Comparative Pharmacology
Head-to-head clinical analysis: AMITRIL versus SURMONTIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMITRIL versus SURMONTIL.
AMITRIL vs SURMONTIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Amitriptyline inhibits the reuptake of serotonin and norepinephrine, thereby increasing their synaptic concentrations. It also blocks histamine H1, alpha-1 adrenergic, and muscarinic receptors.
Tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin, with anticholinergic, antihistaminergic, and alpha-adrenergic blocking properties.
Adults: Initial 25 mg PO once daily at bedtime, increase by 25 mg every 3-7 days as tolerated to typical maintenance 75-150 mg/day PO divided doses or single dose at bedtime. Maximum 300 mg/day.
50-75 mg/day orally in divided doses, increase gradually to 150-300 mg/day. Maximum 300 mg/day. Single bedtime dose may be used for maintenance (50-150 mg).
None Documented
None Documented
Terminal elimination half-life: 15–25 hours (mean 20 h); may extend to >40 h in elderly or hepatic impairment.
11-27 hours (mean approximately 20 hours) for the parent drug; the active metabolite desmethyltrimipramine has a half-life of 15-30 hours. Steady-state is achieved within 5-7 days.
Renal: ~70% as metabolites, <5% unchanged; fecal: ~30% via bile.
Renal excretion of metabolites accounts for approximately 70-80% of elimination, with about 20-30% excreted in feces via biliary elimination. Unchanged drug in urine is less than 5%.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant