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Overview
Amitriptyline belongs to an older class of antidepressants. Under the brand name Elavil, it used to be one of the most frequently prescribed antidepressants. It is now prescribed generically more frequently.
It belongs to a class of compounds called TCAs (tricyclic antidepressants) that includes amoxepine (Asendin), clomipramine (Anafranil), desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil).
The extraordinary popularity of drugs such as Prozac, Paxil, and Zoloft has led to dramatic decline in the TCA class of antidepressants. Yet many people still benefit from such compounds.
Amitriptyline and some of its cousins are also prescribed for anxiety and depression as well as to relieve chronic pain associated with arthritis, fibromyalgia, neuropathy or neuralgia (nerve damage), and migraine headache.
Anafranil is prescribed primarily for obsessive compulsive disorder (OCD)
Side Effects and Interactions
Side effects associated with amitriptyline and many other TCAs include dizziness, drowsiness, constipation, dry mouth, blurred vision, super sensitivity to sunlight, sexual difficulties, urinary retention difficulties, weight gain, heart palpitations, low blood pressure, confusion, forgetfulness, weakness, disorientation, or hallucinations. Some of these adverse effects may disappear over time.
Less common complications to watch out for are changes in blood sugar, anxiety, irritability, sleep disturbances, twitching, tremors, tingling of arms and legs, skin rash, digestive upset, or breast enlargement in men and women. Changes in heart rhythm, stroke or seizures are rare but potentially serious reactions. Report any symptoms to your physician promptly.
Amitriptyline and most other TCAs interact with quite a few other medications.
Combining different categories of antidepressants (TCAs and Prozac-like drugs) can be quite dangerous as TCA blood levels can rise leading to toxicity (confusion, dizziness, delirium, seizures, etc.).
The antidepressants Nardil or Parnate can also become extremely hazardous when taken together with TCAs.
Tagamet (cimetidine) and Tegretol (carbamazepine) may also produce an overdose effect if combined with amitriptyline or other TCAs.
The blood pressure medicine Catapres (clonidine) may lose its effectiveness if taken with amitriptyline or other TCAs. Blood pressure could soar out of control and lead to hypertensive crisis.
There is a concern that ginkgo biloba could possibly make a person more vulnerable to seizures, so it probably should not be taken together with other drugs known to increase the risk of seizures, such as amitriptyline.
Interactions between the herb St.John's wort and amitriptyline are possible. Switching between antidepressants and herbal treatment calls for medical guidance (physicians can find a suggested protocol for gradual substitution of St. John's wort in Hyla Cass's book, St. John's Wort: Nature's Blues Buster).
Check with your pharmacist and physician to make sure amitriptyline or any TCA is safe in combination with any other drugs and herbs you take.
Taking the Medicine
Taking TCAs with food may reduce stomach upset.
Because amitriptyline and related compounds can be sedating, physicians frequently prescribe them at bedtime.
Special Precautions
People with a history or risk of seizures may be more vulnerable to attacks while on TCAs.
Other conditions that pose special risks include glaucoma, heart disease, irregular heart rhythms, hyperthyroidism, kidney or liver disease, and urination problems.
Amitriptyline and many other TCAs are quite sedating. This means they can make driving or other tasks dangerous.
Older people may be especially susceptible to complications such as drowsiness, dizziness and confusion.
Sudden discontinuation of amitriptyline or similar antidepressants may cause withdrawal symptoms such as headache, dizziness, nausea, sleeping problems and general feelings of disorientation and discomfort.
I was given 25 mg of amitriptyline to help with sleep disturbance during a bout with shingles. Now, 6 months later, I have tried 3 times to stop taking it and have had all of the symptoms you describe--in spades. The worst is chronic, debilitating migraines. Is there any protocol for gradual withdrawal? I am told that I "shouldn't be having problems" with such a small dose. How does one withdraw gradually from such a small dose?
