If you have depression, your doctor may prescribe amitriptyline for you.

It’s a prescription drug used to relieve symptoms of major depressive disorder (MDD) in adults and some children.

To learn more about MDD and how amitriptyline is used to treat it, see the “What is amitriptyline oral tablet used for?” section below.

Amitriptyline oral tablet basics

Amitriptyline belongs to a group of drugs called tricyclic antidepressants.

You’ll take amitriptyline oral tablets by mouth.

Amitriptyline oral tablet brand-name versions

Amitriptyline oral tablets aren’t available in a brand-name version.

Amitriptyline oral tablets are a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that amitriptyline oral tablets are based on was called Elavil. But brand-name Elavil is no longer available.

Generic drugs are thought to be as safe and effective as the brand-name drug they’re based on. In general, generics usually cost less than brand-name drugs.

Read this Healthline article to learn more about the differences between generic and brand-name drugs.

Like most drugs, amitriptyline oral tablets may cause mild or serious side effects. The lists below describe some of the side effects that amitriptyline may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of amitriptyline. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that amitriptyline can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read amitriptyline oral tablet’s prescribing information.

Mild side effects of amitriptyline that have been reported include:

* For more information on this side effect, see the “Side effect focus” section below.

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from amitriptyline oral tablets can occur, but they aren’t common. If you have serious side effects from taking this drug, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of amitriptyline oral tablets that have been reported include:

* For more information on this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects amitriptyline oral tablets may cause.

Boxed warning

Amitriptyline oral tablets have a boxed warning. This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Suicidal behaviors and thoughts. Drugs used to treat depression can raise the risk of suicidal behaviors and thoughts in children and young adults. This includes amitriptyline oral tablets.

You have a higher risk for this side effect if you:

  • recently started taking the drug
  • recently had a dosage change
  • are 24 years of age or younger*

* Amitriptyline is not used to treat depression in children younger than 12 years of age.

While taking amitriptyline oral tablets, watch for these symptoms:

What might help

Tell your doctor right away if you have any of the above symptoms while taking amitriptyline. They may adjust your treatment plan as a result. Or they may prescribe a drug other than amitriptyline for your condition.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Weight gain and weight loss

You may have weight gain or weight loss while you’re taking amitriptyline oral tablets. Weight changes were a side effect in studies of the drug.

Keep in mind that weight changes are common in depression, which amitriptyline treats. So you may have weight gain or weight loss while you’re taking amitriptyline because your depression is getting better. Weight changes may not be caused by the drug itself.

What might help

If you’re concerned about weight gain or weight loss while taking amitriptyline, talk with your doctor. They can suggest ways to maintain a healthy weight.

Changes in your mood or behaviors

You may have changes in your mood or behaviors while you’re taking amitriptyline oral tablets. This side effect wasn’t common in studies of the drug. But drugs used to treat depression, such as amitriptyline, may cause mood or behavior changes.

Mood or behavior changes from amitriptyline can include:

Mood or behavior changes can also be a symptom of suicidal behaviors and thoughts. Amitriptyline oral tablets have a boxed warning for this side effect. For more information, see the “Boxed warning” section above.

What might help

Tell your doctor about any changes in mood or behavior you experience while taking amitriptyline. They may check you for a condition called bipolar disorder. People with bipolar disorder have extreme mood changes, usually alternating between episodes of mania and depression.

If you have mood or behavior changes, your doctor will help decide whether amitriptyline is right for treating your condition.

Allergic reaction

Some people may have an allergic reaction to amitriptyline oral tablets. But it’s not clear whether this side effect happened in studies of the drug.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to amitriptyline oral tablets. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about amitriptyline oral tablets.

Is amitriptyline used to treat pain or help with sleep? If so, what are the dosages for pain and sleep?

Amitriptyline is not approved to treat pain or help with sleep. But it may be used off-label for these purposes. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

Amitriptyline is sometimes used off-label to treat certain painful conditions, such as:

Amitriptyline can also be used off-label to treat insomnia (trouble falling or staying asleep).

