Skip to Content

Amitriptyline

Generic Name: amitriptyline (a mee TRIP ti leen)
Brand Names: Elavil, Endep, Vanatrip

Medically reviewed by Sanjai Sinha, MD. Last updated on Jul 9, 2020.

What is amitriptyline?

Amitriptyline is a tricyclic antidepressant with sedative effects. Amitriptyline affects certain chemical messengers (neurotransmitters) that communicate between brain cells and help regulate mood.

Amitriptyline is a prescription medicine used to treat symptoms of depression.

Amitriptyline may also be used for purposes not listed in this medication guide.

Important Information

You should not use amitriptyline if you have recently had a heart attack.

Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

You may have thoughts about suicide when you first start taking an antidepressant such as amitriptyline, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Before taking this medicine

You should not use this medicine if you are allergic to amitriptyline, or:

  • if you have recently had a heart attack.

Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

To make sure amitriptyline is safe for you, tell your doctor if you have ever had:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Amitriptyline is not approved for use by anyone younger than 12 years old.

How should I take amitriptyline?

Take amitriptyline exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

If you need surgery, tell your surgeon you currently use amitriptyline. You may need to stop for a short time.

Do not stop using amitriptyline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using amitriptyline.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Amitriptyline dosing information

Usual Adult Dose for Depression:

OUTPATIENTS:
-Initial dose: 75 mg orally per day in divided doses; this may be increased to 150 mg/day (if needed)
-Maintenance dose: 40 to 100 mg orally per day
-Maximum dose: 150 mg/day

Alternate outpatient treatment regimen: 50 to 100 mg orally as a single dose at bedtime; this may be increased by 25 or 50 mg as needed at bedtime to a total of 150 mg/day

INPATIENTS:
-Initial dose: 100 mg orally per day
-Maintenance dose: 40 to 100 mg orally as a single dose at bedtime
-Maximum dose: 300 mg/day

Comments:
-Dose increases should preferably be made in the late afternoon or at bedtime due to the sedative effect.
-The full therapeutic effect may take as long as 30 days to develop.
-Maintenance doses should be reduced to the lowest amount that will maintain relief of symptoms when satisfactory improvement has been obtained.
-Maintenance therapy should be continued for 3 months or longer to lessen the possibility of relapse.

Use: Relief of symptoms of depression

Usual Geriatric Dose for Depression:

10 mg orally 3 times a day AND 20 mg orally once a day at bedtime

Comments:
-The full therapeutic effect may take as long as 30 days to develop.
-Elderly patients should be monitored carefully and serum levels obtained as clinically appropriate.
-Dose adjustments should be made according to clinical response.

Use: Relief of symptoms of depression

Usual Pediatric Dose for Depression:

12 years or older: 10 mg orally 3 times a day AND 20 mg orally once a day at bedtime

Comments:
-The full therapeutic effect may take as long as 30 days to develop.
-Dose adjustments should be made according to clinical response.

Use: Relief of symptoms of depression

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amitriptyline can be fatal.

Overdose symptoms may include irregular heart rhythm, feeling like you might pass out, seizures, or coma.

What should I avoid while taking amitriptyline?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with amitriptyline.

Avoid driving or hazardous activity until you know how amitriptyline will affect you. Your reactions could be impaired.

Avoid exposure to sunlight or tanning beds. Amitriptyline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Amitriptyline side effects

Get emergency medical help if you have signs of an allergic reaction to amitriptyline: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • signs of a blood clot - sudden numbness or weakness, problems with vision or speech, swelling or redness in an arm or leg;

  • unusual thoughts or behavior;

  • a light-headed feeling, like you might pass out;

  • chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

  • pounding heartbeats or fluttering in your chest;

  • confusion, hallucinations;

  • a seizure (convulsions);

  • painful or difficult urination;

  • severe constipation;

  • easy bruising, unusual bleeding; or

  • fever, chills, sore throat, mouth sores.

Common amitriptyline side effects may include:

  • constipation, diarrhea;

  • nausea, vomiting, upset stomach;

  • mouth pain, unusual taste, black tongue;

  • appetite or weight changes;

  • urinating less than usual;

  • itching or rash;

  • breast swelling (in men or women); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect amitriptyline?

Taking amitriptyline with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking amitriptyline with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may affect amitriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use amitriptyline only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Related questions