Amitriptyline: Unpleasant Side Effects

The active ingredient amitriptyline is primarily used to treat depression. In addition, however, it is also suitable for the treatment of chronic pain. Like many other antidepressants, amitriptyline has side effects. These include headaches, circulatory problems, or weight gain. Get comprehensive information about the effects, side effects, dosage, contraindications and interactions of amitriptyline here.

How amitriptyline works

Amitriptyline is an active substance from the group of tricyclic antidepressants. In medicines, it is usually in salt form as amitriptyline hydrochloride. In addition to amitriptyline, the group of tricyclic antidepressants also includes the active ingredients doxepin and trimipramine. Amitriptyline is used primarily for the treatment of depression associated with anxiety and restlessness due to its calming and mood-lifting effect. In addition to depression, amitriptyline is also used for the long-term treatment of chronic pain. For example, the active ingredient is suitable for the prevention of migraine attacks and tension headaches. Due to its calming effect, amitriptyline is also sometimes prescribed for the treatment of sleep disorders caused by illness. The calming effect of amitriptyline usually sets in a short time after taking it. However, it can take several days or even a few weeks before the antidepressant also has a mood-lifting effect. Taking the active ingredient can increase the patient’s suicidal thoughts, especially at the beginning of treatment. Patients at risk should therefore be closely monitored.

Intake and dosage

Amitriptyline can be taken either orally in the form of tablets or drops or injected as a solution for injection. How the active ingredient must be dosed varies from individual to individual and is determined in each case by the treating physician. Therefore, please understand the following dosage information as general guidelines only. At the beginning of treatment, the amitriptyline dose is slowly increased until the smallest effective dose has been determined. For depression, between 50 and 75 milligrams divided into two or three doses is often given at the beginning. The maximum outpatient dose is 150 milligrams. In older patients, a much lower dose is often sufficient to achieve the desired effect. In general, however, elderly patients should only take the active substance after a careful cost-benefit assessment. If amitriptyline is used to treat chronic pain, a dose of 25 milligrams is usually started. Gradually, the dose may be increased up to 100 milligrams. The drug should be taken in the evening before going to sleep, if possible. This also applies when amitriptyline is used to treat sleep disorders.

Side effects of amitriptyline

When taking amitriptyline, unpleasant side effects may occur, especially at the beginning of treatment. However, these often subside with time. The most common side effects of amitriptyline include headache, dizziness, lightheadedness, fatigue, tremor, low blood pressure, and circulatory problems. Also common are arrhythmias, palpitations, constipation, weight gain, and dry mouth. Often, skin rashes, movement and taste disorders, bladder emptying disorders, sexual excitability disorders, thirst sensation, inner restlessness, confusion, and concentration disorders also occur as a result of taking amitriptyline. Occasionally, ringing in the ears, diarrhea, hypertension, paranoia, and anxiety may occur. Isolated side effects may include intestinal paralysis or obstruction, and liver dysfunction. Finally, in rare cases, side effects such as heart muscle damage, delusions, brain spasms, nerve damage, facial movement disorders, and an increase in intraocular pressure may occur as a result of taking amitriptyline. Likewise, destruction of white blood cells – known as agranulocytosis – is possible.

Amitriptyline overdose.

If you forget to take amitriptyline, the timing is crucial in determining whether or not you should make up for it. If this is already relatively close to the next intake, you should not make up the intake. In case of doubt, consult the doctor treating you.If you have taken too high a dose of the active substance, consult a doctor immediately. Because in case of overdose the active substance can have dangerous side effects. Symptoms that may indicate an overdose are dry mouth, an increased pulse, and problems with urination. In addition, overdose can cause disorders of the central nervous system as well as the cardiovascular system. These may manifest in symptoms such as confusion, clouding of consciousness, cardiac rhythm disturbances, and seizures. In addition, visual disturbances, urinary disorders, and constipation may occur.

Discontinuing amitriptyline

Amitriptyline should never be stopped just like that – otherwise side effects such as insomnia, sweating, anxiety, restlessness, and nausea and vomiting may occur. Instead, the dose of the medication should be slowly decreased over a period of time. Discuss with your treating doctor the best way to stop treatment with amitriptyline. If you do not tolerate the medication well, you should also consult with your doctor and not discontinue amitriptyline lightly on your own. Also, if manic phases occur while taking the drug, it is advisable to contact the doctor treating you. As a rule, he or she will then discontinue the active substance directly. The same applies if new depressive symptoms additionally appear during treatment.