To learn more about using amitriptyline to treat pain or help with sleep, talk with your doctor.

Will I have withdrawal symptoms if I stop taking amitriptyline?

Yes, you may have withdrawal symptoms if you suddenly stop taking amitriptyline.

Symptoms of withdrawal from amitriptyline can include:

Do not stop taking amitriptyline unless your doctor tells you it’s safe to stop. When it’s time for you to stop the drug, your doctor will slowly decrease your dose over time. This will help lower your risk for withdrawal symptoms.

Does amitriptyline treat headaches, such as those caused by migraine?

Amitriptyline isn’t typically used to treat headaches.

However, amitriptyline may be used off-label to help prevent migraine. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

Migraine is a condition that can cause severe headache along with other symptoms. These can include:

  • nausea and vomiting
  • sensitivity to light or sound
  • trouble speaking
  • auras (problems with your vision, speech, or senses that can happen before or after a migraine attack)

To learn more about using amitriptyline to help prevent migraine, talk with your doctor.

How does amitriptyline work? What’s its half-life and how long does it stay in your system?

Amitriptyline belongs to a group of drugs called tricyclic antidepressants.

It works by increasing the levels of chemicals in your brain called norepinephrine and serotonin. Higher levels of these chemicals help improve your mood and lessen the symptoms of depression.

The way a drug works in your body is called its mechanism of action.

A drug’s half-life is the time it takes for your body to get rid of half of the drug. The half-life of amitriptyline is between 10 to 28 hours. So it takes between 10 to 28 hours for half of an amitriptyline dose to leave your body.

Typically, it takes about five half-lives for a drug to leave your system. So amitriptyline will stay in your system for about 2 to 6 days after your last dose.

Is amitriptyline used for anxiety or IBS?

Amitriptyline is not approved to treat anxiety or irritable bowel syndrome (IBS). But the drug may be used off-label to treat these conditions. (Off-label means using a drug for a condition it hasn’t been approved to treat.)

With anxiety, you may feel fear, uneasiness, or worry about everyday situations.

IBS is a condition that affects the digestive system. Its symptoms include:

To learn more about using amitriptyline to treat anxiety or IBS, talk with your doctor.

What should I know about amitriptyline vs. nortriptyline?

Both amitriptyline and nortriptyline (Pamelor) belong to a group of drugs called tricyclic antidepressants. And both drugs are used to treat depression.

Amitriptyline and nortriptyline are very similar. In fact, amitriptyline breaks down into nortriptyline in your body.

To learn more about how amitriptyline and nortriptyline are alike and different, talk with your doctor or pharmacist.

Is amitriptyline a narcotic? And is it addictive?

Amitriptyline isn’t a narcotic. It belongs to a group of drugs called tricyclic antidepressants.

Narcotics, on the other hand, are opioid drugs. “Narcotic” is a term used to describe illegal opioids, such as heroin. It’s also used to describe prescription opioids. Examples include oxycodone (Oxaydo, Roxicodone) and fentanyl (Actiq, Duragesic).

And amitriptyline hasn’t been shown to be addictive. (With addiction, a person wants to take a drug even if it’s causing them harm.)

Your doctor will explain how you should take amitriptyline oral tablets. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Taking amitriptyline oral tablet

You’ll take amitriptyline oral tablets by mouth.

The tablets are available in the following strengths:

  • 10 milligrams (mg)
  • 25 mg
  • 50 mg
  • 75 mg
  • 100 mg
  • 150 mg

Dosage

Your amitriptyline dosage will be based on:

  • your age
  • side effects you may have
  • how much your condition is improving
  • other medical conditions you may have

Your doctor will typically start you on a low dosage. You may take amitriptyline several times a day at first.

If the drug is working to treat your condition and you aren’t having bothersome side effects, your doctor will slowly increase your dose over time. Eventually, you may take amitriptyline oral tablets only once each day.

