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Amitriptyline, used to be more commonly known by its brand name Elavil®. Elavil is not sold in its named form in the US at present, and the generic form is now the most common name for this prescription drug, used primarily in the treatment of depression. The medication is not the most popular one for depression treatment, since it is a tricyclic antidepressant and has significant side effects. However, when introduced and tested by the FDA in the 1980s, it was thought beneficial, and some people still benefit from its use. Medications like amitriptyline have been widely replaced by drugs called selected serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors (SSRIs and SNRIs).
It would be useful to compare amitriptyline to SNRIs. Like most SNRIs, this medication acts to free up epinephrine and serotonin. When these neurotransmitters are available in free form, they can have a positive effect on mood, and help end depression. The medication may also be used to treat migraines, to control bedwetting, as part of complex treatment strategy for chronic pain, and to control some aspects of multiple sclerosis.
Like most antidepressants, there is some risk associated with use of amitriptyline in children, teens and young adults. In these populations, antidepressant use has been linked to increased risk for suicidal ideation and behavior. Evidence that the drug is resulting in negative behavioral changes, or things like panic attacks, and hostility, is indication to contact a doctor immediately. However, people on this drug shouldn’t stop taking without it doctor’s guidance.
Common side effects of amitriptyline include dizziness, drowsiness and fatigue and some people report having strange or scary dreams while using this medication. Others suffer from stomach upset and/or dry mouth. Some people are frustrated by reduction in libido that may accompany use, and a few users of this medication are challenged by difficulty remaining focused on tasks. These side effects can vary and not all people will experience all of the side effects, or they will experience them for a short time only while their bodies adjust to the medication.
There are very serious side effects associated with amitriptyline and these are considered medically urgent. People who experience any of the following should get in contact with their doctors right away or go to the nearest emergency room:
- Rash and hives
- Extreme bruising
- Thirst accompanied by extreme nausea
- Pounding heart rate with excess sweating
- Uncontrolled movement of the muscles or involuntary trembling
- Confusion that occurs suddenly
One of the reasons that tricyclic antidepressants are not preferred to treat depression is because they are extremely toxic in overdose amounts, and overdose is more likely in people suffering from severe depression. It is always essential to contact emergency services if an overdose has occurred, as treatment is required right away. Symptoms of overdose may include changes in heart rate, sweating, seizure, nausea and vomiting, and ultimately unconsciousness or coma.
There are many medications that may interact with amitriptyline. Doctors should have a full list of any meds a person takes, even if they are over the counter medications or herbs, prior to prescribing this drug. Some people are not candidates for amitriptyline because of other medical conditions. People with bipolar disorder, diabetes, hypo or hyperthyroidism, previous or current cardiovascular disease, enlarged prostate or glaucoma, may need to take different levels of this medication or avoid it completely.