Among the most common side effects of amitriptyline are fatigue and drowsiness. Especially at the beginning of the treatment, the side effects very often outweigh the actual antidepressant effect and patients are therefore very sleepy and tired for the first 2 weeks. The reason why amitriptyline leads to side effects such as fatigue is that amitriptyline acts in the brain, where it develops a so-called anticholinergic and slightly antihistaminic effect.
This means that a reduced acetylcholine concentration prevails in the brain. These messenger substances normally ensure that you are awake and concentrated. If amitriptyline leads to a reduced effect or a reduced concentration of acetylcholine, the alertness and concentration will also decrease.
The patient notices this in the form of tiredness, concentration difficulties and slight confusion. However, not every patient experiences the same degree of tiredness or drowsiness. Some patients have almost no side effects from the drug, while other patients experience side effects so serious that they find it difficult to cope with their everyday life. If this is the case, it is important to talk openly with the treating physician (psychiatrist or neurologist) about it so that he or she can change the medication if necessary. In general, the side effect fatigue is very common when taking amitriptyline, but should improve significantly after the first 2 weeks of use.
Side effects on the skin
The drug amitriptyline is a psychotropic drug, i.e. a drug that mainly works centrally in the brain. Due to the general effect in the brain, treatment with amitriptyline also leads to many different side effects. Some side effects of Amitriptyline affect the skin.
In rare cases, skin rashes may occur as a result of taking the drug, although these are often due to an intolerance reaction to amitriptyline. If a rash occurs as a side effect of amitriptyline, a doctor must be consulted, as it may be an intolerance reaction (allergic reaction). Another side effect of amitriptyline that affects the skin is increased sweating.
This is a quite common side effect that affects about one in ten patients. Only in very rare cases there is an altered blood circulation of the skin, although it has not yet been proven whether this phenomenon is related to the intake of amitriptyline. This is the so-called Raynaud phenomenon, in which patients suddenly develop white fingers or feet, especially in cold or stressful situations.
This is due to reduced blood circulation in the skin. In warm weather, the fingers or feet redden because the blood circulation is restored. Whether this side effect of skin circulation can be explained by amitriptyline has so far only been confirmed by a New Zealand study.
In general, skin changes as a side effect of amitriptyline are frequent, but in comparison to other antidepressants rather rare. A generalized skin rash often indicates an intolerance. In addition, sunburn occurs more quickly (due to the increased photosensitivity), which is why patients taking amitriptyline should ensure that they have adequate sun protection.
Hyperpigmentation occurs in rare cases. This means that the skin in some parts of the body, such as the intimate or underarm area, turns darker. Serious side effects of amitriptyline on the skin however are generally rather rare and not to be expected.