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Amitriptyline: uses, side effects and precautions

Amitriptyline: uses, side effects and precautions

March 15, 2023

Although the current trend is towards the majority use of serotonin reuptake inhibitor antidepressants (SSRIs) to the detriment of tricyclic antidepressants, there are still some of the latter that are very popular.

One of these drugs is amitriptyline , an antidepressant widely used in cases of major depression, and with a wide variety of uses both in the treatment and in the prevention of certain physical and psychological alterations.

  • Related article: "Types of psychotropic drugs: uses and side effects"

What is amitriptyline?

Amitriptyline, commercially known under some names such as Elavil, Sarotex or Tryptizole, it is an antidepressant action drug . Specifically, amitriptyline is categorized into tricyclic antidepressants. This type of antidepressant medication is distinguished by inhibiting, in the same amounts, the reuptake of serotonin and norepinephrine.


Therefore, by inhibiting the reuptake of these neurotransmitters, the levels of these increase. In this way, amitriptyline facilitates the maintenance of an emotional balance , which is diminished in depressive disorders, among many others.

Unlike other tricyclic antidepressants, amitriptyline has practically the same efficacy as selective serotonin reuptake inhibitors, making it one of the most widely used antidepressants in its category.

  • Related article: "Tricyclic antidepressants: uses and side effects"

In what conditions is it used?

Like other of its many antidepressant equivalents, amitriptyline is given for the treatment of a wide variety of mental disorders .


One of the main focuses of administration is the treatment of the symptoms of major depressive disorder. This emotional disorder is characterized by deep feelings of anguish and sadness, coupled with low self-esteem and long-term, causing great interference in the daily life of the person.

In addition, it also has a proven efficacy in the treatment of some anxiety disorders such as specific phobias or panic disorders and in the treatment of attention deficit hyperactivity disorder or bipolar disorder in those patients who do not show improvements with traditional treatments for these conditions.

To a much lesser extent, this tricyclic antidepressant is administered in some cases of eating disorders and postherpetic neuralgia , a disease caused by certain types of herpes and that causes great sensations of pain in those who suffer from it.


Many researches have shown that amitriptyline can be particularly useful in the prevention of certain ailments or conditions. Some of them include:

  • Migraines
  • Headaches by tension.
  • Neuropathic pain for fibromyalgia.
  • Diabetic neuropathy.
  • Nocturnal enuresis .
  • Insomnia.
  • Some symptoms of psychosis such as schizophrenia or psychotic depression.

How is it administered?

At the moment, amitriptyline only It is available in tablets for oral use . Although it is usually recommended to administer it in four daily doses and approximately always at the same time, the pertinent doctor can indicate the way of consumption that is most convenient for each specific patient.

Next, we describe a series of generic indications that although they can be used as a guide for their consumption, it is always more convenient to follow the doctor's instructions or, failing that, to go to him when there is any doubt about the treatment.

As a general rule, and as with most psychiatric medication, it is advisable to start treatment with amitriptyline progressively, starting with smaller and more distant doses that increase with the progress of the treatment.

It is necessary to emphasize that, although initially the patient does not experience the expected effects, this should never alter or modify the recommended doses, neither by excess nor by defect. This means that in no case can the patient take the liberty of taking more or less medication of the recommended.

In those cases in which the patient decides to alter the dose or stop taking amitriptyline, this may experience symptoms typical of withdrawal syndrome, as well as severe and sudden changes in mood or sleep problems among many others.

What side effects can this drug cause?

Due to its effects as a tricyclic antidepressant inhibitor of the reuptake of serotonin and norepinephrine, amitriptyline can cause a great variety of side effects in the patient. Despite this, this should not stop consuming it on its own, but it is recommended that, before the frequent or prolonged appearance of these reports to the doctor who prescribed them, in order to adjust or change the treatment.

In the list of most frequent but less serious side effects are:

  • Feeling weak lack of energy or fatigue.
  • Drowsiness.
  • Sickness.
  • Vomiting .
  • Headaches
  • Alterations of the dream and / or nightmares.
  • Feeling confused .
  • Dry mouth.
  • Vision problems or blurred vision.
  • Gastric alterations with or without constipation
  • Urination problems
  • Feeling of pain or numbness of hands or feet.
  • Hyperhidrosis or increased sweating.
  • Alterations in desire and / or sexual performance.
  • Alterations in appetite and changes in weight.

Although it is not usual, amitriptyline also can cause a series of serious side effects , which can compromise the health status of the person. If any of them appears, the patient should contact the doctor immediately. These include:

  • Dizziness and fainting .
  • Talk slow or speech difficulties.
  • Weakness or numbness of a full arm or leg.
  • Pain or strong chest pressure.
  • Alterations or instability of the heart rhythm .
  • Skin disorders such as rashes or hives.
  • Coloring of the skin with a yellowish tone.
  • Uncontrollable tremors .
  • Spasms in jaw, neck or back.
  • Spills or cardinals without apparent cause.
  • Convulsions
  • Hallucinations .

What precautions should be taken with their consumption?

Before starting treatment with amitriptyline, the patient must report any special health condition where you are, especially if it is related to any type of heart condition.

In addition, you must also communicate if the patient has any type of allergy, as well as the consumption of any other type of medication, dietary supplement or vitamin. Finally, there are some compounds made with natural herbs, such as St. John's wort, which can also interfere with the treatment.

In those pregnant patients with anticipation of pregnancy or in breastfeeding period, they should also inform the doctor of their state, since amitriptyline can cause fetal alterations or once the baby is born.

Regarding the precautions that should be taken due to the sedative effects of amitriptyline, those patients whose daily routine involves driving or handling heavy machinery should pay special attention to the effects of this and even avoid this type of tasks or activities.


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