- 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.
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Treatment & Diagnosis
- Hand and Finger Numbness
- Numbness Toes
- Indigestion (Dyspepsia, Upset Stomach)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Chronic Pain
- Loss of Temperature Sensation
- Peripheral Neuropathy
- Interstitial Cystitis
- Tingling in Hands and Feet
- 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
- 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
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- trimipramine (Surmontil)
- Anticholinergic and Antispasmodic Drugs
- Antidepressants (Depression Medications)
- Anxiolytics (for Anxiety) Drug Class Side Effects
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.