Amitriptyline (Elavil)


Amitriptyline (Elavil®) is one of many tricyclic antidepressant medications. Of all the medications in this class, it is one of the most frequently prescribed. Approved by the FDA in 1983, some research has shown amitriptyline to be at least as effective as SSRIs (selective serotonin reuptake inhibitors), such as Prozac®, Zoloft®, and Paxil®) in the treatment of depression. However, many people with depression prefer to take SSRIs because tricyclic antidepressants (TCAs) generally have less tolerable side effects.

What Amitriptyline is Used to Treat

Amitriptyline is primarily used to treat major depressive disorder as well as other types of depression in adults and adolescents. However, it is also used to treat a variety of other conditions including anxiety disorders (including PTSD), ADHD, enuresis (bed wetting), bulimia, irritable bowel syndrome, chronic pain, chronic fatigue syndrome, migraine headaches, and smoking.

How it Works

Scientists don’t know exactly how amitriptyline works in the brain. However, it is generally believed that it helps restore the balance of certain brain chemicals – particularly serotonin and norepinephrine – that play a role in the regulation of mood. Studies have shown that many individuals who battle depression may have low levels of these neurotransmitters.

How it’s Administered

Amitriptyline comes in tablet form, ranging from 10mg to 150mg per tablet. It can be taken on an empty stomach or with food. As with all medications, it should be taken exactly as prescribed. As a general rule, tricyclic medications like amitriptyline are initially prescribed in a low dose to make sure you can tolerate any potential side effects. The dose is gradually increased to a therapeutic level (usually 40mg to 150mg per day for adults).

It can take several weeks for the full effects of amitriptyline to be felt. If you should decide to stop taking the medication, don’t discontinue it abruptly. Doing so could result in unpleasant withdrawal symptoms such as nausea, headaches, tremors, anxiety, restlessness, and dizziness. These same symptoms may also appear if you miss a few doses. It is generally best to slowly taper the dose, per your doctor’s supervision, in order to prevent unpleasant side effects caused by stopping it suddenly.

Potential Side Effects

All tricyclic antidepressants have potential side effects. Some of the side effects of amitriptyline include (but aren’t limited to):

  • Weight gain
  • Increased appetite
  • Dry mouth
  • Drowsiness
  • Headache
  • Fatigue
  • A drop in blood pressure upon standing
  • Constipation
  • Nausea
  • Low libido
  • Sexual performance problems
  • Weakness
  • Sleep problems
  • Blurry vision
  • Rapid heart rate
  • Difficulty urinating
  • Restless leg syndrome
  • Seizures
  • Worsening of depression
  • Suicidal thoughts

Be sure to discuss any side effects with your doctor. Some may continue as long as you take the medication, while others will quickly subside.


Before you take amitriptyline, talk to your doctor about any and all current and past medical conditions. If you are a woman, talk to your doctor if you are pregnant, breastfeeding, or plan to get pregnant. Be sure your doctor knows about any and all medications and supplements that you are taking.

Since tricyclic antidepressants can trigger a manic or hypomanic episode in anyone predisposed to bipolar disorder or who has been diagnosed with it, be sure to discuss your family and personal mental health history with your doctor.

Because of the potential side effect of suicidal thoughts, be sure that you are monitored closely when you first start taking amitriptyline.

Combining amitriptyline with alcohol can be dangerous, as the medication may make the effects of alcohol more intense.

Additional Considerations

While it’s nice to take medication in order to reduce symptoms of depression, anxiety, and other disorders, medication alone is rarely the best treatment. If you are struggling with depression, an anxiety disorder, an eating disorder, or other mental health condition, consider working with a therapist. Appropriate therapy has been shown to be the most effective treatment. Cognitive behavioral therapy is particularly effective for treating both anxiety and depression.

A skilled therapist can help you learn to manage, reduce, and change the thoughts and behaviors that are causing and / or contributing to your disorder.


The information provided on the is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her health professional. This information is solely for informational and educational purposes. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Neither the owners or employees of nor the author(s) of site content take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading this site. Always speak with your primary health care provider before engaging in any form of self treatment. Please see our Legal Statement for further information.

PsyWeb Poll

Are you currently taking or have you ever been prescribed anti-depressants?
Total votes: 3979