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Author: Admin | 2025-04-28
Medically reviewed by Carmen Pope, BPharm. Last updated on Oct 3, 2023. How it worksUpsidesDownsidesBottom LineTipsResponse/effectivenessInteractions 1. How it works Amitriptyline may be used to treat depression or off-label to relieve chronic pain, fibromyalgia, or insomnia.Experts are unsure exactly how amitriptyline works, although historically it was believed that amitriptyline’s effects for depression were due to its ability to rebalance chemicals in the brain, such as serotonin and/or norepinephrine. Studies confirm that amitriptyline is still effective for treating mood disorders, such as depression, even though the way it works is unknown. It is not known how amitriptyline works to relieve chronic pain, fibromyalgia, or insomnia.Amitriptyline belongs to a group of medicines known as tricyclic antidepressants. 2. Upsides May be used for the treatment of major depressive disorder (MDD). May be used off-label (this means it is not an FDA-approved indication; however it may be useful clinically) for the treatment of other conditions such as chronic pain, fibromyalgia, or insomnia. Amitriptyline may be used in addition to other treatments or where alternative treatments have not worked.Recommended on the WHO pain ladder for nerve-related pain unresponsive to opioid-like drugs (such as morphine).Generic amitriptyline is available. 3. Downsides If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Dry mouth, headache, constipation, diarrhea, and sexual dysfunction. May increase the risk of suicidal thoughts or behavior in young adults (similar to other antidepressants). May cause drowsiness and affect a person's ability to drive or operate machinery; some people may develop tolerance to this effect. There is a risk of heart-related side effects with amitriptyline, as well as muscle rigidity, tremors, seizures, increased sensitivity to light, weight gain or loss, hair loss, skin rash, and edema. Interaction or overdosage may cause serotonin syndrome (symptoms include agitation, hallucinations, fast heart rate, dizziness, muscle tremors, nausea, vomiting, or diarrhea). Another rare syndrome, neuroleptic malignant syndrome (NMS) has been reported after starting or increasing the dose of amitriptyline. Symptoms include muscle rigidity, fever, mental status changes, a fast heart rate, and tremors.May cause withdrawal symptoms with abrupt discontinuation (symptoms include nausea, headache, sleep disturbance, and generalized tiredness). These are not indicative of addiction. Taper dosage off slowly under medical supervision. Rare instances of mania have been reported within 2 to 7 days following cessation of chronic treatment with tricyclic antidepressants,
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