What to Know About Elavil (Amitriptyline)

Table of ContentsView AllTable of ContentsUses for ElavilSide EffectsCoping With Side EffectsElavil DosagesWarnings and InteractionsOther Options

Table of ContentsView All

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Table of Contents

Uses for Elavil

Side Effects

Coping With Side Effects

Elavil Dosages

Warnings and Interactions

Other Options

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Elavil is a medication used primarily for the treatment of depression. It is what’s known as atricyclic antidepressant. It can also be used off-label to treat some symptoms of mood disorders, eating disorders, nerve pain, and anxiety.

It’s thought that Elavil was discontinued because of the risk it posed of developing a heart condition while using the medicine. However, in 2017 the FDA put out a notice stating that the reason for discontinuing the drug was unrelated to its safety or effectiveness.

This article breaks down the uses and side effects of Elavil. It also covers how to cope with these side effects, common dosages, and any potential risks of taking the drug.

If you or a loved one are struggling with depression, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with depression, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Amitriptyline has been found to be effective in treating depression.It is FDA-approved in the treatment of depression, but it is also sometimes prescribed off-label to treat other mental health conditions including bulimia, insomnia, post-traumatic stress disorder PTSD), and anxiety.

Other Off-Label UsesIt is also prescribed off-label to treat medical conditions including:Chronic painDiabetic neuropathyIrritable bowel syndrome (IBS)MigraineMuscle pain or stiffnessTrigeminal neuralgia

Other Off-Label Uses

It is also prescribed off-label to treat medical conditions including:Chronic painDiabetic neuropathyIrritable bowel syndrome (IBS)MigraineMuscle pain or stiffnessTrigeminal neuralgia

It is also prescribed off-label to treat medical conditions including:

When taken for depression and other mood problems, people usually begin experiencing some improvements in mood within one to two weeks of taking Elavil. It usually takes several weeks to experience the full effects.

Although Elavil and other brand-name forms of amitriptyline have been discontinued, you can still get this medication under its generic name.

Side Effects of Elavil

Even in its generic form, the side effects you might experience when using Elavil can be split broadly into two categories: mild or severe.

In other words, there are common side effects that typically go away with time and are usually nothing to worry about. On the other hand, there are more severe side effects that might require you to speak to your doctor about possibly lowering your dose or discontinuing the medication.

Common Side Effects

The most common side effects of Elavil include:

While these might only be milder side effects of Elavil, it’s important to speak to your doctor immediately if they remain persistent or worsen.

Severe Side Effects

Experiencing severe side effects while using amitriptyline is uncommon. However, there have been reports of the following side effects sometimes occurring while using this medication:

If you notice any of the above side effects, consult your doctor immediately. However, you shouldn’t discontinue the medication without talking to your doctor first. Suddenly stopping amitriptyline could cause withdrawal symptoms likeanxiety, nausea, headaches, and dizziness.

If your doctor intends to have you discontinue Elavil, they will most likely gradually reduce your dose to wean you off of the medication.

Neuroleptic Malignant Syndrome

In sporadic cases, Elavil can cause a condition called neuroleptic malignant syndrome (NMS). NMS is a reaction to antipsychotic drugs that causes muscle stiffness, fever, or an altered mental state.

Symptoms of NMS include:

If you develop any of the above symptoms while taking this medication, you should get medical help immediately.

While there are very few reports of people developing an allergic reaction to Elavil or amitriptyline, it is possible.Symptoms of an allergic reaction to a medication typically include a swollen face, tongue, or throat, itching, dizziness, or trouble breathing.

Coping With the Side Effects of Elavil

While the more common side effects of this medication are not deadly, they can be bothersome. While using this medication, there are some safe ways to cope with the common side effects. For instance, if you are constantly constipated, you should increase your fiber intake and drink a lot of water.

People who experience dry mouth could also increase their water intake or chew on some ice chips for relief.

If youexperience headacheswhile taking amitriptyline, it’s safe to take over-the-counter pain medications like acetaminophen (e.g., Tylenol). But, if the headaches persist or increase in severity, you should speak to your doctor about them.

Elavil has sedative effects and could cause you to become a little dizzy or drowsy. So, it’s advisable to take this medication in the evening and avoid driving or operating any heavy machinery after taking this medication.

