What is Amitriptyline?
Generic name: Amitriptyline hydrochloride
Drug class: Tricyclic antidepressant (TCA)
Available forms: Tablets (10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg)
Prescription required: Yes
Common brand names: Elavil®, Endep®, Tryptizol®, Laroxyl®
Mayo Clinic – Amitriptyline Overview
Therapeutic Uses of Amitriptyline
Amitriptyline is not only an antidepressant — it has multiple medical uses due to its effects on the brain and nervous system.
1. Depression
Amitriptyline helps relieve symptoms of:
- Persistent sadness or low mood
- Lack of interest or pleasure
- Fatigue and sleep problems
- Appetite or weight changes
2. Chronic Pain & Neuropathic Pain
It’s effective for nerve-related pain (neuropathy) such as:
- Diabetic neuropathy
- Postherpetic neuralgia
- Fibromyalgia
3. Migraine & Tension Headache Prevention
Low doses of Amitriptyline can reduce frequency and intensity of migraines.
4. Insomnia
Because of its sedative properties, doctors sometimes prescribe it off-label for sleep disorders.
NHS – Amitriptyline for Pain and Migraine
Amitriptyline Dosage Guidelines
Dosage depends on the condition, age, and response to treatment.
Always start with the lowest effective dose and increase gradually under medical supervision.
| Condition | Starting Dose | Typical Dose | Maximum Dose |
|---|---|---|---|
| Depression (Adults) | 25–50 mg/day at bedtime | 75–150 mg/day | 300 mg/day |
| Chronic Pain / Migraine | 10–25 mg at bedtime | 25–75 mg/day | 100 mg/day |
| Elderly Patients | 10–25 mg/day | Increase gradually | 75 mg/day |
Note: It may take 2–4 weeks before full antidepressant effects appear.
Drugs.com – Amitriptyline Dosage Guide
Composition
| Component | Function |
|---|---|
| Amitriptyline Hydrochloride | Active antidepressant compound |
| Excipients | Lactose monohydrate, starch, magnesium stearate, talc, coloring agents |
Mechanism of Action
Amitriptyline works by:
- Blocking the reuptake of serotonin and norepinephrine in the brain
- Increasing their availability to improve mood, sleep, and pain control
- Exhibiting anticholinergic effects, which contribute to its sedative properties
PubChem – Amitriptyline Mechanism
Amitriptyline Side Effects
Common Side Effects
- Drowsiness or dizziness
- Dry mouth
- Constipation
- Blurred vision
- Weight gain
- Low blood pressure (especially when standing)
Serious Side Effects (Seek Medical Help)
- Irregular heartbeat or chest pain
- Severe confusion or hallucinations
- Seizures
- Allergic reactions (swelling, rash, itching)
Do not stop taking Amitriptyline suddenly — it can cause withdrawal symptoms such as nausea, headache, and irritability.
MedlinePlus – Amitriptyline Side Effects
Drug Interactions
Avoid taking Amitriptyline with:
- MAO inhibitors (isocarboxazid, phenelzine)
- SSRIs (sertraline, fluoxetine)
- Antihistamines or sedatives (increased drowsiness)
- Alcohol (enhances sedative effect)
- Tramadol or opioids (risk of serotonin syndrome)
Amitriptyline Brand Names
| Brand Name | Manufacturer | Form |
|---|---|---|
| Elavil® | AstraZeneca | Tablet |
| Endep® | Mylan | Tablet |
| Tryptizol® | Lundbeck | Tablet |
| Laroxyl® | Pierre Fabre | Oral drops |
| Saroten® | Lundbeck | Capsule |
Precautions and Warnings
- Avoid alcohol during treatment.
- Not recommended for patients with heart disease, glaucoma, or seizure disorders.
- Use with caution in elderly or pregnant women.
- May cause suicidal thoughts in young adults — close monitoring is essential
How Long Does Amitriptyline Take to Work?
The time it takes for Amitriptyline to work depends on why you’re taking it and your body’s response to the medication.
For pain or migraine prevention, Amitriptyline usually starts working within 1 to 2 weeks,
Is Amitriptyline Addictive?
No — Amitriptyline is not considered addictive in the same way as drugs like opioids, benzodiazepines, or stimulants.