Amitriptyline — what it does and how to use it safely
Amitriptyline is an older antidepressant that still helps a lot of people. Besides treating depression, doctors use it for nerve pain, migraine prevention, and some sleep issues. It’s cheap and effective, but it comes with side effects and drug interactions you should know about.
How it works and common uses
Amitriptyline boosts certain brain chemicals (serotonin and norepinephrine) and slows down some nerve signals. That helps mood and can cut nerve pain signals. Typical uses you’ll hear about: major depression, diabetic neuropathy, post-herpetic neuralgia, chronic tension-type headaches, and preventing migraine. Low doses are often used for pain or to help sleep, not just for depression.
Quick dosing guide and practical tips
Doses vary by reason it’s prescribed. For pain or sleep, doctors may start with 10–25 mg at night. For depression the dose usually starts low and may go up to 75–150 mg a day under close supervision. Take it exactly as prescribed. Many people take it at night because it causes drowsiness.
Start low, go slow. Don’t stop suddenly — your doctor will usually taper the dose to avoid withdrawal symptoms like irritability, flu-like feelings, or sleep problems. Avoid alcohol while taking amitriptyline. Don’t drive or operate heavy machinery until you know how it affects you.
Side effects to expect and watch for
Mild side effects often appear at first and fade over a few weeks. Expect dry mouth, drowsiness, constipation, blurred vision, and weight changes. Older adults may get lightheaded or fall because amitriptyline can lower blood pressure when standing up.
Serious signs need urgent care: fainting, fast or irregular heartbeat, severe confusion, high fever, or new or worse suicidal thoughts. Overdose can affect the heart and be life-threatening — seek emergency help if an overdose is suspected.
Key interactions and safety checks
Amitriptyline interacts with many drugs. Don’t mix it with MAO inhibitors or start/stopp SSRIs without your doctor’s advice — there’s a risk of serotonin syndrome. It can add to sedation with antihistamines, benzodiazepines, or alcohol. Tell your prescriber about heart issues, glaucoma, urinary retention, or if you’re pregnant or breastfeeding.
Got more questions? Keep a list of all your medicines and share it with your doctor or pharmacist. Track any mood changes and side effects, and call your provider if something feels off. Amitriptyline can help, but the right dose and care make all the difference.