The dosage your doctor prescribes can vary depending on your needs, what it is treating, and the strength of the medication.

For the treatment of depression in adults, the starting dose is usually 75 mg divided between two doses taken in the morning and at bedtime. The maximum dose is 150 mg per day.

Teens and older adults are prescribed lower dosages, which are usually taken in 10 mg doses three times a day with a 20 mg dose taken at bedtime.

Dosages for the treatment of other health conditions can vary. For example, the dosage used to treat sleeping problems often ranges from between 10 and 50 mg per day.

If you miss a dose of your medication, take it as soon as you remember. However, if it is close to the time for your next dose, simply skip your missed dose. Never take two doses at once to make up for missing a dose.

Before prescribing amitriptyline, a doctor will take a thorough look into your medical history and find out if you are taking any other medications.

It’s essential to make a list of all medications you are on, including those you might have discontinued recently. Certain drugs interact dangerously with Elavil and, in some cases, could cause fatal results.

Let’s take a look at some of the drugs that can interfere with Elavil and discuss who should not take Elavil.

Drugs That May Interfere With Elavil

Here are some drugs or substances that may negatively impact the efficacy of Elavil.

MAOIs

People who are already takingmonoamine oxidase inhibitors(MAOIs) or have just recently stopped using MAOIs are typically not prescribed Elavil. This is because it can cause very high fevers, convulsions, and death in the most extreme cases. There’s some evidence to suggest that when Elavil is used with epinephrine, it could cause high blood pressure.

Alcohol

Like with most medications, you shouldn’t consume alcohol when using Elavil. Alcohol could heighten its sedative effects and cause the medicine to be ineffective in treating symptoms of depression.

Who Should Not Take Elavil

Here are some populations that Elavil is not recommended for.

People With Heart Problems

One of the more uncommon side effects of using Elavil is an irregular heartbeat. This is why people with heart problems might be discouraged from taking this medication. In severe cases, Elavil has been linked to a condition called QT prolongation, which could cause seizures, fainting, and in fatal cases, death.

Younger People

Research has linked the use of antidepressants to an increased risk ofsuicidal thoughts and ideation, particularly in young people under the age of 25.If you or someone you know who’s on this medication notice any changes in mood or behavior, it’s crucial to speak to a doctor about it immediately.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Other Populations

In almost no scenario should Elavil ever be prescribed to the following people:

The 5 Types of Antidepressants

Alternatives to Elavil

Today, tricyclic antidepressants like Elavil are typically not the first option for doctors when prescribing antidepressants to people living with depression.

Selective serotonin reuptake inhibitors(SSRIs) like Prozac, Celexa, and Cipramil, andserotonin-norepinephrine reuptake inhibitors(SNRIs) like Cymbalta, Effexor, and Fetzima are typically tried first. Research shows that they tend to have fewer side effects than tricyclic antidepressants.

Other Treatments for Depression

In addition to medication, doctors and mental health professionals may also recommend psychotherapy and lifestyle modifications for the treatment of depression. Some that may help include:

