Amitriptyline, a tricyclic antidepressant, is now mostly replaced by SSRIs and SNRIs. It can have side effects such as dizziness, drowsiness, and fatigue, and serious side effects such as skin rash and seizures. It can interact with other drugs and may not be suitable for people with certain medical conditions.
Amitriptyline, was more commonly known by its brand name Elavil®. Elavil is not currently sold in its denominated form in the United States, and the generic form is now the most common name for this prescription drug, used primarily in the treatment of depression. The drug is not the most popular for treating depression, as it is a tricyclic antidepressant and has significant side effects. However, when it was introduced and tested by the FDA in the 1980s, it was found to be beneficial and some people still benefit from its use. Drugs such as amitriptyline have largely been replaced by drugs called select serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs).
It would be helpful to compare amitriptyline with SNRIs. Like most SNRIs, this drug works to release adrenaline and serotonin. When these neurotransmitters are available in free form, they can have a positive effect on mood and help end depression. The drug may also be used to treat migraine, to control bedwetting, as part of a complex treatment strategy for chronic pain, and to control some aspects of multiple sclerosis.
Like most antidepressants, there is some risk associated with the use of amitriptyline in children, adolescents, and young adults. In these populations, antidepressant use has been linked to an increased risk of suicidal ideation and behavior. Evidence that the drug is causing negative behavior changes, or things like panic attacks and hostility, is an indication to seek immediate medical attention. However, people taking this drug should not stop taking it without doctor’s guidance.
Common side effects of amitriptyline include dizziness, drowsiness, and fatigue, and some people report having strange or frightening dreams while using this drug. Others suffer from stomach upset and/or dry mouth. Some people are frustrated with the reduction in libido that can accompany use, and some users of this drug are challenged by difficulty staying focused on tasks. These side effects can vary, and not all people will experience all of the side effects, or will only experience them for a short time as their bodies adjust to the medication.
There are very serious side effects associated with amitriptyline and these are considered medically urgent. People who experience any of the following conditions should contact their doctors right away or go to the nearest emergency room:
Skin rash and hives
Extreme bruising
Thirst accompanied by extreme nausea
Rapid heartbeat with excessive sweating
seizures
Hallucinations
Uncontrolled muscle movement or involuntary trembling
Confusion that occurs suddenly
One reason tricyclic antidepressants are not preferred to treat depression is because they are extremely toxic in overdose amounts, and overdose is more likely in people with severe depression. It is always essential to contact 911 in the event of an overdose, as immediate treatment is required. Overdose symptoms may include heart rate changes, sweating, seizures, nausea and vomiting, and eventually loss of consciousness or coma.
There are many drugs that can interact with amitriptyline. Doctors should have a complete list of all medicines a person takes, even if they are over-the-counter or herbal, before prescribing this drug. Some people are not candidates for amitriptyline due to other medical conditions. People with bipolar disorder, diabetes, hypo- or hyperthyroidism, a history of or current cardiovascular disease, an enlarged prostate, or glaucoma may need to take varying levels of this drug or avoid it entirely.
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