Guidelines

• PO: Typical 50 mg (Range: 10–150 mg)

Target Organ Systems

• nervous

Pathways It Modulates

• BDNF / TrkB neurotrophic signaling (activator) — BDNF (chronic) + direct TrkB partial agonist (Jang 2009)
• Tricyclic + atypical antidepressants (inhibitor) — SERT + NET + H1 + M1 + α1 + Na channel

Chemical Identifiers

• PubChem CID: 2160
• Formula: C20H23N
• Molecular weight: 277.41 g/mol
• InChIKey: KRMDCWKBEZIMAB-UHFFFAOYSA-N
• SMILES: CN(C)CCC=C1C2=CC=CC=C2CCC3=CC=CC=C31

References

• PMID 711927