Patient/caregiver was instructed upon therapeutic uses of amitriptyline as follows:

Major depression

• Amitriptyline, by inhibiting the reuptake of serotonin and noradrenaline, enhances the actions of these chemicals in the nerve cells.
• This helps with improved communication, appropriate desired nerve stimulation, thus contributing to controlling symptoms of depression, such as, disturbed sleep, diminishing appetite, compromised energy levels, exhaustion, and lack of interest in activities of daily living.

Bulimia nervosa

• Binge eating and purging, characteristically seen in bulimia nervosa respond to treatment with amitriptyline.
• Guilt and anxiety brought on by binge eating contribute to repeated purging activity and continues to establish as a vicious cycle of events, leading to the development of the disorder, bulimia nervosa.
• By regulating the concentrations of neurochemicals in the brain, especially levels of serotonin and noradrenaline, amitriptyline controls the guilt and anxiety, thus preventing the purging activity.
• This contributes to breaking the cycle of binge and purge, thus offering relief from symptoms of bulimia nervosa.

Bed-wetting in children

• Action of the neurochemical acetylcholine on the smooth muscle of bladder results in contraction of bladder, bladder emptying, and urination.
• Amitriptyline reportedly inhibits the action of acetylcholine on the bladder and thus, inhibits bladder emptying.
• This action of amitriptyline helps with preventing/reducing episodes of nocturnal urination and bed-wetting in children.