Amitriptyline: Uses, dosage, and side effects 

Amitriptyline is a type of medication called a tricyclic antidepressant. So, what is amitriptyline used for? As the name might suggest, it can be prescribed to treat depression. However, it can also be used to manage nerve pain (also known as neuralgia) or chronic pain (long-term pain). As it has many uses, the dosage and the effect of the medication will depend on the condition you are treating. Amitriptyline can be taken as a tablet or a liquid. On this Meds for Less blog we’ll some commonly asked questions about Amitriptyline. 

What is Amitriptyline? 

You may have heard of this medication being prescribed to treat depression. Actually, although Amitriptyline is a type of antidepressant, specifically, it is a tricyclic antidepressant that can be used in a range of conditions, from depression to different types of pain. Nerve pain (or neuralgia) is the key example where Amitriptyline is indicated. It may also be used to treat chronic pain or prevent migraines. It can take up to 6 weeks for the medication to manage your pain. 

Amitriptyline can come as a tablet or a liquid. It is important to note that a common side effect of Amitriptyline is sleepiness or drowsiness, thus it is often taken in the evening. It is important that you do not drive or operate heavy machinery if the medication makes you drowsy. 

Common Uses of Amitriptyline 

Now let’s talk about amitriptyline uses. Amitriptyline is a very useful medication for clinicians as it can treat quite a few conditions. In addition to its use in treating depression, Amitriptyline is also commonly used to manage different types of pain. For example, if the root cause of your pain is related to a nerve (also called neuralgia), it is unlikely that painkillers like paracetamol or ibuprofen alone can manage the pain. Amitriptyline however, is quite effective at managing this kind of nerve pain. Other types of pain that this medication can help manage include chronic pain and preventing migraines. 

The dose of amitriptyline prescribed will thus also depend on what condition or problem you are treating. This means that if you are taking amitriptyline for anxiety, it will likely not also give you the painkiller effect as the dose is different. Do not try to use this medication for any other condition than what it was prescribed for. 

How to Take 

Always take Amitriptyline exactly according to your doctor’s instructions. However, there is some general advice on how to take amitriptyline that may be helpful:

Possible Side Effects of Amitriptyline

As with all medication, there are some short-term and long-term side effects. Here are some amitriptyline side effects for your information: 

Short-Term Side Effects

Short term or more common side effects often go away on their own or with home treatment. They usually get better as your body starts getting used to the Amitriptyline. Some short-term side effects include: 

• Constipation or finding it difficult to pee
• Feeling like your mouth is dry
• Headaches or dizziness
• Feeling more sleepy/drowsy 

Typically, if you make sure to stay hydrated and eat a balanced diet (increase the fibre content), avoid or cut down on alcohol, and take paracetamol when needed, these side effects should gradually disappear after the first few weeks. If these symptoms persist for example you are unable to pee, it is important to seek medication attention promptly. 

You should also seek emergency medical attention if you notice any signs of a serious allergic reaction (anaphylaxis) such as but not limited to:

• Swelling tongue, lips, mouth, or throat
• Struggling to breathe or swallow
• Sudden confusion or becoming unconscious
• An itchy or swollen rash 

Long-Term Effects and Risks

There is not as much research on amitriptyline long-term effects and risks associated with Amitriptyline. However, it is possible that there is an increased risk of:

• Liver damage
• Kidney damage
• Confusion
• Dementia
• Appetite changes and weight changes
• Increased pressure in the eye
• Breast enlargement
• Suicidal ideation 

Amitriptyline and Mental Health Conditions 

By taking Amitriptyline, there is a small risk of increased thoughts of suicide, typically in young people. This may sound strange if you are taking amitriptyline for depression or amitriptyline depression medication but this particular side effect often wears off as you get used to the medication. Thus, it is important that you tell your doctor about any changes to your mood or any mental health conditions that you may have before starting Amitriptyline. Your doctor may monitor your mood after starting the medication. Tell your doctor if you have noticed:

• Increased thoughts of ending your life
• Increased anxiety
• Increased feeling of agitation or panic attacks 

Interactions and Precautions 

Alcohol and Amitriptyline 

It is best to avoid drinking alcohol if you are taking amitriptyline, especially if you have just started the treatment. This is because Amitriptyline may interact with alcohol and increase your risk of or worsen side effects. Also, there is a higher risk of Amitriptyline overdose symptoms when you take the medication with alcohol, that can lead to serious and potentially fatal consequences. If you have a history of alcoholism or feel that it will be difficult to control your alcohol consumption, it is important to tell your doctor this if you are discussing Amitriptyline treatment.

Pregnancy, Breastfeeding, and Fertility 

Pregnancy: If you are pregnant, Amitriptyline is generally considered a safe medication to use. Although, it is recommended that you use a different painkiller like paracetamol if that can manage your pain.

Breastfeeding: If you are breastfeeding, in most cases of healthy babies, Amitriptyline is generally safe to use. However, it should be noted that small amounts of the medication can go into the breast milk. There have only a small number of cases of breastfed babies experiencing side effects. If you notice any changes to your baby’s feeding, sleeping, peeing/pooing, or behaviour, consult a medical professional promptly. 

Fertility: If you are trying to get pregnant, the research currently says that Amitriptyline is safe to use and does not affect fertility. 

If you are starting/taking Amitriptyline and you fall into any of these categories, it is important to consult a medical professional who can assess you and give advice that is more specific to your situation. 

Withdrawal and Stopping Amitriptyline

It is very important that you do not suddenly stop Amitriptyline and without medical supervision and guidance. This is because you may experience additional side effects by doing this. These may include muscle pains, fatigue, or flu-like symptoms. If you feel that the medication is not working for you, you must speak to your doctor who can assess the situation and discuss how to stop the medication safely.