Generic Name: Amitriptyline Hydrochloride
Brand Name(s): Elavil, Endep
Drug Class: Tricyclic Antidepressant, Anticholinergic, Sedative, Analgesic
Similar Class Drugs: Imipramine, Trimipramine, Doxepin
Available Dosage Forms: 10-150 mg tablets
What is Amitriptyline?
Amitriptyline is a tricyclic antidepressant principally indicated and approved by the FDA to treat depression. Depression is believed to be caused by deficits of mood-regulating neurotransmitters, mainly serotonin, and norepinephrine.
How it treats depression is not fully understood. But it is hypothesized that Amitriptyline inhibits the uptake of both neurotransmitters that are responsible for mood regulation.
Non-FDA approved indications for Amitriptyline1:
In adults
– Chronic pain (diabetic neuropathy, fibromyalgia)
– Anxiety, post-traumatic stress disorder
– Migraine prophylaxis
– Tension headache
In children
-Nocturnal enuresis in children aged 6 years.
However, Amitriptyline should be prescribed only when the condition is irresponsive to first-line treatment in an otherwise healthy patient.2
How to Use Amitriptyline?
Caution must be practiced when administering the drug and should not be used without a prescription by your doctor. Oral administration is most often prescribed; low doses for off-label uses (other than depression) and high doses for depression. Make sure not to alter the dosage yourself as it may result in worsening of side effects such as headache and dizziness.
The drug has sedative effects, and therefore, it is advised to take the drug at bedtime. You can take the drug with or without food and swallow the tablet with water. If you remember missing a dose, take it only if there is sufficient time for the next dose. Allotting a fixed time of the day for drug intake might help you in following your dose schedule more efficiently.
Dosages in pediatric patients with major depressive disorder (MDD) must be strictly monitored as it might accentuate the illness in the initial stages of treatment.
What Are the Side Effects of Amitriptyline?
Common side effects after using Amitriptyline are weight gain, dryness of the mouth, dizziness, headache, and drowsiness.
Adverse side effects can be life-threatening and include cardiac arrhythmias, CNS effects in fetuses of pregnant mothers, psychosis in schizophrenic patients, and suicidal tendency in chronically depressed individuals.
Who Should Not Use Amitriptyline?
– Pregnant and breastfeeding mothers
– Children under the age of 12 years
– Patients who have schizophrenia and manic episodes
– Those with suicidal tendencies
– In cardiac arrhythmias
– In patients with a recent episode of myocardial infarction (heart attack)
– And those with a history of Amitriptyline hypersensitivity
Safer and better alternatives to Amitriptyline are in use today. We strongly recommend seeking treatment from a professional health care provider only.
References
- Thour A, Marwaha R. Amitriptyline. [Updated 2020 November 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537225/
- Elavil. Rxlist.com. Available from https://www.rxlist.com/elavil-drug.htm#description. [Published: 2019 April 2]. Accessed July 7, 2021.
