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Amitriptyline Patient Tips

How it works

  • Amitriptyline is used to treat depression and is thought to work by increasing levels of serotonin and/or norepinephrine in the brain.
  • Amitriptyline belongs to a group of medicines known as tricyclic antidepressants.


  • Effective for the treatment of major depressive disorder (MDD).
  • May be used off-label for the treatment of other conditions in addition to other treatments or where alternative treatments have not worked (for example chronic pain, fibromyalgia, insomnia).
  • Recommended on the WHO pain ladder for nerve-related pain unresponsive to opioid-like drugs (such as morphine).


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.
  • Risk of heart-related effects, muscle rigidity, tremor, 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 tremor, nausea, vomiting, diarrhea).
  • 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.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Amitriptyline is an effective antidepressant but may cause drowsiness initially and a withdrawal syndrome with abrupt discontinuation.


  • Take higher dosages late afternoon or in the evening to minimize daytime sedation.
  • Do not stop suddenly as withdrawal symptoms may occur. Slow dosage reduction over weeks to months is recommended.
  • Monitor patients for worsening of depression or suicidal thoughts particularly during the first few months of therapy. Also monitor for serotonin syndrome.
  • Report any unusual side effects to a doctor.
  • May increase the risk of sunburn; protect yourself from the sun when outdoors.

Response and Effectiveness

  • Peak concentrations reached in 4 to 8 hours. Metabolized to an active metabolite (nortriptyline) so effects are long-lasting. Antidepressant effect may take several weeks to develop.


Amitriptyline [package insert] Revised 11/2015. Accord Healthcare Inc. Accessed 02/2016. Gupta SK, Shah JC, and Hwang SS. Pharmacokinetic and pharmacodynamic characterization of OROS® and immediate-release amitriptyline. Br J Clin Pharmacol. 1999 Jul; 48(1): 71–8.

  • 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.

  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Revision Date: 2017-04-11 03:58:31