1. What is amitriptyline?
Amitriptyline is a medication used to treat depression as well as some types of pain and migraines. It comes in the form of tablets or as a liquid and is only available on prescription.
It’s from a group of medications known as the tricyclic antidepressants (TCAs). It’s thought to work by increasing the amount of serotonin in your brain.
Amitriptyline is the generic name of the medication. It is also sold under the brand name Elavil, amongst others.
2. How long does it take for amitriptyline to start working?
It usually takes 4 to 6 weeks for amitriptyline to reach its full effect. If you’ve recently started taking amitriptyline and feel that it isn’t working, try to stick with it for at least 6 weeks to give it time to work.
However, if at any point you begin to experience thoughts of suicide or self-harm, you must see a doctor immediately.
3. I’m experiencing side effects while on amitriptyline. What ways can I try to help cope with them?
Some people experience side effects while taking fluoxetine. Usually, these side effects are fairly mild and common and may get better over time as your body gets used to the fluoxetine.
Here are some common side effects and ways to cope with them:
- Constipation – try to drink more water and eat more foods that are rich in fiber, for example, fruits, vegetables, and cereals. It may also help to do more exercise.
- Feeling dizzy – this is probably due to low blood pressure, so don’t get up quickly after sitting or lying down, and try to drink more water.
- Dry mouth – have sugar-free sweets or chew on sugar-free gum
- Feeling tired, sleepy, or weak – take amitriptyline just before bedtime and drink less alcohol.
- Headache - rest and drink plenty of water. If your headaches don’t go away after a week or they become more severe, see a doctor.
- Trouble peeing – try to relax and don’t try to force it out. If you can’t pee at all, you must see a doctor right away.
(For tips on how to cope with sexual side effects, please go to question 5: “Amitriptyline is affecting my sex life. How can I deal with sexual side effects caused by amitriptyline?”)
Some side effects are serious and can be dangerous. If you experience any of the following side effects, you must see a doctor immediately:
- Thoughts of suicide or harming yourself
- Fast or irregular heartbeat
- Yellow skin or eyes – this may be a sign of liver problems
- Headache, confusion, feeling weak, or muscle cramps or seizures – this may be a sign of low sodium levels
- Changes in your eyesight, or pain, swelling, or redness in your eyes
- Severe constipation
- Stomach pain from being unable to pee
- Signs of stroke: weakness on one side, difficulty thinking or speaking, losing your balance, or blurred vision
It is also important to be aware of the signs of an allergic reaction. If you experience an allergic reaction to amitriptyline, you must see a doctor immediately.
Signs of a serious allergic reaction include:
- Skin rash – for example itchy, red, or swollen skin
- Tightness in the chest or throat
- Trouble breathing or talking
- Swollen mouth, face, lips, tongue, or throat
4. What are the signs of amitriptyline overdose?
If you think you’ve taken too much amitriptyline, it’s important to see a doctor right away. Symptoms of overdose include vomiting, shaking, feeling dizzy or faint, feeling sleepy, fast or uneven heartbeat, trouble breathing, and seizures.
5. Amitriptyline is affecting my sex life. How can I deal with sexual side effects caused by amitriptyline?
Some people experience sexual side effects while on amitriptyline. You may feel that your sex drive has gone down. In men, other side effects can include difficulty in getting an erection (erectile dysfunction), problems ejaculating, and breast swelling.
In women, these side effects can include vaginal bleeding and breast swelling.
These side effects should go away after a few weeks. If they still bother you after a few weeks, talk to your doctor. They may suggest switching to another antidepressant.
Talk to a doctor immediately if you are a woman and you experience vaginal bleeding after menopause.
6. Can amitriptyline cause weight gain or weight loss?
Some people find that amitriptyline affects their appetite – it can make you feel more hungry when you’re taking it, or less hungry. This may cause your weight to go up or down, but typically, weight gain is more common.
If you’re experiencing changes in your weight and it bothers you, talk to your doctor or pharmacist for advice.
7. Are there any long term side effects of taking amitriptyline?
Amitriptyline is safe to take for a long time, and there are no known long term side effects of taking amitriptyline. Talk to your doctor if you are concerned about how amitriptyline may affect your health.
8. Is amitriptyline addictive?
No, amitriptyline is not addictive. However, if you stop taking amitriptyline abruptly instead of weaning yourself off it slowly, you may experience symptoms of withdrawal, which include headache, feeling sick, shaking, feeling weak and unwell, feeling overexcited or extremely happy, and speech problems. If you experience withdrawal symptoms, you should see a doctor.
9. When is the best time of day to take amitriptyline?
Generally, amitriptyline is taken once a day. It can make you feel sleepy, so it’s a good idea to take it just before bedtime. If you’re still feeling drowsy in the morning, try taking your amitriptyline a little earlier in the evening.
10. I’d like to stop taking amitriptyline. How can I come off it safely? Will I experience withdrawal?
If you think you’d like to stop taking amitriptyline, talk to your doctor so that they can discuss this decision with you and help you gradually wean off amitriptyline by slowly reducing your dose over time. Don’t stop taking amitriptyline abruptly, as it may cause you to experience withdrawal symptoms such as headache, feeling sick, shaking, feeling weak and unwell, feeling overexcited or extremely happy, and speech problems. If you start to experience withdrawal symptoms, you should see a doctor. Never stop taking your medication without first talking to a doctor about it.
