What is Amitriptyline? - Uses & Side Effects

Instructor: Jennifer Kinder
Learn about amitriptyline and disorders it is prescribed to treat illustrated with a real life example. Gain information on side effects including those that are benign, allergic reactions, or life threatening.

Amitriptyline

Paul has been struggling lately with feeling depressed. He started feeling this way a few months ago and can't seem to shake it. Despite sleeping 12 hours a night he still feels exhausted. He feels like his head is in a fog, and he can't concentrate long enough to read the e-edition newspaper. He used to go 4-wheeling with some friends from work over the weekend, but that isn't even any fun any more. He's lost 10lbs over the last month because he had no appetite and feels like he is forcing himself to eat. Paul schedules an appointment with his primary care doctor to see what is wrong with him. His doctor says that Paul is struggling with depression. Paul and his doctor discuss different options for treatment, including therapy and medication. Paul's doctor suggests he try the antidepressant, amitriptyline, to see if it decreases his depression.

Based on Paul's symptoms, his doctor diagnosed him with depression and prescribed a medication proven to improve symptoms of depression. Amitryptyline is an antidepressant designed to treat, or alleviate, depression. It is the genetic formulation for the brand name medication Elavil.

Uses

Amitriptyline is considered a tricyclic antidepressant, meaning that it affects different brain chemicals to help decrease depression. The neurotransmitters, or brain chemicals, amitriptyline affects specifically are norepinephrine, serotonin, and acetylcholine. It is believed that depression is caused by an imbalance of these chemicals, and that achieving a different chemical balance with an antidepressant, alleviates depression.

As described above, amitriptyline is primarily prescribed to treat depression. However, it is also commonly prescribed to treat nerve pain, eating disorders, anxiety, and panic attacks. It is also prescribed for the preventative management of migraines.

Side Effects

Amitriptyline has many side effects which range from non-serious and uncomfortable to serious and potentially life threatening.

The benign but uncomfortable side effects of amitriptyline are similar to other antidepressants and include feeling sleepy, feeling dizzy, having a dry mouth, being constipated or having a problem urinating, blurred vision, and weight gain. Sometimes these side effects will decrease the longer the person takes amitriptyline, or they just become less bothersome. If these side effects are too uncomfortable, the prescriber might stop amitriptyline and start another antidepressant.

There are some side effects that can suggest something more serious is occurring, such as having muscle spasms, having a flat expression, bruising easily, stomach pain, or experiencing a low libido.

More potentially serious side effects are allergic reactions (hives, throat swelling, itching) fainting/dizziness, seizure, eye/vision problems, having black stools, or throwing up a substance that looks like coffee grounds.

Taking amitriptyline can also cause a fatal reaction called neuroleptic malignant syndrome. Neuroleptic malignant syndrome is a potentially fatal condition that can be caused by medications that affect the brain chemical dopamine. Even though amitriptyline doesn't necessarily directly affect dopamine, it can still potentially cause this disorder. Symptoms of this syndrome include fever, paranoia, stiff muscles, excessive sweating or salivation, fast heart beat, and high blood pressure. These symptoms require immediate medical attention.

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