- What is amitriptyline, and how does it work (mechanism of action)?
- Is amitriptyline available as a generic drug?
- Do I need a prescription for amitriptyline?
- What are the side effects of amitriptyline?
- What is the dosage for amitriptyline?
- Which drugs or supplements interact with amitriptyline?
- Is amitriptyline safe to take if I'm pregnant or breastfeeding?
- What else should I know about amitriptyline?
What is amitriptyline, and how does it work (mechanism of action)?
- clomipramine (Anafranil),
- doxepin (Sinequan),
- imipramine (Tofranil),
- trimipramine (Surmontil),
- amoxapine (Amoxapine),
- desipramine (Norpramin), and
- protriptyline (Vivactil).
Individuals with depression may have an imbalance in neurotransmitters, chemicals that nerves make and use to communicate with other nerves. Like all TCAs, amitriptyline increases levels of norepinephrine and serotonin, two neurotransmitters, and blocks the action of acetylcholine, another neurotransmitter. It is believed that by restoring the balance of these different neurotransmitters in the brain that depression is alleviated (for example, the mood is elevated). Amitriptyline was approved by the FDA in May 1983.
What are the side effects of amitriptyline?
Sometimes troublesome side effects include:
- fast heart rate,
- blurred vision,
- urinary retention,
- dry mouth,
- sexual dysfunction
- weight gain or loss, and
- low blood pressure on standing (orthostatic hypotension).
Rare side effects include:
Amitriptyline is used with caution in patients with seizures since it can increase the risk of seizures.
Amitriptyline also is used with caution in patients with prostate enlargement because of the risk of increasing the inability to urinate.
Amitriptyline can cause elevated pressure in the eyes of some patients with glaucoma.
If amitriptyline is discontinued abruptly, dizziness, headache, nausea, and restlessness may occur. Withdrawal symptoms may occur when even a few doses are missed. Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.
What is the dosage for amitriptyline?
Amitriptyline may be taken with or without food. The recommended adult dose is 100-300 mg daily in divided doses or at bedtime. The initial dose is 50-100 mg at bedtime that may be increased by 25 or 50 mg at bedtime as needed. The lowest effective dose should be used.
Which drugs or supplements interact with amitriptyline?
Epinephrine should not be used with amitriptyline, since together they can cause severe high blood pressure.
Alcohol blocks the antidepressant action of amitriptyline but increases its sedative effect. Cimetidine (Tagamet) can increase blood levels of amitriptyline and its side effects by preventing the elimination of amitriptyline.
Is amitriptyline safe to take if I'm pregnant or breastfeeding?
Safety of amitriptyline in pregnancy and children is not established.
Amitriptyline is secreted in human milk and potentially can adversely affect the nursing infant.
What else should I know about amitriptyline?
What preparations of amitriptyline are available?
PREPARATIONS: Tablets: 10, 25, 50, 75, 100, and 150 mg.
How should I keep amitriptyline stored?
Amitriptyline should be stored at room temperature in a tight, light resistant container. Storage should be avoided at temperatures above 30 C (86 F).
Quick GuidePhysical Symptoms of Depression in Pictures
Amitriptyline (Endep [Elavil - this brand name drug is no longer available in the U.S.])is an antidepressant medication. In patients with depression, abnormal levels of brain chemicals called neurotransmitters may relate to their depression. Amitriptyline elevates mood by raising the level of neurotransmitters in brain tissue. Amitriptyline is also a sedative, and is useful in the treatment of insomnia, restlessness, and nervousness. It has also been found to be helpful in the treatment of fibromyalgia and symptoms related to chronic pain. It is extremely important to be aware of the drug interactions related to amitriptyline, effects on pregnancy and nursing mothers, as well as common side effects on the user.
Multimedia: Slideshows, Images & Quizzes
Depression Quiz: Signs & Symptoms
Many people do not recognize the symptoms and warning signs of depression and depressive disorders in children and adults. With...
Fibromyalgia Symptoms, Diagnosis & Treatment
What is fibromyalgia? Fibromyalgia is a chronic condition that causes pain and stiffness of the tendons, muscles, and joints....
