Amitriptylin har erfaringsmessig mer sedativ effekt og er et alternativ som kan doseres om kvelden til pasienter med smerte og innsovningsvansker. Trisykliske antidepressiver må brukes med forsiktighet ved epilepsi og er blant annet kontraindisert ved kjent kardial arytmi.Male starter oftest den smertestillende behandling med et svagt virkende mid
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