Questions about taking amitriptyline oral tablet

  • What if I miss a dose of amitriptyline oral tablets? Take your missed dose as soon as you remember. If it’s almost time to take your next dose, you can skip your missed dose. Then you’ll take your next amitriptyline dose at its regular time. You should not take any extra doses of amitriptyline to make up for a missed dose. Doing so can raise your risk for side effects from the drug. If you aren’t sure whether to skip a dose or take it, talk with your doctor or pharmacist.
  • Will I need to use amitriptyline oral tablets long term? Yes, you may use amitriptyline long term if you aren’t having bothersome side effects and the drug is working for you. Your doctor will recommend the right length of time for you to take the drug.
  • Can amitriptyline oral tablets be chewed, crushed, or split? The manufacturer of amitriptyline hasn’t stated whether the tablet can be chewed, crushed, or split. If you have trouble swallowing amitriptyline tablets whole, talk with your doctor or pharmacist.
  • Should I take amitriptyline oral tablets with food? You can take amitriptyline with or without food.
  • How long do amitriptyline oral tablets take to work? After you start using amitriptyline, it may take up to 1 month for your depression symptoms to ease. Talk with your doctor about what to expect with amitriptyline treatment.
Questions for your doctor

You may have questions about amitriptyline oral tablets and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will amitriptyline oral tablets affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor as well as other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

When considering treatment with amitriptyline oral tablets, there are a few things you should discuss with your doctor first. These include:

  • other medications you take
  • other medical conditions you may have
  • your overall health

These factors and others are described in more detail below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking amitriptyline oral tablets, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with amitriptyline oral tablets.

Interactions with drugs or supplements

Amitriptyline oral tablets can interact with several types of drugs. These drugs include:

* Because of this interaction, you should not take amitriptyline with an MAOI.

This list does not contain all types of drugs that may interact with amitriptyline. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of amitriptyline oral tablets.

Boxed warning

Amitriptyline oral tablets have a boxed warning. This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Amitriptyline may cause suicidal behaviors and thoughts in children and young adults who take drugs that treat depression.

For more information, see the “What are amitriptyline oral tablet’s side effects?” section above.

Other warnings

Amitriptyline oral tablets may not be right for you if you have certain medical conditions or other factors that affect your health. Factors that keep you from taking a drug are sometimes called contraindications.

Talk with your doctor about your health history before you take amitriptyline oral tablets. Factors to consider include those in the list below.

  • Bipolar disorder. Before taking amitriptyline oral tablets, tell your doctor if you have bipolar disorder. The drug can raise your risk for mania or hypomania (moments of extremely high excitement and energy related to bipolar disorder). Talk with your doctor about your risk for these side effects from amitriptyline.
  • Eye problems. Before starting amitriptyline oral tablets, tell your doctor if you have eye problems, such as glaucoma. Amitriptyline can raise your risk for having a glaucoma attack (sudden worsening of glaucoma that leads to blurry vision and severe eye pain).
  • Heart problems, including a recent heart attack. Tell your doctor about any heart problems you have before taking amitriptyline oral tablets. Amitriptyline can cause serious heart problems, such as abnormal heart rhythm and heart attack. You may have an increased risk for these side effects if you already have heart problems before taking amitriptyline.
  • Liver problems. If you have liver problems, tell your doctor before starting amitriptyline oral tablets. They may monitor you more closely for side effects from the drug.
  • Schizophrenia. Before starting amitriptyline oral tablets, tell your doctor if you have schizophrenia. Amitriptyline can worsen certain symptoms of schizophrenia. If you have this condition, your doctor may prescribe a drug other than amitriptyline for you.
  • Seizures. If you have seizures, tell your doctor before taking amitriptyline oral tablets. Amitriptyline can cause seizures. So you may have a higher risk for this side effect if you already have seizures.
  • Urinary retention. If you have urinary retention (problems emptying your bladder completely), tell your doctor before starting amitriptyline oral tablets. Amitriptyline can worsen this condition. So your doctor may prescribe a different drug for you.
  • Allergic reaction. If you’ve had an allergic reaction to amitriptyline oral tablets or any of the drug’s ingredients, you should not take this drug. Ask your doctor which other medications are better options for you.
  • Using monoamine oxidase inhibitors (MAOIs). You should not take amitriptyline oral tablets with MAOIs, a group of drugs used to treat depression. Taking amitriptyline with MAOIs can raise your risk for serious side effects, including seizures and death. Before starting amitriptyline, tell your doctor if you take MAOIs. They’ll likely prescribe a drug other than amitriptyline for you.
  • Having a planned surgery. Tell your doctor if you have a planned surgery. They may have you stop taking amitriptyline oral tablets for several days before the surgery. But do not stop taking the drug unless your doctor tells you it’s safe to do so.

