Side effects on the heart
Patients taking amitriptyline must expect increased adverse effects, especially in the first 2 weeks. Side effects of amitriptyline that affect the heart are particularly frequent. On the one hand, it can lead to an increase in heart failure, which is why patients with such a disease are advised against taking amitriptyline.
In addition, amitriptyline can cause side effects on the heart, such as a faster heartbeat (tachycardia) or heart stumbling (palpitations). Changes in the ECG also occur frequently (i.e. in every tenth patient) when taking amitriptyline. In addition, patients become increasingly dizzy after getting up, as the cardiovascular system can be affected by Armitriptyline.
This leads to a so-called orthostatic hypotension, which means that the blood pressure is very low. This can lead to the patient becoming dizzy if he or she stands up too quickly, as the brain cannot be supplied with sufficient blood for a short time. Since many of the side effects of amitriptyline affect the heart, it is important that patients are regularly examined by means of an ECG and that the patient informs his doctor if he frequently stumbles or notices a heartbeat that is too fast. In general, amitriptyline often (in 1-10% of all patients) causes side effects on the heart, which lead to changes in the ECG. In addition, a so-called AV block can occur, resulting in irregular heartbeats (cardiac arrhythmia).
Duration of side effects
How long side effects of amitriptyline last is very difficult to estimate. In general, however, the side effects predominate in the first two weeks, and are thus more pronounced than the actual antidepressant properties of amitriptyline. This is due to the fact that it takes a certain amount of time until the messenger substances serotonin and noradrenalin are present in the brain and blood in an increased concentration, which in turn leads to a mood-lifting and antidepressive effect.
The side effects of amitriptyline, on the other hand, start earlier, as the so-called anticholinergic effect already occurs after a few days and causes concentration problems and increased fatigue. The duration of the side effects should be limited to the first 2-3 weeks. Nevertheless, some patients may suffer from the side effects of amitriptyline permanently. It is important here that the patient decides for himself whether the antidepressive effect of amitriptyline outweighs the side effects and whether the drug improves his quality of life. How long the side effects of taking amitriptyline last depends very much on the dose, the weight and the individual metabolism of the patient.
In general, the psychotropic drug amitriptyline is a drug with many side effects. A quite common central nervous side effect of amitriptyline is a reduction in libido. This means that many patients only have a reduced sexual desire due to the intake of amitriptyline.
In some cases this can go so far that the patient becomes impotent while taking the drug. However, this impotence is limited to the duration of taking amitriptyline. If a patient stops taking Amitriptyline, side effects such as loss of libido are reversible and the patient can feel sexual pleasure again after a short time.
In general, many male patients in particular are afraid of this undesired effect, but it should be remembered that patients in a depressive phase also have no sexual desire and cannot feel sexual desire (libido). Thus, the loss of libido as a side effect of amitriptyline is a side effect that patients should accept if it means that they feel better again and can participate more actively in life. A reduction of the libido occurs in approximately every 100th – 1000th patient. Impotence is also very rare.