- Side effects
- Risks and complications
Amitriptyline was also available under the brand name Endep, but the Food and Drug Administration (FDA) have discontinued these brands.
Amitriptyline is still available under its generic name. It belongs to the wider class of drugs called tricyclic antidepressants. Most of these drugs work by increasing the availability of dopamine and norepinephrine in the brain.
Having low levels of these brain chemicals is associated with depression and other mental health conditions.
This article outlines the side effects and risks associated with amitriptyline.
Side effects of amitriptyline may include headaches, dry mouth, and drowsiness.
The most commonly reported side effects of amitriptyline include:
Although less common, the following side effects may also occur:
In some cases, amitriptyline may cause the following serious adverse reactions:
In addition to potentially causing side effects, amitriptyline may interact with other medications a person is taking. Such medications include:
Monoamine oxidase inhibitors
Tricyclic antidepressants can be fatal if a person takes them alongside monoamine oxidase inhibitors (MAOIs).
MAOIs are an older type of antidepressant medication. Although doctors have mostly phased out their use, some may still prescribe them when modern antidepressants are not effective.
Doctors also sometimes use MAOIs off-label to help people manage bipolar disorder and Parkinson’s disease.
Taking MAOIs with amitriptyline or other tricyclic antidepressants can cause dangerously high fever, severe convulsions, and even death.
Examples of MAOIs include:
People should be careful when switching from an MAOI to a tricyclic antidepressant. In such cases, experts recommend stopping the MAOI and waiting a minimum of 14 days before starting on a minimal dosage of tricyclic antidepressant.
A doctor may increase the amount gradually, if necessary.
A person may have a severe reaction if they take amitriptyline alongside other antidepressants.
Amitriptyline may also cause severe reactions when a person uses it in combination with other antidepressants, such as:
Central nervous system depressants
Central nervous system (CNS) depressants are drugs that slow brain activity, relax the muscles, and have a calming effect on the body. Doctors sometimes prescribe them to help treat anxiety, acute stress, and sleep disorders.
Examples of CNS depressants include sedatives, tranquilizers, and hypnotics. Amitriptyline can enhance the effects of these drugs, so people should not take both at the same time.
Alcohol is also a CNS depressant. Because amitriptyline can enhance the effect of alcohol, it increases the risk of overdose in people with alcohol addiction.
Cisapride is a medication that doctors used to prescribe to treat heartburn. The FDA withdrew the drug in 2000 following reports that it increased the risk of heart problems.
Doctors may still prescribe the drug, but only in rare cases when it is necessary.
Taking amitriptyline alongside cisapride further increases the risk of heart arrhythmias and other serious cardiac events.
Other drug interactions
Amitriptyline also interacts with several other drugs, including:
Due to safety concerns, drug manufacturers advise against the use of amitriptyline while taking these drugs.
Additional risks and complications
A person should speak to their doctor about the other possible risks of taking amitriptyline. These include:
Suicidal thoughts and behaviour
The term “suicidality” refers to having suicidal thoughts and exhibiting suicidal behavior.
Taking antidepressants can increase the risk of suicidality in adolescents and young adults with major depressive disorder and other psychiatric conditions.
Although the risk of this is very low, the FDA state that doctors should routinely monitor people taking these medications for signs of suicidality and worsening clinical symptoms.
Worsening heart conditions
Amitriptyline is not suitable for people with a history of the following heart and circulatory problems:
Disturbed sleep and dreams may be a symptom of amitriptyline withdrawal.
Although there is no evidence to suggest that amitriptyline is addictive, the drug can cause temporary withdrawal symptoms.
These symptoms are more likely to affect people who stop taking the drug abruptly. However, they may also occur in people who reduce their dosage gradually.
Symptoms of amitriptyline withdrawal may include:
The FDA do not recommend the use of amitriptyline by children under 12 years of age. The maximum daily dose for adults is 300 milligrams.
Overdose of amitriptyline or other tricyclic antidepressants can be fatal. The following signs and symptoms indicate a serious overdose requiring urgent medical attention:
Other signs of overdose that require attention include:
People who have accidentally taken an extra dose of their medication should call a doctor for further instruction.
In other cases of overdose, people should call the emergency services. The signs and symptoms of amitriptyline overdose can develop rapidly.
Amitriptyline is a tricyclic antidepressant that doctors can prescribe to help treat depression and other psychiatric conditions. Although Elavil used to be available, the FDA called for the discontinuation of the brand.
Amitriptyline has a range of possible side effects, some of which can be very serious. It is important to note that not everyone experiences all or any side effects, and the benefits of the drug may outweigh the risks.
However, amitriptyline may not be suitable for certain people, particularly those with a history of heart or circulatory problems.
To avoid adverse drug interactions, people who are considering treatment with amitriptyline should tell a doctor about all of the other medicines they are taking or have recently taken.
This content was originally published here.