Apo-Amitriptyline Adverse Reactions

Note: Included in this listing are a few adverse reactions not reported with this specific drug. However, pharmacological similarities among the tricyclic antidepressant drugs require that each reaction be considered when amitriptyline is administered.
Behavioural: Activation of latent schizoprenia, high doses may cause temporary confusion or disturbed concentration, or rarely, transient visual hallucination, hypomanic reactions, drowsiness which usually disappears with continuance of therapy; insomnia, giddiness, restlessness, agitation, fatigue, nightmares, disorientation, delusions, excitement, anxiety and jitteriness.
Neurological: epileptiform seizures, numbness, tingling, paresthesias of the limbs, including peripheral neuropathy; dizziness, fine tremor, headache, ataxia, seizures, alteration in EEG patterns, extrapyramidal symptoms, tinnitus and incoordination; severe tremor only observed with high doses.
Autonomic: evidence of anticholinergic activity, such as urinary retention, reversible dilatation of the urinary tract, constipation and more rarely paralytic ileus of particular concern in the elderly, dry mouth, blurred vision and disturbance of accomodation.
Cardiovascular: a quinidine like effect and other reversible EEG changes such as flattening or inversion of T waves and bundle branch block, orthostatic hypotension, hypertension, palpitaion, arrhythmias, heart block and with toxic doses, ventricular tachycardia and fibrillation, myocardial infarction and stroke. A few instances of unexpected death have been reported in patients with cardiovascular disorders.
Toxic and allergic effects: bone marrow depression including agranulocytosis, eosinophilia, purpura and thrombocytopenia, jaundice rarely. Allergic type reactions manifested by skin rash, urticaria, photosensitization or swelling of the face and tongue and itching occurred rarely.
Gastrointestinal: nausea, epigastric distress, heartburn, vomiting, anorexia, stomatitis, peculiar taste, diarrhea, parotid swelling, black tongue.
Endocrine: testicular swelling and gynecomastia in the male, breast enlargement and galactorrhea in the female, increased or decreased libido, elevation and lowering of blood sugar levels.
Metabolic: increased appetite, weight gain or weight loss in some patients.
Ophthalmologic: Precipitaion of latent glaucoma or aggravation of existing glaucoma; blurred vision and mydriasis.
Miscellaneous: other side effects that may occur include fainting, weakness, urinary frequency, increased perspiration and alopecia.
Withdrawal symptoms: Abrupt cessation of treatment after prolonged administration may produce nausea, headache and malaise, these are not indicative of addiction.