- What is amitriptyline, and how does it work (mechanism of action)?
- What are the uses 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.
Is amitriptyline available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for amitriptyline?
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 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.
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Is amitriptyline safe to take if I'm pregnant or breastfeeding?
Safety of amitriptyline in pregnancy and children is not established.
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 amitriptyline be 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).
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.
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Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most 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 to food or medications, but usually the cause of the allergy (the allergen) is unknown.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a GI (gastrointestinal) disorder with signs and symptoms that include abdominal pain, bloating, increased gas (flatulence), abdominal cramping, diarrhea, constipation, and food intolerance.Two new tests are now available that may help diagnose irritable bowel syndrome with diarrhea and constipation (IBS-M) irritable bowel syndrome with diarrhea (IBS-D), and irritable bowel syndrome with constipation (IBS-C). Treatment for IBS includes diet changes, medications, and other lifestyle changes to manage symptoms.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
Shingles, or herpes zoster, is a painful rash caused by the varicella zoster virus. Other shingles symptoms include headache, fever, nausea, and body aches. Treatment focuses on pain management and shortening the duration of the illness with antiviral medications.
Migraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Peripheral neuropathy is a problem with the functioning of the nerves outside of the spinal cord. Symptoms may include numbness, weakness, burning pain (especially at night), and loss of reflexes. Possible causes may include carpel tunnel syndrome, shingles, vitamin or nutritional deficiencies, and illnesses like diabetes, syphilis, AIDS, and kidney failure. Peripheral neuropathy is diagnosed with exams and tests. Treatment for the condition depends on the cause. Usually, the prognosis for peripheral neuropathy is good if the cause can be successfully treated or prevented.
Cyclic Vomiting Syndrome (CVS)
Cyclic vomiting syndrome is a condition in which affected individuals have severe nausea and vomiting that come in cycles. Researchers believe that cyclic vomiting syndrome and migraine headaches are related. Triggers of cyclic vomiting syndrome are emotional stress and infections. People with cyclic vomiting syndrome are at an increased risk of dehydration. Cyclic vomiting syndrome is difficult to diagnose. Treatment varies from person to person, but is generally directed toward relief of the symptoms of the condition.
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 (flatulence), loose stools, frequent stools, abdominal pain, diarrhea, and nausea. New non-FDA approved IBS tests may help diagnose IBS and IBS-D. Treatment of IBS-D is geared to toward managing symptoms with diet, medication, and lifestyle changes.
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 tension or stress headaches are lack of sleep, increased stress (referred to as a stress headache), skipping meals, dehydration, medical diseases or conditions, anxiety, or changes at home, work, or school. Treatment of tension headaches include prescription and OTC medications, stress management, and treating any underlying illness or condition.
Fibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress reduction, exercise, and medication are the standard treatments for fibromyalgia.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Postherpetic neuralgia (PHN) is a painful complication of shingles. Symptoms include severe pain, itchy skin, and possible weakness or paralysis of the area. There is no treatment for postherpetic neuralgia that is effective for all patients.
Childhood ADD or ADHD (Attention Deficit Hyperactivity Disorder in Children)
Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. There are three types of ADHD: the predominantly inattentive type, the predominantly hyperactive/impulsive type, and the combined (inattentive, hyperactive, and impulsive) type. Stimulant medications are the most common medication used to treat ADHD.
Adult ADHD (Attention Deficit Hyperactivity Disorder)
About 2%-6% of adults have ADHD, a common behavioral problem. Symptoms include impulsivity, hyperactivity, and inattention. Treatment may involve ADHD education, attending a support group, skills training, and medication.
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 bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
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 frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
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 tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common separation anxiety treatment methods include therapy and medications. Factors that contribute to how quickly or successfully a child moves past separation anxiety by preschool age include: how well the parent and child reunite, the skills the child and adult have at coping with the separation, and how well the adult responds to the infant's separation issues. For example, children of anxious parents tend to be anxious children.
Duck syndrome is a situation initially coined at Stanford University whereby a college student may seem to be calm on the surface when actually he or she is frantically struggling to stay above water to meet the demands of student life.
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 nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Attention Deficit Hyperactivity Disorder (ADHD) in Teens
Attention deficit hyperactivity disorder (ADHD) in teens is a disruption of neurocognitive functioning. Genetics contribute to ADHD. Symptoms of ADHD in teens include inattention, hyperactivity/impulsivity, or a combination of these. Treatment may include cognitive behavioral therapy, behavior therapy, medication, or alternative therapies.
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Spinal Muscular Atrophy (SMA)
Spinal muscular atrophy (SMA) is an inherited (genetic) disease that attacks motor neurons (nerve cells) in the spinal cord. As the nerve cells die, muscle cells weaken and cause signs and symptoms that affect head and neck control, walking, crawling, breathing, and swallowing. There are numerous types of spinal muscle atrophy. Treatments for spinal muscle atrophy are directed at managing symptoms of the disease. There is no cure for spinal muscle atrophy, and some types cause death.
People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs such as deteriorating teeth, sore throat, constipation, thinning hair, and dehydration. Treatment of bulimia may involve cognitive behavior therapy, family therapy, nutritional counseling, and medication.
Treatment & Diagnosis
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- Numbness Toes
- Hand and Finger Numbness
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- Indigestion (Dyspepsia, Upset Stomach)
- Chronic Pain
- Peripheral Neuropathy
- Spinal Muscular Atrophy (SMA)
- Interstitial Cystitis
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- Complex Regional Pain Syndrome (CRPS)
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Medications & Supplements
- Antidepressants (Depression Medications)
- Anxiolytics (for Anxiety) Drug Class Side Effects
- Anticholinergic and Antispasmodic Drugs
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- nortriptyline (Pamelor)
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor)
- desipramine (Norpramin)
- imipramine (Tofranil)
- Side Effects of Elavil (amitriptyline)
- trimipramine (Surmontil)
Prevention & Wellness
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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.