Pronunciation: a-mee-TRIP-ti-leen
Brand names: Elavil, Endep, Vanatrip
Dosage form: tablets (10mg, 25mg, 50mg, 75mg, 100mg, 150mg)
Drug class: Tricyclic antidepressants
What is amitriptyline?
Amitriptyline is a tricyclic antidepressant used to treat symptoms of depression (FDA approved), and amitriptyline is used off-label for insomnia, migraine prevention, ADHD, eating disorders, bipolar disorder, anxiety, psychotic disorders, and some types of pain. Amitriptyline may work by increasing chemical messengers (neurotransmitters) serotonin and norepinephrine that communicate between brain cells and help regulate mood.
The first amitriptyline brand was Elavil, which was FDA-approved on April 7, 1961, and has since been discontinued. Other amitriptyline brand names include Vanatrip and Endep, which have also been discontinued. Amitriptyline is now available as a generic medication. Amitriptyline is from the drug class tricyclic antidepressants (TCA).
Amitriptyline is available in combination with chlordiazepoxide for the treatment of patients with moderate to severe depression associated with moderate to severe anxiety. Amitriptyline, in combination with perphenazine, is FDA-approved for types of severe anxiety and/or agitation.
Amitriptyline side effects
Common amitriptyline side effects
Common amitriptyline side effects may include dry mouth, vision changes, sleepiness (sedation), tiredness, appetite or weight changes, constipation, diarrhea, nausea, vomiting, upset stomach, mouth pain, unusual taste, black tongue, urinating less than usual, breast swelling (in men or women), lower sex drive, impotence, or difficulty having an orgasm.
Serious amitriptyline side effects
Allergic reactions: Get emergency medical help if you have signs of an allergic reaction to amitriptyline, including difficulty breathing, hives, or swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- signs of a blood clot – sudden numbness or weakness, problems with vision or speech, swelling or redness in an arm or leg;
- unusual thoughts or behavior;
- a light-headed feeling, like you might pass out;
- chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
- pounding heartbeats or fluttering in your chest;
- confusion, hallucinations;
- a seizure (convulsions);
- painful or difficult urination;
- severe constipation;
- easy bruising, unusual bleeding, or
- fever, chills, sore throat, mouth sores.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA .
Warnings
You should not use amitriptyline if you have recently had a heart attack.
Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
You may have thoughts about suicide when you first start taking an antidepressant such as amitriptyline, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Amitriptyline may trigger an angle closure glaucoma attack in a patient with anatomically narrow angles who does not have a patent iridectomy.
Before taking this medicine
You should not use this medicine if you are allergic to amitriptyline or any of the inactive ingredients or:
- if you have recently had a heart attack.
Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have used an “SSRI” antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.
To make sure amitriptyline is safe for you, tell your doctor if you have ever had:
- bipolar disorder (manic-depression) or schizophrenia;
- mental illness or psychosis;
- liver disease;
- heart disease;
- a heart attack, stroke, or seizures;
- diabetes (amitriptyline may raise or lower blood sugar);
- glaucoma; or
- problems with urination.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
