Amitriptyline can be of tremendous benefit to people who suffer from depression and anxiety, but it must be taken with care.

Key takeaways:

• Amitriptyline can act as an antidepressant to treat mental health issues
• It can also help with managing physical pain
• This drug has many side effects to consider, including dependence

Amitriptyline, sometimes called Elavil, is a tricyclic antidepressant (TCA). It helps increase levels of serotonin (the brain’s natural “feel good” chemical) and regulate the brain’s chemical balance. This can elevate mood while encouraging other positive mental and physical effects. Amitriptyline is also prescribed to treat some forms of physical pain.

Potential benefits of amitriptyline

Patients may experience improved mental and/or emotional states with less negative and intrusive thoughts. Improved sleep, increased energy, and decreased tension and anxiety are further potential results. Off-label, amitriptyline has also proven effective in reducing the physical pain of some chronic conditions including arthritis and migraines. Amitriptyline pills prescribed in various strengths may be taken up to four times daily depending on medical instructions and patient sensitivity. How quickly amitriptyline takes effect varies. Some start to notice positive effects in as little as one to two weeks.

Considerations before use

Patients with certain medical conditions may experience difficulties with amitriptyline or have to avoid it altogether. These conditions include:

• Earlier hypersensitivity to amitriptyline
• Epilepsy
• Liver, kidney, or heart issues
• Diabetes (amitriptyline can affect blood sugar levels)
• Schizophrenia or bipolar disorder
• Eye conditions⠀

Amitriptyline isn’t a controlled substance, but a prescription is required to obtain it as it may interact with some other antidepressants and heart medications. It’s also a category C drug which means there are not enough studies of its effects on pregnant women to provide satisfactory safety data. Pregnant women, those trying to conceive, and breastfeeding mothers should discuss the risks with their doctors because amitriptyline can cross the placenta and be transmitted via breast milk. Amitriptyline can react negatively with alcohol so your healthcare provider is likely to recommend against drinking until all traces of the medication have left your system. Anyone scheduled to undergo surgery of any kind (including dental surgery) may also need to avoid amitriptyline.

Is amitriptyline addictive?

While amitriptyline’s ability to improve mood and decrease pain makes it potentially addictive, a well-monitored, strictly timed prescription actually has a low potential for dependence. It would require large quantities of amitriptyline to be taken deliberately in order to classify as drug abuse. Occurrences of people doing so to seek either an amitriptyline “high” or extreme sedation are not typical. This is because while amitriptyline can elevate mood, it doesn’t do so dramatically by producing huge boosts to happiness or calmness. A more understated balance is what’s ideally achieved. Anyone choosing to abuse amitriptyline – or any other antidepressants – tends to do so under the mistaken notion that good feelings will amplify in relation to how much they take.  That said, because it is sometimes used for pain relief, amitriptyline can lead to physical dependence, especially if used for long periods of time. Signs of dependence can include:

• Needing more to achieve previous effects
• Fixating on using and obtaining it
• Negative changes in behavior and appearance
• Combining amitriptyline with other substances, like alcohol, to increase its effects⠀

If you do take amitriptyline for a long period of time, keep an eye out for these symptoms, and also be sure to check in with your doctor on a regular basis. If you need to stop taking amitriptyline,  most doctors recommend tapering off rather than quitting cold turkey to prevent harsh withdrawal symptoms. Withdrawal symptoms may include disturbed sleep, flu-like symptoms (chills, sweats, aches), restlessness, and irritability. Some may experience nausea, manic moods, or speech issues.

Other side effects of amitriptyline

In addition to potential withdrawal symptoms, amitriptyline has an extensive list of other possible side effects. Some are temporary and will disappear or can be eased with medical care. Drowsiness and dizziness have been reported, as have headaches, confusion, and delirium. Other possible outcomes include, but are not limited to:

• Hypersensitive allergic reactions to amitriptyline
• Mood swings
• Dry mouth
• Heart or liver issues
• Increased appetite and weight gain
• Manic episodes
• Negative interactions with other medications.

Suicidal ideation is among the most serious side effects and has been reported to a marked degree in adolescents and adults younger than 24. Other extreme reactions to this drug include seizure, coma, and amitriptyline toxicity, the latter of which can be fatal. It’s also important to note that some side effects of responsible use may also result from amitriptyline abuse. This makes it doubly important to speak to a doctor who can help you in either case.

Managing and minimizing side effects

Amitriptyline’s side effects require close monitoring by healthcare providers. Among the primary factors monitored are cardiovascular health, liver function, body mass index (BMI), and thyroid function. The patient’s mental health and behavior should also be regularly assessed.  Speak to your medical provider immediately if you experience any new and unpleasant thoughts or physical sensations. The Poison Control Helpline can be reached toll-free at 1-800-222-1222 or via their website and you can get free, confidential advice on amitriptyline misuse by calling the Addiction Center at (870) 515-4356.

Reduce the cost of amitriptyline with ModRN Health

It’s essential to speak to a trusted healthcare professional so you can make informed decisions about every factor associated with amitriptyline use. Unfortunately, cost is another factor to consider, especially if you’ll be using amitriptyline for an extended period of time. This is where ModRN Health can be of great assistance. We help our members locate the most affordable brand-name and generic prescriptions at the pharmacies closest to them, saving up to 90% on the cost of their medications. Over time, this can amount to hundreds of dollars in savings on antidepressants and less financial stress on you. Sign up for a free account today and let us help you stay healthy for less!