Amitriptyline used to be better known by its brand name Elavil®. Elavil is not currently sold in its named form in the US, and the generic form is now the most common name for this prescription medication, used primarily in the treatment of depression. The drug is not the most popular for the treatment of depression, as it is a tricyclic antidepressant and has significant side effects. However, when it was introduced and tested by the FDA in the 1980s, it was considered beneficial, and some people still benefit from its use. Medications such as amitriptyline have been largely replaced by medications called selected serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs).
It would be useful to compare amitriptyline with the SNRIs. Like most SNRIs, this drug works to release epinephrine and serotonin. When these neurotransmitters are freely available, they can have a positive effect on mood and help end depression. The drug can also be used to treat migraines, control bedwetting, as part of a complex treatment strategy for chronic pain, and control some aspects of multiple sclerosis.
Like most antidepressants, there is some risk associated with the use of amitriptyline in children, adolescents, and young adults. In these populations, the use of antidepressants has been linked to an increased risk of suicidal ideation and behavior. Evidence that the medication is resulting in negative behavioral changes, or things like panic attacks and hostility, is an indication to contact a doctor immediately. However, people taking this drug should not stop taking it without a doctor's guidance.
Common side effects of amitriptyline include dizziness, drowsiness, and fatigue, with some people reporting strange or frightening dreams while using this medication. Others suffer from an upset stomach and/or dry mouth. Some people are frustrated by the reduced libido that can accompany use, and some users of this drug are challenged by difficulty staying focused on tasks. These side effects can vary, and not everyone will experience all side effects, or will experience them for a short time only while their bodies adjust to the medication.
There are very serious side effects associated with amitriptyline and they are considered medically urgent. People who experience any of the following symptoms should contact their doctors right away or go to the nearest emergency room:
- rash and hives
- extreme bruises
- Thirst accompanied by extreme nausea
- Strong heartbeat with excessive sweating
- seizures
- hallucinations
- Uncontrolled muscle movement or involuntary tremor.
- confusion that occurs suddenly
One of the reasons tricyclic antidepressants are not preferred for treating depression is because they are extremely toxic in overdose amounts, and overdose is more likely in people suffering from severe depression. It is always essential to contact the emergency services if an overdose has occurred, as immediate treatment is required. Symptoms of overdose may include changes in heart rate, sweating, seizures, nausea and vomiting, and ultimately unconsciousness or coma.
There are many drugs that can interact with amitriptyline. Doctors should have a complete list of medications a person is taking, even if they are over-the-counter medications or herbs, before prescribing this medication. Some people are not candidates for amitriptyline due to other medical conditions. People with bipolar disorder, diabetes, hypo- or hyperthyroidism, previous or current cardiovascular disease, an enlarged prostate, or glaucoma may need to take different levels of this drug or avoid it altogether.