To Laura: Some people are very sensitive to elavil. I have a very severe form of panic disorder and have been on it a couple of times. Though most people require about 150 mg to block panic attacks, I only required 15 mg. Each time I had to step down the dose by 5 mg to ease withdrawal. Try cutting your tablet in half. Also, it comes in 10 mg tablets so see if your doctor will prescribe those to help you ease down. You are paying him; he should listen to you! Fortunately, I have a great psychiatrist who helped me through it.
ive been taking 50 mg of amitriptyline for 3 months for my depression, but have very bad suicidal thoughts and attempted to kill my self
i was admitted to hospital and psychiatric treatment but the doctor still told me to stay on these tablets knowing they are making me worse? i dont understand why? he says they are the best for me as the older anti depressants are more of a sedative to calm my mood but they just make me feel terrible
I've been on Amtriptiline for years. I have chronic insomnia due to a major panic disorder. I also take a low dose of Clonazepam and I've slept great for the past 8 years. (I should probably note I take zoloft low dose each morning too.) I've had to increase the amptritiline and even the clonazepam little by little to sleep better, but lately I feel horrible and the adjustments do not seem to make a difference. I'm going to bed the same time and even increased the clonazepam (which usually works), but for almost a week I feel like I haven't gotten any sleep at all. It's horrible... I have no energy... I can't concentrate at work and the workday seems like it will never end.
Can anyone relate? Every time I explain it to a family member or friend... they dismiss how awful not sleeping makes one feel and pretty much act like it's not a big deal. My husband knows otherwise, he has first-hand knowledge just by watching what I'm going thru. My doctor is away for the next few days and I'm going to try to increase the amptriptiline some tonight. I left work early and I think they think I'm slacking or being irresponsible. Nobody knows the low energy and tiredness I go thru day after day and I'm so over-tired, I can't just take a nap or go to sleep right away... it actually takes longer to fall asleep being so overtired.
(Only people in the same situation understand what I mean by that.) Speaking of same situations, I feel so ALONE with this disorder, can anyone relate?? Thank you for listening and I look forward to any feedback.
Diane
I have taken amitriptyline for irritable bowel syndrome for over 10 years. I started with 25 mg and have experimented with various doses. I have taken 75 mg for the last two years. In the last few years I have noticed a particular type of disorientation. But when I am driving I sometimes have trouble deciding whether I need to turn right or left to get to some destination.
I frequently make the wrong choice. If I park the car I can easily sketch an accurate diagram of the streets needed for a particular route, but I have trouble multitasking and making the correct choices while I am driving. I have lived in the same place for 27 years and I am very familiar with the streets in my town.
I wonder if this problem could be due to the amitriptyline. Before I started taking amitriptyline I rarely had to think about navigating while driving. It just seemed to happen automatically (subconsciously I suppose). Has anyone else had a similar experience?
My DR. put me on Amitriptylin 100mg. I did not start them yet. I'm on lexapro 20 mg have been for two weeks. I have no ENERGY!!!!! I feel so tired and feel like i can't get organized.I also feel I'M in a fog and can't function. If Amitriptylin causes drowsiness how can it help with energy? This is a major problem for me.I have no energy,no mood.
i have been taking 100mg of amiltriptyline for about a year for nerve pain. i have just spent a weekend by the sea (england) and after sitting on the beach for an hour followed by an hour in the garden, i have suffered extreme sunburn on my face, arms and legs.
i am quite dark skinned and have never burnt in the sun before. the side effects on the drug leaflet mention sensitivity to light but not severe sunburn. i have since looked on the net and most info advises sunblock. i wish someone had told me about this as i am feeling very sore and unwell.