Psychotherapy

Self-Help Strategies

15 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Federal Register.Determination that Elavil (Amitriptyline Hydrochloride) oral tablets, 10, 25, 50, 75, 100, and 150 milligrams, were not withdrawn from sale for reasons of safety or effectiveness.Undurraga J, Baldessarini RJ.Randomized, placebo-controlled trials of antidepressants for acute major depression: Thirty-year meta-analytic review.Neuropsychopharmacol. 2012;37(4):851-864. doi:10.1038/npp.2011.306Brueckle MS, Thomas ET, Seide SE, et al.Adverse drug reactions associated with amitriptyline - protocol for a systematic multiple-indication review and meta-analysis.Syst Rev. 2020;9(1):59. doi:10.1186/s13643-020-01296-8Wong J, Motulsky A, Abrahamowicz M, Eguale T, Buckeridge DL, Tamblyn R.Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system.BMJ. 2017;356:j603. doi:10.1136/bmj.j603Thour A, Marwaha R.Amitriptyline. StatPearls Publishing; 2021.U.S National Library of Medicine.Amitriptyline.Food and Drug Administration.Amitriptyline hydrochloride tablets, USP.Berman BD.Neuroleptic malignant syndrome.Neurohospitalist. 2011;1(1):41-47.NHS UK.Amitriptyline: A medicine used to treat pain and prevent migraine.Saraghi M, Golden LR, Hersh EV.Anesthetic considerations for patients on antidepressant therapy—part i.Anesthesia Progress. 2017;64(4):253-261.Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J.Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database.BMJ. 2015;350:h517. doi:10.1136/bmj.h517Steffens DC, Krishnan KR, Helms MJ.Are Ssris Better than Tcas? Comparison of Ssris and Tcas: A Meta-Analysis.Centre for Reviews and Dissemination (UK); 1997.Driessen E, Hollon SD.Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.Psychiatr Clin North Am. 2010;33(3):537-555. doi:10.1016/j.psc.2010.04.005Cuijpers P, Noma H, Karyotaki E, Cipriani A, Furukawa TA.Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: a network meta-analysis.JAMA Psychiatry. 2019;76(7):700. doi:10.1001/jamapsychiatry.2019.0268Cui N, Cui J, Xu X, et al.Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study.Front Psychiatry. 2021;12:508810. doi:10.3389/fpsyt.2021.508810

15 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Federal Register.Determination that Elavil (Amitriptyline Hydrochloride) oral tablets, 10, 25, 50, 75, 100, and 150 milligrams, were not withdrawn from sale for reasons of safety or effectiveness.Undurraga J, Baldessarini RJ.Randomized, placebo-controlled trials of antidepressants for acute major depression: Thirty-year meta-analytic review.Neuropsychopharmacol. 2012;37(4):851-864. doi:10.1038/npp.2011.306Brueckle MS, Thomas ET, Seide SE, et al.Adverse drug reactions associated with amitriptyline - protocol for a systematic multiple-indication review and meta-analysis.Syst Rev. 2020;9(1):59. doi:10.1186/s13643-020-01296-8Wong J, Motulsky A, Abrahamowicz M, Eguale T, Buckeridge DL, Tamblyn R.Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system.BMJ. 2017;356:j603. doi:10.1136/bmj.j603Thour A, Marwaha R.Amitriptyline. StatPearls Publishing; 2021.U.S National Library of Medicine.Amitriptyline.Food and Drug Administration.Amitriptyline hydrochloride tablets, USP.Berman BD.Neuroleptic malignant syndrome.Neurohospitalist. 2011;1(1):41-47.NHS UK.Amitriptyline: A medicine used to treat pain and prevent migraine.Saraghi M, Golden LR, Hersh EV.Anesthetic considerations for patients on antidepressant therapy—part i.Anesthesia Progress. 2017;64(4):253-261.Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J.Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database.BMJ. 2015;350:h517. doi:10.1136/bmj.h517Steffens DC, Krishnan KR, Helms MJ.Are Ssris Better than Tcas? Comparison of Ssris and Tcas: A Meta-Analysis.Centre for Reviews and Dissemination (UK); 1997.Driessen E, Hollon SD.Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.Psychiatr Clin North Am. 2010;33(3):537-555. doi:10.1016/j.psc.2010.04.005Cuijpers P, Noma H, Karyotaki E, Cipriani A, Furukawa TA.Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: a network meta-analysis.JAMA Psychiatry. 2019;76(7):700. doi:10.1001/jamapsychiatry.2019.0268Cui N, Cui J, Xu X, et al.Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study.Front Psychiatry. 2021;12:508810. doi:10.3389/fpsyt.2021.508810