11. Can I take amitriptyline while pregnant?
There is no simple answer to this question – it will depend on your individual situation and is something that you must discuss with your doctor to decide what is best for you and your baby.
Amitriptyline has been linked to a small increased risk of problems in the baby, so it’s generally a good idea to avoid taking it during pregnancy unless it’s necessary. However, it is also very important that you remain well during your pregnancy. Your doctor will help you weigh up the risks and benefits to yourself and your baby, and help you decide whether it is best for you to stay on amitriptyline or come off it. It is likely that your doctor will only recommend that you stay on amitriptyline during pregnancy if it’s really necessary.
Don’t stop taking amitriptyline or any other medication without first speaking to your doctor. If you become pregnant while taking amitriptyline, see your doctor as soon as you can so they can help you decide whether to continue with the medication.
12. Can I take amitriptyline while breastfeeding?
Talk to your doctor if you think you may need to take amitriptyline while breastfeeding your baby, as the answer to this question depends very much on your individual circumstances.
Generally, it’s a good idea to avoid taking amitriptyline while breastfeeding unless it’s really necessary. This is because amitriptyline does pass into breast milk and can cause side effects in the baby.
However, it only passes into breast milk in very small amounts which are unlikely to harm the baby, and it’s generally thought to be safe to take amitriptyline while breastfeeding if your baby is healthy.
It is also important that you remain well for yourself and your baby.
Talk to your doctor so that they can help you weigh up the benefits and risks to yourself and your baby and then decide whether it is best for you to stay on amitriptyline or come off it.
If you do decide to take amitriptyline while breastfeeding, talk to your doctor if you notice that your baby is unusually sleepy or isn’t feeding as well as usual.
13. Can I drive while on amitriptyline?
Amitriptyline can make you feel sleepy. So if you’ve recently started taking amitriptyline, it’s a good idea to avoid driving for a while until you’ve seen how amitriptyline makes you feel. Most people are able to drive as usual while taking amitriptyline, but it’s best to be careful until you know that amitriptyline won’t affect your driving.
14. Can I drink alcohol while on amitriptyline?
Generally, it’s safe to drink alcohol while taking amitriptyline. However, it may make you feel more sleepy than usual, so it’s a good idea to be cautious. If you’ve only recently started taking amitriptyline, it’s probably best to avoid alcohol for a while until you’ve seen how the medication makes you feel.
15. Can I take recreational drugs such as marijuana, cocaine, or heroin with amitriptyline?
It’s best not to take recreational drugs while on amitriptyline, as it hasn’t been properly tested with recreational drugs, so it’s not really known how they may react with each other or whether it’s safe to take them together.
Marijuana (cannabis) may make you feel more drowsy when taken together with amitriptyline, particularly if you’ve recently started taking amitriptyline. It may also cause a fast heartbeat.
Heroin or methadone can make you feel extremely sleepy when taken together with amitriptyline.
Cocaine, amphetamines, or ecstasy may give you an irregular and dangerous heartbeat when taken together with amitriptyline.
If you think you may take recreational drugs while on amitriptyline, talk to your doctor for advice on how to do this as safely as possible.
16. Can I take painkillers such as paracetamol, ibuprofen, or naproxen with amitriptyline? And what about codeine and tramadol?
If you’d like to take a painkiller while on amitriptyline, it’s always best to speak to a doctor or pharmacist so that they can recommend one which is safe for you to take.
SSRIs, such as amitriptyline, have been found to interact with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Gastrointestinal (GI) bleeding is a potentially serious side effect of NSAIDs and the risk has been shown to increase when combined with SSRIs. If you are concerned about your risk of GI bleeding and ulcers, speak to your doctor or pharmacist before taking painkillers such as ibuprofen or naproxen.
Paracetamol is not an NSAID and is considered safe to take with amitriptyline.
If you think you may need to take a stronger painkiller such as codeine or tramadol, it’s important to speak to a doctor or pharmacist for advice as these medications can make you very sleepy when taken together with amitriptyline.
17. Can I take Adderall with amitriptyline?
Don’t take Adderall together with amitriptyline without talking to a doctor or pharmacist first. Taking these two medications together may result in increased blood pressure, fever, headache, or a fast or irregular heartbeat. If your doctor believes that it is necessary for you to take both Adderall and amitriptyline, they will monitor you regularly for signs of serious side effects.
18. Can I take Benadryl with amitriptyline?
Don’t take Benadryl together with amitriptyline without first checking with your doctor or pharmacist. This is because Benadryl contains the active ingredient diphenhydramine, which when taken together with amitriptyline may lead to increased side effects such as drowsiness, blurred vision, dry mouth, trouble peeing, constipation, irregular heartbeat, and confusion.
Talk to a doctor or pharmacist if you would like further advice on sleep aids or allergy medication which can be taken together with amitriptyline.
19. Can I take Ambien with amitriptyline?
It’s best to avoid taking Ambien while on amitriptyline unless your doctor has specifically advised you to take these two medications together.
Ambien contains the active ingredient zolpidem, which when taken together with amitriptyline may lead to increased side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people may also experience impaired thinking or have trouble with motor coordination.
Talk to a doctor or pharmacist if you would like further advice on sleep aids which can be taken together with amitriptyline.
The content on this page is provided for informational purposes only. If you have any questions or concerns about your treatment, you should talk to your doctor, pharmacist, or healthcare professional. This is particularly important if you are taking multiple medications or have any existing medical conditions.
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