My22 yr old daughter was recently put on a graduated dose of 10mg Elavil increasing to 30mg per day over a span of 9 weeks. This is for chronic diarrhea/gastroparesis. She had been diagnosed with epilepsy in January, 2008. She had been seizure free since April, but since her dose of the Elavil increased to 20mg she has had 2 seizures. I asked every doctor BEFORE she started this if it would be ok with the seizures and all of them, Primary, GI, and neurologist said it was such a low dose she would be fine. Well, it seems to me it's increasing seizure activity. Any thoughts? Thanks
Hi everyone,
I was diagnosed with neuropothy 2 years ago, I was put on Elavil, Dr. put me on 50 mg, but it had some side effect, so got 10 mg pills, and adjusted them, 30 mg held the leg pain away. I have other health issues, and after several iron anemia, ( I'm a male) and several scans showing no problems, ( had several infusions) I decided to study myself, the Dr. did not seem to have my best interest at stake, gastrolgist said I would have to have iron infusions rest of my life, I did not like or accept that answer.
I read about gluten allergy (wheat) I had several of the symptoms. I requested a blood test, and VIOLA, i WAS HIGHLY ALLERGIC, ( $120,000 in scans later) in researching gluten allergies, nerve pain (neuropothy) was a symptom).
I started going off Elavil 30 mg, to 20, 10 later, to 5mg, and 3 days ago off. The leg pain has not returned, (off wheat for 3 months) the allergy was causing nerve pain) the Elavil gave me rapid heart beat, and heart Dr. told me to try to go off, normal heart beat has returned.
But have had major stomach pain for 3 days (withdrawal symptom). Elavil has too many side effects and warnings, I believe it should be avoided. The gluten allergy caused much of my discomfort, and that simple diet change, corrected many, have a simple blood test, or google gluten allergy. good luck
I took Elavil in October 2008 and after 6weeks of being on the medicine I was feeling great. I was provided the drug for chronic back pain and depression. And after 6 weeks of taking the medicine, mentally I was fine. I had no pain in my back, but I started having palpitations. I had 17 PVC's in 15 minutes. So I immediately stopped taking the drug. So here now in February 2009 I am still having palpitations and now I am wondering could I have heart problems from this medicine? I have an appointment to go and talk with my Dr. soon.
I've been on the generic Elavil for almost 2 months now for Fibromyalgia sleep problems. I get really drowsy when I take it, so I only take it at night, and as of so far, I'm loving it. It's been working wonders for my sleep disorder and I'm very pleased with it.
I'm on 25mg amitrip at night, I would like to withdraw, but I'm scared I'll get withdraw symptoms. Has anyone else gotten some advice about withdrawing safely?
I took elavil for many yrs for fibromyalgia, migraine headaches & insomnia and it worked excellently. Unfortunately I had to go off of it because of the dryness it was causing my nose. I am very sensitive to meds and I had to cut the 10mg tablets into 4ths and go down 1/4 at a time, giving it a couple weeks at each dose, in order to avoid the withdrawal.
I still have had a very hard time getting used to life without it, migraines are back, fibro pain is back, etc. I have had no appetite since going off it and have lost a lot of weight. Anyway, for weaning off of it, I suggest you be creative with cutting the tablets up. They are hard to cut, I used a razor blade, and only tried to get one good piece out of each tablet. Only cut the dose as fast as your body can deal with it, you are the one who has to live with it.
I wish I had a dollar for every person who said "you shouldn't have any problems stopping such a small dose." Hah.
Hi,
I have been taking 10mg of Amitriptyline for years for a constant,cronic headache and I feel it helped me not wake up with such a bad headache in the morning and reduced my migraine attacks a lot. Due to wanting to start a family with my fiance, soon to be husband I have to go on Amitriptyline. I have talked to my doctor and he said it just a matter of stop taking it because of the low dose.
Well last night was the first time not taking it and I feel sick to my stomache and weird feeling in my head, kind of spacey feeling! Will this go away in time and I just have to ride it out? Anyone else on a 10mg and went off it and felt okay after a bit of being off it?
I think I might have picked bad timing going off it as wedding is coming up in just over a month. Hope I don't feel crappy for too long! Can't go back on it cause we are now not using a condom as of last night and who knows if I could become pregnant and I can't take this medication while trying or if I become pregnant.