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Federal Register.Determination that Elavil (Amitriptyline Hydrochloride) oral tablets, 10, 25, 50, 75, 100, and 150 milligrams, were not withdrawn from sale for reasons of safety or effectiveness.Undurraga J, Baldessarini RJ.Randomized, placebo-controlled trials of antidepressants for acute major depression: Thirty-year meta-analytic review.Neuropsychopharmacol. 2012;37(4):851-864. doi:10.1038/npp.2011.306Brueckle MS, Thomas ET, Seide SE, et al.Adverse drug reactions associated with amitriptyline - protocol for a systematic multiple-indication review and meta-analysis.Syst Rev. 2020;9(1):59. doi:10.1186/s13643-020-01296-8Wong J, Motulsky A, Abrahamowicz M, Eguale T, Buckeridge DL, Tamblyn R.Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system.BMJ. 2017;356:j603. doi:10.1136/bmj.j603Thour A, Marwaha R.Amitriptyline. StatPearls Publishing; 2021.U.S National Library of Medicine.Amitriptyline.Food and Drug Administration.Amitriptyline hydrochloride tablets, USP.Berman BD.Neuroleptic malignant syndrome.Neurohospitalist. 2011;1(1):41-47.NHS UK.Amitriptyline: A medicine used to treat pain and prevent migraine.Saraghi M, Golden LR, Hersh EV.Anesthetic considerations for patients on antidepressant therapy—part i.Anesthesia Progress. 2017;64(4):253-261.Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J.Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database.BMJ. 2015;350:h517. doi:10.1136/bmj.h517Steffens DC, Krishnan KR, Helms MJ.Are Ssris Better than Tcas? Comparison of Ssris and Tcas: A Meta-Analysis.Centre for Reviews and Dissemination (UK); 1997.Driessen E, Hollon SD.Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.Psychiatr Clin North Am. 2010;33(3):537-555. doi:10.1016/j.psc.2010.04.005Cuijpers P, Noma H, Karyotaki E, Cipriani A, Furukawa TA.Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: a network meta-analysis.JAMA Psychiatry. 2019;76(7):700. doi:10.1001/jamapsychiatry.2019.0268Cui N, Cui J, Xu X, et al.Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study.Front Psychiatry. 2021;12:508810. doi:10.3389/fpsyt.2021.508810

Federal Register.Determination that Elavil (Amitriptyline Hydrochloride) oral tablets, 10, 25, 50, 75, 100, and 150 milligrams, were not withdrawn from sale for reasons of safety or effectiveness.

Undurraga J, Baldessarini RJ.Randomized, placebo-controlled trials of antidepressants for acute major depression: Thirty-year meta-analytic review.Neuropsychopharmacol. 2012;37(4):851-864. doi:10.1038/npp.2011.306

Brueckle MS, Thomas ET, Seide SE, et al.Adverse drug reactions associated with amitriptyline - protocol for a systematic multiple-indication review and meta-analysis.Syst Rev. 2020;9(1):59. doi:10.1186/s13643-020-01296-8

Wong J, Motulsky A, Abrahamowicz M, Eguale T, Buckeridge DL, Tamblyn R.Off-label indications for antidepressants in primary care: descriptive study of prescriptions from an indication based electronic prescribing system.BMJ. 2017;356:j603. doi:10.1136/bmj.j603

Thour A, Marwaha R.Amitriptyline. StatPearls Publishing; 2021.

U.S National Library of Medicine.Amitriptyline.

Food and Drug Administration.Amitriptyline hydrochloride tablets, USP.

Berman BD.Neuroleptic malignant syndrome.Neurohospitalist. 2011;1(1):41-47.

NHS UK.Amitriptyline: A medicine used to treat pain and prevent migraine.

Saraghi M, Golden LR, Hersh EV.Anesthetic considerations for patients on antidepressant therapy—part i.Anesthesia Progress. 2017;64(4):253-261.

Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J.Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database.BMJ. 2015;350:h517. doi:10.1136/bmj.h517

Steffens DC, Krishnan KR, Helms MJ.Are Ssris Better than Tcas? Comparison of Ssris and Tcas: A Meta-Analysis.Centre for Reviews and Dissemination (UK); 1997.

Driessen E, Hollon SD.Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators.Psychiatr Clin North Am. 2010;33(3):537-555. doi:10.1016/j.psc.2010.04.005

Cuijpers P, Noma H, Karyotaki E, Cipriani A, Furukawa TA.Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: a network meta-analysis.JAMA Psychiatry. 2019;76(7):700. doi:10.1001/jamapsychiatry.2019.0268

Cui N, Cui J, Xu X, et al.Health Conditions, Lifestyle Factors and Depression in Adults in Qingdao, China: A Cross-Sectional Study.Front Psychiatry. 2021;12:508810. doi:10.3389/fpsyt.2021.508810

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