Use with alcohol

You should not drink alcohol while taking amitriptyline oral tablets.

You may have a higher risk of overdose with amitriptyline if you drink alcohol while taking the drug.

Before taking amitriptyline, tell your doctor if you take disulfiram (Antabuse) to treat alcohol use disorder. Taking amitriptyline with this drug can cause delirium. (Delirium is a condition that causes problems with thinking, remembering, and paying attention.)

If you have questions about drinking alcohol while taking amitriptyline, talk with your doctor.

Pregnancy and breastfeeding

It may not be safe to take amitriptyline oral tablets while you’re pregnant or breastfeeding.

If you have questions about using amitriptyline during pregnancy or while breastfeeding, talk with your doctor.

If you have depression, your doctor may prescribe amitriptyline oral tablets for you.

It’s a prescription drug used to relieve symptoms of major depressive disorder (MDD) in adults and children ages 12 years and older.

MDD refers to symptoms of depression that happen almost every day for at least 2 weeks. These symptoms can include:

  • loss of interest in activities you used to enjoy
  • changes in weight or appetite
  • feeling angry, hopeless, or irritable

Amitriptyline belongs to a group of drugs called tricyclic antidepressants. It works by increasing the levels of chemicals in your brain called norepinephrine and serotonin. Higher levels of these chemicals help improve your mood and lessen the symptoms of depression.

Do not take more amitriptyline oral tablets than your doctor prescribes. Using more than this can lead to serious side effects. If you have serious side effects from an amitriptyline overdose, you may need overdose treatment.

Symptoms of overdose

Severe symptoms caused by an overdose can include:

What to do in case you take too much amitriptyline oral tablet

Call your doctor if you think you’ve taken too much amitriptyline. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

Financial assistance to help you pay for amitriptyline oral tablets may be available. Medicine Assistance Tool and NeedyMeds are two websites that provide resources to help reduce the cost of amitriptyline oral tablets.

These websites also offer tools to help you find low-cost healthcare and certain educational resources. To learn more, visit the websites.

If you have questions about using amitriptyline oral tablets for depression, talk with your doctor.

You may also want to ask your doctor about other depression treatments. Here are a few articles you might find helpful:

Below are a few questions you can ask your doctor about amitriptyline oral tablets:

  • How will I know if amitriptyline is working to treat my depression?
  • Should I take other medications with amitriptyline to treat my depression?
  • Does amitriptyline interact with any medications I’m taking?

To learn more about depression, including stories from people living with the condition, subscribe to Healthline’s online newsletter.

Q:

Does my age affect my risk for side effects from amitriptyline?

Anonymous patient

A:

A: Yes, your age can affect your risk for side effects.

Children and young adults up to 24 years old have an increased risk for suicide compared with adults older than 24 years of age.

Older people may be more susceptible to other side effects of amitriptyline.

It’s recommended that people ages 65 years and older, as well as children ages 12 to 17 years, take a lower dose of the drug. This can help lower the risk for side effects in these age groups.

Amitriptyline is not recommended for use in children younger than 12 years old.

You should talk with your doctor about any side effects you experience while taking amitriptyline.

Dena Westphalen, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.