Wish I had of seen this website before last night as i had no idea you could get as low as 5mg of this medication or cut my pill in half. That may have helped me go off it instead of cold turkey!!
Since my earlier post about going off Amitriptyline 10mg well it's not good. I feel sick to my stomache and bad headache. Now today I have woken up with diareaha to top it all off. I also can't stop crying cause I feel like crap.
My fiance and I have decided I must go back on medication at least until after the wedding and honeymoon. Now it's just a matter of waiting to see if I am pregnant which will be a good 3-4 weeks and then I can go back on it.
May be by some miracle in this time I feel better and can stay off it or better yet I am pregnant. Being pregnant would be worth this pain! Also of course we have to start having sex with a condom again. Darnit cause we really want children but I guess this wasn't a good time to try and this was a learning lesson!
I have been on this for 2+ months for fibro. and PLMD---I CAN'T SLEEP ANYMORE!!!!!! I have trouble w/ meds--I'm very sensitive to everything. This is having the opposite effect that is is supposed to have. It's torture! Is anyone else having this problem? I'm hoping to try Savella when it becomes available mid-year.
Do not stop taking the amytripyline. I have currently tried to do so and I feel terrible, I was given it for sleep disorder and severe anxiety at night and have been on it for 5 months.
I figured if I got myself a job and was more mentally active I would be fine, but boy was I wrong. If I don't take it my head is in a right mess, I feel like I can't concentrate and don't feel myself, so I would recommend carrying on taking the meds and I'm going to talk to my GP to see what he can do for me!
I have been on 75 mg of elavil for the past years for my fibro and problems sleeping. I have discontinued it with my doctors help by taking 25mg for 2 weeks and the last week of 25 a night. I have not been able to sleep since I started the withdrawal, cramping, bowels problems restless legs. I am trying to get in touch with my Dr to see if theses symptoms will eventually go away. I am sorry I ever started the drug I am 68 yrs old and I feel like heck.
Has anyone experience leg and calves pain from taking the medicine?I take 20mg a night. I was experiencing pain so bad I couldn't walk for very long.
Hi everyone, I've read most of the comments left on this website, I've been on amitriptyline for several months now and have been prescribed it for chronic headaches. Recently I started feeling severe chest pains in the middle of my chest. I went to my doctor about it and he said that it was because I had an inflamed joint connecting my sternum and rib cage, has anyone else had heart or chest problems as a result of being on the drug?
I'm on 20 mg for 4 months. I started noticing urination problems almost immediately as well as an insatiable appetite. Since it helped excruciating pain, I continued. The last week, I have tinnitus. A nightmare. I'm going to wean myself off. The drug is a miracle drug for pain and for sleep but the weight gain, urinating problems and not tinnitus- not worth it!! I will ask my dr. tomorrow but am wondering how any of you weaned off. I know I must be slow, but how slow is slow? Have you ever heard of someone going from 20mg, down to 10mg and then wean from that? Thanks.
I have had a bad back for the past year and am now only taking 20mg of amytripyline. It is great for my sciatic pain however I too am finding hard knowing how and when to stop taking it. I have tried but each time the pain comes back and I have trouble dropping off the sleep. I will try the suggestions made regarding cutting down by a quarter of a 10mg per 2 weeks. How long have some of you out there been on these drugs?
Doctor put me on Elavil in 1986 for nervous condition after having surgery and blood clots. Have taken the lowest dose for all these years. Wanted to quit taking it about 7 years ago. Gradually reduced the pill into halves for weeks, than quarters for a few more weeks and then only a quarter of a pill every other night. After another week, I quit and - - - - - - - - -couldn't sleep for days. I was a zombie. I started taking 1/2 pill nightly and slept like a log.
I have tried to wean myself off of these pills about 6 times since then, but each time I get totally off of them, NO SLEEP!!!! I am now trying again and am in my 2nd week. If I get to the point of NO SLEEP, what do I do, except go back on them. Help!