Amitriptyline

About

Amitriptyline is a medicine used to treat several conditions, most commonly depression and certain types of nerve pain. It belongs to a group of medicines called tricyclic antidepressants (TCAs).

Amitriptyline works by increasing the levels of certain natural chemicals (serotonin and noradrenaline) in the brain that help improve mood and relieve pain.

It is prescribed for conditions such as:

• Depression and low mood
• Chronic nerve (neuropathic) pain
• Prevention of migraine or tension headaches
• Sleep problems (insomnia) related to pain or low mood
• Bladder pain syndrome (in some cases)

Amitriptyline is usually available in the form of:

• Tablets (10 mg, 25 mg, 50 mg)
• Liquid oral solution

How and When to Use It

Take amitriptyline exactly as prescribed by your doctor.

Dosage: The dose depends on the condition being treated.

For depression, the usual starting dose is 25–50 mg daily, increased gradually if needed. For pain or migraine prevention, lower doses (10–25 mg at night) are usually effective.

Take your dose once a day, usually in the evening or before bedtime, as it can make you drowsy.

Swallow the tablet whole with water — do not chew or crush it.

Do not stop taking amitriptyline suddenly; your doctor will advise how to reduce the dose gradually.

Contraindications

Amitriptyline should not be used if you have:

• Allergy to amitriptyline or other tricyclic antidepressants
• Recently had a heart attack (myocardial infarction)
• Severe liver disease
• Heart rhythm disorders
• Are taking certain antidepressants called monoamine oxidase inhibitors (MAOIs)

Side Effects

Like all medicines, amitriptyline can cause side effects, although not everyone gets them. Many side effects improve as your body adjusts to the medicine.

Common side effects:

• Drowsiness or tiredness
• Dry mouth
• Constipation
• Blurred vision
• Weight gain or increased appetite
• Dizziness, especially when standing up

Serious but less common side effects:

• Irregular heartbeat or palpitations
• Severe constipation or urinary retention
• Confusion or hallucinations (especially in older adults)
• Allergic reactions (swelling, rash, difficulty breathing)
• Thoughts of self-harm (rare, mainly at the start of treatment)

Seek urgent medical help if you experience chest pain, fainting, severe dizziness, or swelling of the face or throat.

Pregnancy, Breastfeeding & Fertility

Amitriptyline is sometimes used during pregnancy if the benefits outweigh the risks. It should be prescribed with caution and under medical supervision.

Small amounts can pass into breast milk — your doctor may discuss alternative options if you are breastfeeding.

There is no clear evidence that amitriptyline affects fertility in men or women.

Interactions With Other Medications

Amitriptyline can interact with several medicines:

• Other antidepressants (especially MAOIs or SSRIs) — may increase risk of serotonin syndrome
• Alcohol — increases drowsiness and risk of side effects
• Sleeping pills, sedatives, or anxiety medications — enhance sedative effects
• Heart rhythm medicines — may increase risk of irregular heartbeat
• Anticholinergic medicines (e.g., for Parkinson’s or bladder problems) — increase risk of dry mouth, constipation, or confusion

Frequently Asked Questions