Low Blood Pressure (Hypotension): Symptoms, Signs, Causes
What is low blood pressure (hypotension)? Explore low blood pressure causes, symptoms, and signs. Discover what is considered low...
Related Disease Conditions
Shingles, or herpes zoster, is a painful rash caused by the varicella zoster virus. Other shingles symptoms include headache,...
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches,...
Hives (Urticaria & Angioedema)
Hives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an allergic reaction. The allergy may be...
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on...
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection,...
Peripheral Neuropathy (Causes, Symptoms, Treatment Medications)
Peripheral neuropathy is a problem with the functioning of the nerves outside of the spinal cord. Symptoms may include numbness,...
Head and Neck Cancer
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph...
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms that include abdominal pain, bloating,...
Tension Headache (Symptoms, Relief, Causes, Treatment)
A tension headache s one of the most common types of headaches, and the exact cause is not known. Factors that may contribute to...
Fibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress...
Duck syndrome is a situation initially coined at Stanford University whereby a college student may seem to be calm on the surface...
Cyclic Vomiting Syndrome (CVS)
Cyclic vomiting syndrome is a condition in which affected individuals have severe nausea and vomiting that come in cycles....
Postherpetic neuralgia (PHN) is a painful complication of shingles. Symptoms include severe pain, itchy skin, and possible...
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one...
Myofascial Pain Syndrome
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with...
Childhood ADD or ADHD (Attention Deficit Hyperactivity Disorder in Children)
Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems...
IBS-D (Irritable Bowel Syndrome with Diarrhea)
IBS-D or irritable bowel syndrome with diarrhea refers to IBS with diarrhea. Symptoms of IBS-D include intestinal gas...
Adult ADHD (Attention Deficit Hyperactivity Disorder)
About 2%-6% of adults have ADHD, a common behavioral problem. Symptoms include impulsivity, hyperactivity, and inattention....
Insomnia (Symptoms, Causes, Remedies, and Cures)
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up...
Interstitial Cystitis (IC) and Painful Bladder Syndrome (PBS)
Interstitial cystitis (IC)/painful bladder syndrome (PBS) is an inflammatory disease of the bladder that can cause ulceration and...
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults...
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under...
Attention Deficit Hyperactivity Disorder (ADHD) in Teens
Attention deficit hyperactivity disorder (ADHD) in teens is a disruption of neurocognitive functioning. Genetics contribute to...
People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs...
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes...
Spinal Muscular Atrophy (SMA)
Spinal muscular atrophy (SMA) is an inherited (genetic) disease that attacks motor neurons (nerve cells) in the spinal cord. As...
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty...
Treatment & Diagnosis
- Numbness Toes
- Hand and Finger Numbness
- Tingling in Hands and Feet
- Loss of Temperature Sensation
- Indigestion (Dyspepsia, Upset Stomach)
- Peripheral Neuropathy
- Interstitial Cystitis
- Chronic Pain
- Doctor: Checklist to Take To Your Doctor's Appointment
- Depression FAQs
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Fibromyalgia Treatment...Methods Using Available Medicines
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- What Are The Side Effects of Nortriptyline Withdrawal?
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Anticholinergic and Antispasmodic Drugs
- Antidepressants (Depression Medications)
- Anxiolytics (for Anxiety) Drug Class Side Effects
- Drug Interactions
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor)
- nortriptyline, Pamelor, Aventyl - has been discontinued in the U.S.
- desipramine, Norpramin
- imipramine, Tofranil, Tofranil-PM
- trimipramine (Surmontil)
Prevention & Wellness
- 'Off-Label' Antidepressants Common, But Where's the Evidence?
- Study Questions Use of Migraine Meds in Kids, Teens
- Antidepressants Not Just for Depression Any More
- Beware Safety Risks Posed by 'Off-Label' Drug Use
- Weight Gain From Antidepressants Is Minimal, Study Suggests
- Behavioral Therapy Might Ease Kids' Migraine Symptoms
- Obesity May Increase Migraine Odds
- Antidepressants Celexa, Lexapro Tied to Irregular Heartbeat: Study
- Prescription Meds Can Put on Unwanted Pounds
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.