*Nortriptyline, the most important metabolite, has a half-life of 36 hours
(18-60 hours). It has a polymorphically controlled metabolism (debrisoquine metabolism).
In subjects with a slow metabolism (in Switzerland about 9% of the population)
high therapeutic doses can lead to toxic plasma levels very quickly.
*The daily dose can also be divided in 2 or 3 single doses, as a rule, however, one nightly dose is better tolerated. The treatment should normally last at least six months.
**The necessity of an individual dosage cannot be emphasized enough. In the hospital higher daily doses can be permitted exceptionally (up to 300 mg). Smaller doses are often effective for pain (25 mg/day). Injection of amitriptyline is poorly documented.