Amitriptyline as a stimulant of the ascending reticular activating system, and its counterproductive action administered nocturnally to treat insomnia

Abstract

Amitriptyline is an antidepressant that works by increasing the levels of the neurotransmitters Serotonin and Noradrenaline in the brain. It is commonly used to treat insomnia even though it is not indicated for this purpose. It produces problems of temporary or permanent rebound insomnia and physiological hyperarousal. This insomnia originates because Noradrenaline produced in the Locus coeruleus stimulates the ascending reticular activating system, which in turn activates the cerebral cortex causing wakefulness. A bibliographic review was carried out in databases and scientific journals such as: ResearchGate, Scielo, ScienceDirect and Elsevier including 30 scientific articles for the analysis. It was argued how Amitriptyline produces insomnia according to its mechanism of action. It was also concluded with this work that Amitriptyline is a counterproductive antidepressant to treat insomnia because it produces Locus coeruleus hyperactivation.